12 year old implants - Visual “ripple” on the inside of my left breast. Can a revision fix this? (Photos)

Question

My implants are 12 years old. My first set was perfect, but after a few months my left implant rotated and i had to have a revision (Originally had the 410 allergan tear drop implants). My surgeon replaced those with with round silicone, moderate profile 265 cc. Since that surgery, my left breast has never looked perfect. For as long as i can remember I’ve had a visual “ripple” in the inside of my left breast, but after having 2 kids and breastfeeding the ripple is more prominent. I’ve also noticed my right implant appears to be mostly over the muscle, when I lean forward the implant appears to turn sideways, but when I lean back it goes back to normal. Is this an issue? Maybe need my pockets tightened? If you did a revision, how would you recommend these be fixed? My main issue is the ripple on the inside, I’m not able to hide it in triangle bikinis so I’m limited with swimsuits. The original op note said they were dual plane. Are there different levels to that, and is it possible to put a new set under more of the muscle, or is that not possible since the muscle was cut during the original surgery?

Paul E. Chasan, MD, FACS · Answer

Thank you for your question. I have been in practice for over 30 years and revision her breast surgery is a large portion of my practice, and I have written many papers on this topic.  Most likely, your implants are in a subglandular position.  I have a whole gallery of patients very similar to you in which the implant slide down the chest and have significant wrinkling.  The best surgery for you would be to reposition the implants into a submuscular position much higher on your chest and perform a breast lift procedure.  There is no reason to have scars that meet in the midline as in the Bellasoma technique.  You should be able to have an excellent result.  Best wishes to you.

Gary M. Horndeski, MD · Answer

At this time, I recommend explantation and breast lift using the Bellesoma. The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained if not injured during your previous surgery. Later, fat transfers or small implants can be placed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Harry T. Haramis, MD, FACS · Answer

Unfortunately, repeated breast implant surgeries can have residual issues and less desirable outcomes.

Rippling can be caused by the implant , pocket exposed, muscle activity, etc.

Switching to higher filled gels may reduce visible rippling.

If it’s due to muscle, converting to over the muscle can alleviate but would recommend mesh such as Strattice to better cover implants, this would also reduce seeing rippling.

An exam and consultation with a plastic surgeon is recommended to better diagnose your situation as well as discuss your best options and expectations.

12 year old implants - Visual “ripple” on the inside of my left breast. Can a revision fix this? (Photos)

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