48, saline, under muscle 240cc, correct explant with revision - would this require implants again? (Photos)

Question

I am 48, had breast explant surgery six months ago. I had capsular contracture in the right breast. My implants were saline under muscle 240 cc, armpit incision. I had implant removal with total capsulectomy under the breast fold. There’s a noticeable extra fold of skin in cleavage area when I push my right breast inward. I would like to have it corrected. My surgeon said maybe in office. Would this require implants again? I am considering it. Thank you

Alan Gonzalez, MD, FACS · Answer

Hello @RCoceanlover, thank you for your question. Revision surgery will depend on the technique used by the specialist. Personally, when I perform an explant, I perform a breast aesthetic inmediate reconstruction with a technique called BRALAN (Breast Reconstruction Anatomical Lift Augmentation) along with a lift that helps to get the desired results. An L-shaped incision allows me to give the best results. To shed more light, I have attached a video.  The best way for you to decide if this is right for you is to consult with a board certified plastic surgeon who specializes in these types of revisions who can assess your exact needs and recommend the best course of action based on their expertise. Best wishes! Alan Gonzalez MD, FACS. International Federation for Adipose Therapeutics and Science Member (IFATS), American Society of Plastic Surgery Member (ASPS), Colombian Society of Plastic Surgery member (SCCP)

Shaher W. Khan, MD · Answer

Hello, thank you for your question. It sounds like you’re navigating the post-explant recovery and are now considering options for addressing the excess skin and potential asymmetry in your breasts, especially following the capsular contracture and explant surgery. Please see the video I have attached to discuss your questions. Given your concerns about the excess skin and your previous experience with implants, discussing your options thoroughly with your surgeon is essential. They will provide the best guidance tailored to your specific situation and goals. Whether you decide to go with implants again or pursue a lift or fat grafting, having a clear understanding of each option will help you make an informed decision.

Raffy Karamanoukian, MD, FACS · Answer

Removal of breast implants, intact or ruptured, may have positive implications if patients are symptomatic. A constellation of symptoms associated with breast implant illness, and autoimmune disease are considered when treating patients who have breast implants and are concerned about foreign body reaction. In our office, we begin this journey with a consideration of symptoms and exclusion of obvious autoimmune problems. In many of our patients, en bloc removal of breast implants with capsulectomy is important and beneficial. Further clinical evidence about breast implant illness is evolving and will continue to guide treatment. I would suggest removal if there is a possibility of foreign body reaction.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Daniel Barrett, MD · Answer

Dear RCoceanlover,
it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Shana Kalaria, MD · Answer

I would recommend fat grafting to the area of depression and the fold. This will pop that area out and make it look more similar to the other side. It does not require another implant. Please visit with a board-certified plastic surgeon. Good luck!

Connie Hiers, MD, FACS · Answer

If you have donor fat, this could be used to improve or perhaps that areas of thin tissue. Please discuss this with your surgeon who has examined you.

Camille Cash, MD · Answer

This is a difficult question to answer without an examination.  At six months post op you are not likely to notice much further improvement without intervention.  Placing implants should help improve the contour, but further information is needed to determine if there are other options.

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