Capsulotomy - would this procedure help my implant drop ?

Question

Hello. I had a 390 saline implants placed 3 years ago. My left side sits higher than my right. My doctor has suggested a capsulotomy without removing or replacing the implant. The breast itself is not super firm, mostly it just sits higher than the right. He does not feel it’s capsular contracture upon in person examination. Would this procedure help the implant drop? Also would it be in a lower placement right after surgery or will it be something that takes a moment to drop as I have a vacation in July. Thank you.

Wayne I. Yamahata, MD · Answer

In the absence of a significant capsule or capsular contracture, a capsulotomy alone should be adequate for repositioning of the implant. To confirm the diagnosis and treatment options would require an actual physical examination. Following a capsulotomy, you should see immediate improvement in the symmetry, but it may take weeks or longer for the implant to settle into the final position.

Daniel Barrett, MD · Answer

Dear bristol193,

I understand your concern. However, without a proper assessment, it would be difficult to determine what is wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Matthew S. Kilgo, MD · Answer

Hello and thank you for your question.
While it is difficult to answer your question accurately without photographs or the benefit of a physical examination, the most common causes for a "high riding" implant include preoperative asymmetry, differential pocket dissection or capsular contracture. If your breast folds were symmetric before the surgery and the implant remains soft, capsulotomy will likely lead to lower implant position and should be apparent immediately. If the implant is below the muscle, it may help to do additional muscle release to a type II or type III dual plan position. Good luck. I hope this helps.

Ronald J. Edelson, MD · Answer

A capsulotomy along the lower edge of the capsule will allow the implant to drop. This is commonly done and should take care of the problem

Connie Hiers, MD, FACS · Answer

Releasing the capsule will help the implant drop and this will be seen right after surgery. Your pocket is just tight inferiorlly.

Mats Hagstrom, MD (license on probation) · Answer

The left breast sits higher on the chest wall on all people.
This is true for both men and women.
For most people the left breast is about half an inch higher on the chest wall.
If you look at lots of before, and after pictures, you’ll notice this.
The breast position is determined by the position of the infra mammary fold aka IMF. You can’t lower the breast position on the chest wall.
Opening the IMF on the left side can lead to serious complications that need further surgery.
Without seeing pictures, we can’t begin to make a quality assessment.
Consider reposting with quality before and after pictures.
Based on what you describe, I would say there’s no indication for revision surgery because the left breast is normally higher than the right side.
Best,
Mats Hagstrom MD

Mustafa Aydinol, MD - Account Suspended · Answer

Hello!Thank you for sharing your situation. Based on what you described, a capsulotomy without replacing the implant can definitely help the implant settle into a lower, more natural position. Since your surgeon does not believe there is true capsular contracture, this approach sounds reasonable.
Typically, after a capsulotomy, the implant is positioned lower during surgery, but it may still take some time &mdash; a few weeks &mdash; for the final result to fully settle as swelling decreases and the tissues adjust. Given that your vacation is in July, you should have enough time to heal and enjoy your trip, but I recommend discussing your timeline closely with your surgeon to set realistic expectations.
Wishing you a smooth recovery and a wonderful vacation!

Capsulotomy - would this procedure help my implant drop ?

Answers (7)

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