Do I need another breast pocket surgery correction? (Photo)

To truly answer your question would require a formal consultation and examination of your breasts. I suspect the recommendation would be to tighten your pockets again and possible add a mesh for support. A smaller implant may also be suggested.

I'd suggest supplementing the suture plication with a mesh product such as Galaflex or Durasorb. This would provide needed support and a longer lasting result

There are women who make very flimsy and weak capsules, which allow the implants to drift south or to the sides. However, with modern technology, resorbable mesh, repair should be relatively permanent.

Thank you for your question. A large portion of my practice is dedicated to breast surgery and revision breast surgery. I have been in practice for over 28 years. In your case, you would benefit from an internal bra procedure - capsulorrhaphy. I wrote the very first paper on capsulorrhaphy over 20 years ago. I find that many surgeons are not skilled at this procedure and have high rate of recurrence. You should be able to have an excellent result. Best wishes to you.

This is a great question. It does appear based on the picture the implant is slightly malpositioned lower and off to the side. Doing a revision where the pocket is tightened is usually a good solution, however if this was already tried and the same problem recurred, you may be a good candidate for an internal bra or mesh to reinforce the pocket. The internal bra will help keep the implant in the correct position and prevent it from migrating to other positions over time. The mesh is not permanent, but the effects are long lasting and somewhat permanent. The mesh is biodegradable, meaning it becomes integrated into your own body.

Your breast implants are only held up by the skin envelope laterally and inferiorly. As a result, the weight of the implants causes the skin to stretch, weaken and descend. Your alternatives are use smaller implants or remove the implants, use the same implants again and just reinforce the sides again or place artificial mesh. However, the mesh is a passive device and will fade with time. You may be better off with doing a donut mastopexy to raise the nipple-areola complex higher, do inferior and lateral reinforcements and place the implants higher on the chest wall and perhaps smaller implants.

Best Wishes,

Gary Horndeski, M.D.

Dear a.grey,
I determine migration from the patient's position on their back and if the implants go off to the side of the chest. Several lifestyle habits can contribute to lateral migration that I steer my patients away from. 1. isolated pectoral exercises pound your implants out laterally, which can contribute to the lateral breakdown of the implant pocket; 2—being a tummy sleeper. 3. a genetic disposition to weak tissue.
If lateral migration is truly this issue and it is repetitive, your surgeon can also integrate the use of Strattice, a dermal tissue matrix to work as an internal bra.
This can be a very complex issue. I wish you the best.

Hi,Sorry to hear you are struggling to get these implants where they belong, this can be very frustrating. Has your surgeon discussed trying mesh with you? Think of it as an internal bra. It complements capsulorraphies (what you likely had to tighten your pocket), and gives the implant more security in its correct position. Once you begin to have this issue, which unfortunately is not terribly uncommon in women with thinner skin/little breast tissue, it is hard to fully correct. Make sure you are wearing securely fitting bras day and night. Best of luck!

The problem is your implant is too large and heavy for your tissue to support. It does not matter how many times the pocket is tightened, your implant will drop down from the weight. I would suggest going smaller and having the pocket tightened again. Smaller is less weight and less stress on your already stretched breast tissue.

It looks like your implants are much bigger than your baseline breast diameter.
When using excessively large implants, the chance of complications and undesirable side effects go up significantly.
If the implant pocket is not made correctly the first time then each time you have surgery to correct it, it becomes increasingly more complicated.
Your situation is complex, and there is no simplistic yes or no answer to your questions or concerns. This requires an in person evaluation with access to all previous operative reports and pre-and post operative pictures for each of your previous procedures.
Best,
Mats Hagstrom, MD