Should I have the next set of implants put over the muscle?

I have had 3 different sets of implants and 1 surgery to move them back into place.....4 surgeries all together. (This all began to fix a botched reduction) These implants-2 sets of silicone and one of saline, have been all under the muscle. I am going to need a 5th as these last ones are not good either-one breast dropped and one has a capsular contraction.

Doctor Answers 4

Should I have the next set of implants put over the muscle?

I am sorry to hear about the complications you have experienced. Capsular contraction can be a very frustrating complication for both patients and surgeons.  In my practice, I have found the most success treating these difficult problems utilizing techniques such as sub muscular pocket conversion (if relevant), capsulectomy, use of fresh implants, and the use of acellular dermal matrix.  I do not advocate the use of the sub glandular position unless absolutely necessary; this position of breast implants is prone to a variety of complications.



Acellular dermal matrix is a biologic implant that carries the ability to become integrated into native tissue. It is made by taking a full thickness section of skin from a donor source (his human, porcine, or bovine in origin).  I hope this, and attach link ( demonstrating a case utilizing acellular dermal matrix) helps.  Best wishes for  a complication free outcome that you will be pleased with long-term.

Should I have the next set of implants put over the muscle?

Very very difficult to say without seeing you. It is possible you may need to change pocket position but you also will likely need a product such as Alloderm to help reconstruct your internal breast. After so many surgeries you literally lose support of the internal breast. Alloderm like products which are biologic mesh's we use in breast cancer reconstruction all the time have been shown to decrease capsular contracture. The definition of insanity is doing the same thing over and over and getting the same result. So you need to try something different, I just have no idea what that is unless I physically can see you and see what your issues are. I hope this helps you out. 

Sincerely, 

DrRickAZ

Richard J. Brown, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 45 reviews

Capsular comtracture

I am sorry to hear about all of your troubles but I think it's time you get this right once and for all so  you don't keep having surgery.  If you have a capsular contracture, the treatment is to completely remove the implant and capsule and replace it with an acellular dermal matrix and a new implant. The adm is a barrier so you don't have another capsule form which is very common. I highly recommend you see multiple Board Certified surgeon for heir recommendations prior to surgery. Best of luck. 

Another surgery

With your complicated history and lack of photographic documentation along the way, it's going to be difficult for any online consultant to give you any sage advice. When you're going for a 5th operation, I would make sure that the person you select, has the ability, confidence and track record of dealing with these more difficult cases. It may be a good idea to see a few board-certified plastic surgeons in your region with demonstrated expertise in revision cosmetic breast surgery. Best of luck.

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 44 reviews

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