What is wrong with my implants and what can I do to make them better?

Question

I had breast implant revision for the third time three years ago. This is what I have in each breast: Type: Ergonomix® Round Family: Demi with Qid ® Surface: SILKSURFACE® Base: 11.5 Projection: 3.9 Volume: 300 I just feel the don’t sit right, there’s too much gap in between them and they feel hard. what would you reccomend for a revision? I asked for more upper pole fullness which I kind of have but not quite.

Patrick Tansley, MSc, MD, FRCS(Plast) · Answer

Dear Good426378, Thank you for your question. Several issues seem apparent from your photographs, including but not limited to, breast implant malposition and asymmetry. However, more information is needed to understand your situation properly before recommendation(s) can be offered. FYI - the gel within Ergonomix implants is softer in consistency than the alternative Motiva range; your comment that they 'feel hard' (in conjunction with features in the photographs supplied) may suggest capsular contracture - the commonest complication affecting anyone with breast implants. You may wish to consider seeking the assessment and advice of a specialist plastic surgeon experienced in revisional aesthetic breast surgery. Best of luck. Kind regards, Patrick Tansley, Specialist Plastic Surgeon. (Australian registration: MED 0001651716, Registered medical practitioner, Specialist Plastic Surgeon (Specialist Registration Surgery – Plastic Surgery); United Kingdom registration: 4153720, GMC Specialist Register (Plastic & Reconstructive Surgery).

Sugitha Seneviratne, MBBS, FRACS (Plas), FACCS · Answer

Hello Good 426378,
Thank you for your questions, implant information and photographs.
The images reflect asymmetry with issues related to the left breast which may be the consequences of implant displacement (superiorly and laterally) and/or capsular contracture. Whilst the issues can be corrected, careful clinical examination and surgical planning is essential to ensure a good outcome.
I recommend consultation with a specialist plastic surgeon with experience in revision breast surgery who can undertake clinical examination and advise you on appropriate next steps including imaging.
Best wishes and I hope this information is helpful.
Dr Sugitha SeneviratneSpecialist Plastic Surgeon

Daniel Barrett, MD · Answer

Dear Good426378,

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

Vasileios Vasilakis, MD, FACS · Answer

Hello,
Thank you for the question. It appears that you need revision of the pocket to improve the position of the implants.
I wish you the best. 
Vasileios Vasilakis, MD, FACSDouble Board Certified Plastic SurgeonHouston, TX.

Mehmet Ozdemir, MD · Answer

I am so sorry you’re going through this; it’s exhausting to feel like you’ve been through three rounds of surgery and still aren't seeing what you pictured in the mirror. That "hard" feeling is the big red flag here it usually means your body has created a tight layer of scar tissue (capsular contracture) that is literally squeezing the implant, making it feel firm and often pushing it out toward your armpits, which explains that wide gap. Because the Ergonomix Demi is a softer, lower-profile implant, it might not have enough "oomph" to overcome that tissue tightness or fill out your upper cleavage. For a fourth revision, we’d want to focus on a capsulectomy to clear out that scar tissue and then switch to a higher-profile implant with a slightly wider base to physically bring the volume closer together. Adding a little fat grafting in the center can also work wonders to soften that gap and give you the cleavage that implants alone sometimes can't reach.

Jacob Carlson, MD · Answer

Based on the pictures you have provided here, it looks like the lower-inner quadrant of your left breast hasn't rounded out as much as the right side has. This could be due to a few things: position of the implant, the pocket, and/or the capsule around the implant. To address this, the implant position may need to be changed; the pocket (or possibly the muscle) might need to be released more. In addition to those changes, you might consider using a larger volume implant if you want to stick with the Demi profile to accomplish more upper pole fullness. Or you could switch to a Mini profile implant, but if you do that, you're going to lose some projection forward.

Danielle S. Hayes, MD · Answer

Hello, thank you for your question. You look like you may be experiencing capsular contracture. When a breast implant feels hard or is displaced upward/narrowed, that is the cause. To remedy this issue, you will need to remove the capsule and replace the implants.

What is wrong with my implants and what can I do to make them better?

Answers (7)

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