Breast implant with mesh to hold up pocket - what does this look like? (Photos)

Question

Surgeons please help. What does this look like?? Breast implant with mesh to hold up pocket. This is really hard to live with:(

Gary M. Horndeski, MD · Answer

Your photographs are somewhat limited. It appears you had a breast lift with implants. There are several types of mesh and some meshes are absorbable. If the mesh is absorbable then the shape may change and improve. I would recommend waiting 6 months from the date of surgery before reaching a final decision. You may need a revision of this.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

William J. Hedden, MD · Answer

Mesh to hold an implant up from bottoming out should not look any different then a normal breast augmentation. Currently the issue I see from looking at your pictures is that the remaining breast gland as pulled away to the sides and left just thin tissue or thin tissue with mesh covering the lower central portion. This is fixable. There are several options. 1)The best way to fix this which you likely will not want is to remove the implants and revise the lift then come back later to place the implants. This will allow the tissue that’s been pulled to the sides of the implants to be re-approximated. This will be the best way to fix it with the highest chance for the best result. 2) if you have silicone you could revise the lift as stated above and then switch the pocket to subglandular ( above the muscle) and just make sure to release or open it up enough at the top. This would let you fix it in one setting. 3)fat transfer to the area devoid of tissue. Not a good choice as it’s too unpredictable and may take several surgeries to get it close. 4) revise the lift bringing the tissue together, and then placing mesh in at the same time to help prevent the implant from putting pressure on the tissue at the bottom which lead to the separation. This could be done leaving the implant in place. The downside of this is that when the lower glandular tissue is brought back together if it does not have a period of time to heal before the weight of the implant is placed on it this is more likely to happen again. I have seen this many times from other surgeons and have fixed it will all of the above options but the best is #1, then next best option is #4. For more information please feel free to email us. Have a great day. 
Dr Hedden

Connie Hiers, MD, FACS · Answer

Using the mesh does give weak tissue more support, but does increase the risk of capsule formation and scar tissue.  Perhaps your surgeon can soften and fill in that area with fat transfers. It will take at least 2 to 3 sessions for only a small amount can be one at a time because of the scar tissue.

Kenneth R. Francis, MD, FACS · Answer

Dear castleridge,
This looks like one of the dreaded complications, or consequences of mesh placement.  Too many surgeons jump directly to mesh placement for breast implant support without appreciating the risks of scarring, infection and contracture of the material.  We don't know when you had the mesh placed, or what type of mesh it is, and it may be that over time there will be improvement, absorption of mesh material and softening.  Good luck!

Mats Hagstrom, MD (license on probation) · Answer

If you want us to give you any type of meaningful response, then please consider giving us a complete scenario, so we have an understanding of what’s going on.
Clearly, you’ve had at least one operation previously. Understanding what surgeries you’ve had would be a good start. Generally speaking to make an assessment on the outcome of a plastic surgery operation. We need to see complete sets of proper before and after pictures. If you’ve had more than one operation, then we need to see before and after pictures for each of the previous procedures. If you don’t have before, and after pictures, then ask your surgeon or surgeons to forward the pictures they took. Your post does not make it clear if you’ve had mash placed or if you are contemplating having that procedure. The pictures you’ve included show breast that have contractile scar tissue, causing a deformation in the lower half of the breast. That is probably obvious to you as well. Without knowing anything else we can’t really give you any quality response. A Breast implants with supporting mesh should ideally look perfect. That doesn’t always happen and the difference between the two scenarios can sometimes be complex and dependent on multiple variables.
Follow up with your provider and discuss your concerns with him or her. Alternatively, schedule in person a second opinion consultations with other plastic surgeons in your community.
Corrective implants that have bottomed out using mesh, internal sutures or cadaver dermal products like Alloderm are complex and difficult procedures. Patients contemplating having this type of surgery should always confirm that the surgeon has the experience necessary to do these procedures with quality outcomes.
Best,
Mats Hagstrom, MD

Breast implant with mesh to hold up pocket - what does this look like? (Photos)

Answers (5)

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