Possible revision surgery after a failed bilateral capsulorrhaphy? What are my options, if any? (Photo)

Question

Had a breast augmentation in 2017 the reason being of having asymmetric breasts. However I noticed that they would fall into my armpits when laying down with NO rippling or palpability. My doctor agreed to fix the issue. He stated that he would perform a bilateral capsulorrhaphy with mesh, but on OD, decided that no mesh was needed. After my revision in 2018, I felt my implants "popping" onto my rips. I was suggested fat grafting, but isn't sure if I'll be able to gain the weight that is needed

Donald R. Revis Jr, MD · Answer

Good afternoon!I would recommend the Original Internal Bra, my strong permanent internal suturing technique which will correct your lateral displacement- it works and it lasts. This is the most common revision procedure I perform, 5-6 times a week- it works and it lasts and I have the 10-15 year followups that prove it!For the rippling I would consider adding a sheet of Strattice mesh (ADM) to the outer border of your pockets. However, the Strattice mesh by itself will not correct the lateral displacement- only the correct Internal Bra suture repair can do that. In other words, the correct fix is the Internal Bra, and in 20% or so of patients I will add Strattice to help thicken your natural tissues and reduce any chances of rippling.

James J. Chao, MD · Answer

Hello Dr. Chao here,
Thank you for your question, Fat grafting should be able to help you with about 50-60% for correction of the rippling. 
Thank you,
James J. Chao, MD, FACS

Larry C. Leverett, MD, FACS · Answer

Previously submitted for your review are suggestions from several really good surgeons. However, I routinely repair this problem with no mesh at all. The internal capsulorhaphy (pocket modification)  uses the patients own tissues. This saves a couple thousand dollars in mesh fees, eliminates the need for a drain, and provides a permanent durable result independent of dissolvable non-permanent mesh. You may keep the implant or change them if you prefer. As far as the cleavage, it is important to 1) ensure that the previous surgeon divided the pectorals muscle adequately and 2) to ensure that the patient doesn't cause this herself with forceful pectorals exercises such as weigh lifting which is the principal cause of bottoming out in this manner.

Richard Baxter, MD · Answer

It looks like the mesh would have been a good idea. I would do that before fat grafting. The mesh will add support and coverage while fat grafting can only add a little bit of coverage.

Farbod Esmailian, MD · Answer

Although it is difficult to tell form the photos what is going on, what I do see is the implant rippling laterally.  If you have displacement of your implants to the side then this may be a good time to have placement of an internal bra with such a product called galaflex.  This is a synthetic product that will dissolve after about 18 months.  But during this time it will support your tissues and implants to help your body develop scar tissue to help support them.I would recommend you see a board certified plastic surgeon that has experience in breast revision surgery.Hope that helps.

Possible revision surgery after a failed bilateral capsulorrhaphy? What are my options, if any? (Photo)

Answers (10)

Answer: Internal bra with Galaflex mesh after failed capsulorrhaphy

Answer: Internal bra with Galaflex mesh after failed capsulorrhaphy

Answer: Breast Revision Surgery

Answer: Breast Revision Surgery

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Everything you need to know about Breast Implant Revision

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Possible revision surgery after a failed bilateral capsulorrhaphy? What are my options, if any? (Photo)

Answers (10)

Answer: Internal bra with Galaflex mesh after failed capsulorrhaphy

Answer: Internal bra with Galaflex mesh after failed capsulorrhaphy

Answer: Breast Revision Surgery

Answer: Breast Revision Surgery

Browse related questions

Recommended reading

Everything you need to know about Breast Implant Revision

Our mission is to create a world where every investment in modern beauty is Worth It.