I’m having a explant and uplift next week. I have nagore gummy bear type 390cc I was a 34B before implants and now 34DD. I’m having breast pain and illness issues. I want a en bloc removal but my surgeon states he usually only does partial removal but will do a full removal on me but it can effect for the blood supply to the nipple and the look of the breast. Do I need a en bloc or would a total removal suffice?
August 8, 2019
Answer: NOT MANDATORY Gummy Bear is the nick name for highly cohesive shaped gel implants. They are similar to a gummy bear. I do not like them because they are not as natural feeling as memory gel implants. The breast determines the shape of soft pliable implants. Stiff rubbery implants can support and shape the breast. The problem with gummy bears is that they may look good in the standing position, but may sit like stones when laying down. However they have a place in reconstructive breast surgery where tissue is missing and a shaping force is needed from within. Then shape trumps natural feel.Capsulectomy (enbloc resection) is optional in removal and mastopexy with these implants. This operation is already compromised by reduced circulation. The flaps and nipple-areola depend on circulation from the periphery of the breast due to the dead space from the removed implant. Your surgeon should make a determination of the risk depending on the amount and consistency of the remaining breast tissue. Partial capsulectomy is common to allow the breast tissue to mobilize into the new shape better. Complete capsulectomy increases the chance of post operative bleeding. A post operative hematoma can cut off blood supply to the flaps and nipples irreversibly within hours. This is a risk/benefit calculation that requires an experienced surgeon. When in doubt, a two stage procedure may be prudent. This decision can be made at surgery if the capsule is suspicious or severely calcified.
Helpful
August 8, 2019
Answer: NOT MANDATORY Gummy Bear is the nick name for highly cohesive shaped gel implants. They are similar to a gummy bear. I do not like them because they are not as natural feeling as memory gel implants. The breast determines the shape of soft pliable implants. Stiff rubbery implants can support and shape the breast. The problem with gummy bears is that they may look good in the standing position, but may sit like stones when laying down. However they have a place in reconstructive breast surgery where tissue is missing and a shaping force is needed from within. Then shape trumps natural feel.Capsulectomy (enbloc resection) is optional in removal and mastopexy with these implants. This operation is already compromised by reduced circulation. The flaps and nipple-areola depend on circulation from the periphery of the breast due to the dead space from the removed implant. Your surgeon should make a determination of the risk depending on the amount and consistency of the remaining breast tissue. Partial capsulectomy is common to allow the breast tissue to mobilize into the new shape better. Complete capsulectomy increases the chance of post operative bleeding. A post operative hematoma can cut off blood supply to the flaps and nipples irreversibly within hours. This is a risk/benefit calculation that requires an experienced surgeon. When in doubt, a two stage procedure may be prudent. This decision can be made at surgery if the capsule is suspicious or severely calcified.
Helpful
