3rd surgery with Siri; already bottoming out and implants are falling in armpits? 2 months post-op (Photo)

Hi BB,Thanks for your question and photo. It is really hard to assess based on only this view. SERI usually has no give to it, so where it is placed is where it stays and it usually dissolves in one to two years. I have extensive experience with it. I would wait to see how everything turns out in 6-12 months before looking for other options. If you had implant exposure, the prudent thing to do would have been to remove the implant and let your tissue heal before going through with another revision. Now, just wait, let your tissues heal. Seek another 2 or 3 opinions from board certified plastic surgeons that perform a lot of breast revisions. Please discuss your concerns with your surgeons. They usually try to help their patients as much as possible. Good Luck.All the best,
Carlos Mata MD, MBA, FACS

#breastrevision #docmata
Board Certified Plastic Surgeon

Hello,I am sorry you are going through this.  I understand that after three surgeries you want another surgeon, even if he didn't do anything wrong per se. Go visit a few ABPS certified/ASAPS member surgeons and get an examination. 

It is unfortunate that you are having such problems after breast surgery. Re-operations can be a challenge. Since you are only two months out from your last surgery it may be prudent to wait until you are at least six months post-op to let the tissues heal. In most cases the original surgeon is in the best position to advise you regarding your options so consider his/ her recommendations. If you want a second opinion then save some time by obtaining all your medical records such as operation reports, breast implant information, pre and post-op photos, etc to help the next surgeon review your case. Hope it all works out for you.

Please before choosing another plastic surgeon review their before/after photos and ask them to show you photos of similar cases to yours.  It would be good if you can also speak to a patient or two who had the same situation and had the repair.

Your photo does not help evaluation, but from what you have said, I would allow healing for 6-12 months, and then find a surgeon with experience performing revisions.Good luck,

Dear bb81,Boy, you have had a rough run of it and I am sorry. The angle of your photo does not really show a malpositioned implant, only that the scar is a little high. I would not recommend that you use the scar as a point of reference though because after a reduction or lift they could likely end up higher that the crease.You have had a lot of surgery this year, and my first inclination is to encourage you to wait at least a year before you proceed so that you are fully healed. I read in your bio that you also had an exposed implant previously, so waiting gives everything time to really play out and settle.Sometimes poor results are technique related, sometimes it is the patient's anatomy, and sometimes it can be tissue related. I can understand you may not want to go back to the same surgeon, and honestly if this last one turns out poorly they may loose faith in them self as well. My recommendation is that you keep your relationship with your surgeon as positive as possible and stay nice (as should they). If it turns out that you will need another procedure you may want to ask your surgeon what they would suggest, or if you should even seek out more of a specialist in this area and ask who they might recommend you see for a second opinion in your city or regionally. Working together with your surgeon on this may be to your advantage. I try hard to help out colleagues when I can, as I am sure other surgeons do as well when they get in a tough spot. Be sure you have a complete set of photos, operative reports, and progress notes if you go for additional consults. With out these it can be difficult to fully evaluate your situation.Best of luck,

I am sorry to hear about the complications you have experienced; I'm sure this is very frustrating to you and your plastic surgeon.  Although I cannot give you precise advice without in-person evaluation, some general thoughts be helpful to you:Plastic surgeon experience matters greatly when it comes to these types of revisionary breast operations.  Based on your post, you will likely be best off seeking consultation with board-certified plastic surgeons who can demonstrate significant experience helping patients with challenging revision breast cases. Generally, the lateral breast implant displacement can be corrected using an internal suture technique (capsulorraphy), decreasing the size of the pockets and moving the implants toward the midline. In my practice, I use a 2 layered suture technique to close off the space laterally (towards the axilla). The use of acellular dermal matrix is an option ( although not usually necessary) especially if significant implant rippling/palpability is present.
I hope this, and the attached link, (dedicated to revisionary breast surgery concerns) helps. Best wishes.

 Despite the best efforts of a well-meaning surgeon, at times, the result is not what you the patient had expected. If you have lost confidence in your surgeon's ability to correct this problem, then it's time that you seek a second or third opinion from experienced cosmetic breast surgeons in your area. You might want to bring a copy of your chart and photos which would help the next surgeon understand where you've been so that a proper recommendation could then be made. Good luck.