Breast implant revision - should I proceed with a surgeon that is not sure they can fix existing concerns? (Photo)

Question

The new surgeon i have scheduled my Brest revision surgery and implant exchange with has told me that he can not guarantee that he can repair the right implant, which never dropped properly. The original surgeon offered to cut the bottom of the muscle and release it as he suspects that is the problem. He uses natrelle implants (for the replacement), and I was wanting to try motiva ergonomix line, and the surgeon I chose has a good reputation. However, of the 5 surgeons I had consults with for this revision, he’s the only one who emphasized more than once that he’s not sure he can fix it. He’d have to wait and see when he gets in there. The other surgeon‘s badically said they would make the repair and exchange the implant. Im questioning now if I am m a mistake because more than the implant exchange I want them to look normal. Ive had previous implants and they sat perfectly in the pocket. (Also none of the surgeon suspected capsular contractions Tge implant moves, and it is soft.

Gianfranco Frojo, MD · Answer

This is a complicated situation that requires more information to truly figure out what is the best procedure for you. I would recommend at minimum an ultrasound to see the breast tissue, capsule and implants. If your implants are above the muscle, which it appears they might be, I would highly recommend placing them below the muscle as a pocket plane change. You may also require a capsulectomy on the right side if that high-riding implant is from early capsular contracture. There is a large amount of rather decent quality evidence that suggests the only place a breast implant should be placed is below the muscle to minimize the overall potential complication risk. With respect to complications, this is mainly related to capsular contracture risk, implant visibility, and also maintaining maximal residual blood supply to the breast.

Yasemin Aydinli, MD · Answer

Interestingly, the surgeon who admits he cannot guarantee the repair may be the most trustworthy of the five, because revision surgery genuinely is unpredictable until the tissue is seen from inside. Releasing the lower muscle edge is a standard maneuver for an implant that never dropped, so the plan itself is sound. Implant brand preferences can be discussed openly before booking. Choose based on revision experience and trust, not on who promises the most.

Gregory A. Buford, MD, FACS · Answer

Even though your breast may feel soft, I suspect that you have a moderate degree of capsular contracture.  To fix this, I would change out both breast implants and perform a right capsular revision (to release the implant and allow it to soften).

While no surgeon can guarantee 100% success with any procedure, I would be a little hesitant if your surgeon is not confident that he/she can fix this.

I hope that helps and wish you the very best outcome!

Mats Hagstrom, MD (license on probation) · Answer

I think most of your issues come from having chosen implants that are too big for you.
After having had multiple breast surgeries, all surgeonsshould tell you that they cannot guarantee outcomes and the best they can do is try.
The more previous procedures you’ve had the more complex situation becomes. In paragraph using excessively large implants is the most common reason of patients end up with revisions and complications.
Best,
Mats Hagstrom MD

Breast implant revision - should I proceed with a surgeon that is not sure they can fix existing concerns? (Photo)

Answers (4)

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