Follow up - My doctor wants to try the "popcorning" cauterization method. Is he taking the easy way out? (Photo)

Thank you for the question.  Its hard to know what the best option to shorten the distance between the areola and the breast fold would be for you.  I think tightening the capsule in that area (capsulloraphy) is likely to be the most effective.  The skin will redrape once this is done and no additional external scars are needed.  "pop corning" the capsule may work but somehow I feel that that is a better option for the side of the breast where the weight of the implant is not as much.All the best,Dr. Remus Repta

I think I answered this already, but usually  to fix a pocket that is too large, one places sutures in the areas that need to be adjusted. Some also use an ADM for additional support.

This is not fun to go through!! My usual approach is to try a 'less invasive' option first, which can be 'popcorning' (the least invasive -- using heat to shrink the capsule) or a partial capsulectomy/capsulorrhaphy (second most invasive -- removing a wedge of capsule from the lower portion of the breast, and then suturing the fresh capsule edges together with anchoring sutures). If this fails, and it sometimes does, then it means your tissues are no longer holding the implant up, so you need to consider adding additional support. There are a variety of mesh options available to add support (most invasive -- SERI or Stattice). Something else to consider is doing down in implant size a little bit as this will mean less weight and stretch on the tissues. In general, if you have already had the capsule removed and sutured, then you probably want a more invasive solution. Sit down with your surgeon and discuss what your concerns are. They may not understand how much this is bothering you and will likely appreciate your honesty. Hope that helps!CDK