Areolas Are Caving Under After Removing Breast Implants, Is This Permanent?

Question

I am 4 weeks post-explant after dealing with constant capsular contracture for 11 years. I am slowly healing but continue to deal with the areola pulling in and under where the incision was made (more significant on the left). Will this heal over time or is it a permanent situation?

Jed H. Horowitz, MD, FACS · Answer

Good day! Generally, it is a bit too soon to see final results as bruising and swelling may persist. Nipple inversion may occur after trauma and can be corrected with a procedure performed in the office under local anesthesia which is commonly performed with breast revision surgery. In severe cases of nipple inversion the breast ducts may need to be severed. For others, devices such as the Niplette by Advent can be used without surgery with some success. It is often used after surgery to create suction and maintain the correction. Do not hesitate to ask your doctor about any additional aftercare instructions you need for best results. Best of luck! #RealSelf100

Richard J. Bruneteau, MD · Answer

It’s not unusual for patients
to experience breast distortion following removal of breast implants when
severe capsular contractures are present.Under these circumstances, patients are often emotionally devastated by breast
distortion and associated loss of breast volume.When this situation arises in the immediate postoperative
period it can be difficult to know if this distortion is permanent.In some cases swelling resolves and tissue
remodels over the course of three to six months with significant improvement in
the aesthetic result.In other cases,
the deformity may be permanent and secondary surgery may be indicated.This may include implant replacement, breast
lift, and possibly grafting procedures.If your’e concerned about the appearance of your breasts
following implant removal, consultation with a board certified plastic surgeon
is appropriate.This surgeon should be
able to formulate an appropriate treatment plan.

Tom J. Pousti, MD · Answer

Thank you for the question in pictures.  

	Unfortunately, it is too early to know if the contour depression that you are experiencing will be a long-term result  after your breast implant removal surgery. Sometimes it is amazing how the body will &ldquo;fill in&rdquo; defects with time and contraction of the skin envelope. I would suggest continued follow-up with your plastic surgeon (assuming he/she is a well experienced board-certified plastic surgeon).  In the event  that revision surgery is necessary  he/she will be most familiar with the situation and  therefore best equipped to help you.

	Best wishes.

Marialyn Sardo, MD · Answer

It is still early after your explantation surgery to determine the level of contour irregularity. It may take several months for the breast contours to improve. If there still is tethering or indentations after 6 months, revisional surgery can be done to release scar tissue or fill with own tissue. It may be useful to massage the area daily. Consult with your surgeon for advice on how to optimize the healing process and appearance of the breasts.

David Bogue, MD · Answer

After an explantation, it may take several months for the breast contours to smooth out. If the indentations persist, a revision surgery may help by releasing scar, or the interposition of fat from a fat transfer may help. Give things a little more time (at least 3-6 months) and then reassess.

Robert Brueck, MD · Answer

From your photos this mat improve as time goes on.You may need a slight revision or perhaps soem of your own fat or other tissue may need to be added later to fill the depression but this should not be a problem.

Samir Shureih, MD · Answer

There is still some swelling according to the pictures. So it may improve some, but you will have still a major deformity.

	You need to know if a total capsulectomy was done?

	did they repair the breast tissue under the nipple areola?

	You need to wait 6 months then explore your options with an experienced BOARD CERTIFIED PLASTIC SURGEON (AMERICAN BOARD OF PLASTIC SURGERY)

Jonathan J. Staiano, FRCS (Plast) · Answer

4 weeks is too soon to make any long term decisions but it does look like you may be left with a deformity of your breasts. Give the scarring 6 months or so to settle and massage your breasts to help soften the scars. I find that fat transfer is the best way to help with this problem, although you may need more than one session. All the best.

Areolas Are Caving Under After Removing Breast Implants, Is This Permanent?

Answers (8)

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