6 months post op, gap is too wide, breast fall under armpits, I'm 500cc, submuscular silicone. Ps says I need belvaderm (Photo)

I don't feel I need the belvaderm slings I'm narrow chested & only 125 lbs, I think he made the pockets way too wiDE. He even said so, but I think he's trying to get extra money saying revision with belvaderm slings would be $2300 , I think he can go in & make breast pockets SMALLER without the slings. Can this be done?

Doctor Answers 9

6 months post op, gap is too wide, breast fall under armpits, I'm 500cc, submuscular silicone.

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Small framed thin women with large implants can develop pockets that are too large, either from the initial dissection needing to be large enough to accommodate the implant, or from the pocket stretching in the postoperative period. Correction can be attempted with a procedure called a capsulorrhaphy where the pocket is sutured closed along the outside, but the failure rate for this procedure is moderately high due to the thin nature of the capsule tissue and the continued pressure of the large implant. Buttressing the repair with an acellular dermal matrix material or a surgical scaffold material like SERI mesh improves the success rate of the capsulorrhaphy which is why your surgeon recommended it.

Implant revision

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Your breasts are a bit low, but they dont look bad.  You may have gone too large for your frame, perhaps a high or an extra high profile implant would have fit you better, but any implant over 400 cc has more complications.
You may consider waiting longer to do the revision, so that the implant capsules get stronger to be able to sew the pockets tighter.  Otherwise, the mesh you are describing is needed to provide support for the implants.

6 months post op, gap is too wide, breast fall under armpits, I'm 500cc, submuscular silicone. Ps says I need belvaderm

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What you are describing and what is demonstrated in the one posted photo are polar opposites??? Best to seek second opinions ion person... 

Implant issue

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The larger the implants, often the wider the implants. Perhaps you need a different profile. Yes, the pocket can be adjusted without an ADM, but some surgeons like to reinforce the repair with this as well.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Bottoming out

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I believe the problem is more a descent of the implants on your chest wall as well as lateral displacement.  This can be corrected without Alloderm by using the capsule that normally forms around implants to secure them in place. However, sometimes the capsule formed has very little integrity and needs to be supported by additional tissue.  In this case Alloderm and other biological constructs can help.  There may be cheaper alternatives to Alloderm as well you can ask about.  I would recommend having it available in case it is necessary to ensure you correct this problem without needing a further revision.

Post-op #BreastAugmentation Results

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From your photos, your breasts look wide, but it may be related to the width of the implant. The implant is relatively well positioned considering the implant, but this may not be your ideal aesthetic. You likely need a higher profile implant (a more narrow base) to keep the volume, enhance your cleavage and narrow the base. It depends on the dimensions of the current implant. Mesh options are helpful for tightening the breast pocket, but not absolute. 

You should see a board certified plastic surgeon in your area to get a formal opinion through an in-person consultation.
Best of luck,
Vincent Marin, MD
San Diego Plastic Surgeon

Vincent P. Marin, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 52 reviews

Do you need a revision?

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Well since you are 6 months post-op I would think you have settled to the final level.  It appears that your implants are a little low and may have some bottoming out.  I use SERI mesh by Allergan whenever I do this procedure.  As far as the fees this is something you have to discuss with your doctor.  For the SERI the cost alone is about 2500 for the larger sheet.  I must say I am not familiar with the belvaderm sling.  Why not sit down and talk to your surgeons about options without the belvaderm.

Breasts fall under the armpits and a wide gap

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Thank you for your question and from you photos you have a good result but what I can't see is how far you implants migrate laterally. If they do in fact fall out this far you can have this repaired with closure of the pocket surgically.  You may or may not need the sling depending on how sever the problem is but I would not use an ADM ( adermal cellular matrix)  at this point.  I think you are talking about Beladerma which is an ADM. Part of your problem is the size and weight of your implants which tend to drop and stretch the skin and capsule over time. I would seek out multiple consults and find someone who has done a lot of these repairs so you can get the best outcome.

John D. Smoot, MD
La Jolla Plastic Surgeon
4.7 out of 5 stars 14 reviews

6 months post op, gap is too wide, breast fall under armpits, I'm 500cc, submuscular silicone. Ps says I need belvaderm (Photo)

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You are small with a narrow chest. YOu have large implants and a significant amount of breast tissue I would guess. All that volume has to go somewhere and so it goes all over the chest including laterally. It's just how it works.

Of course the easiest way to achieve your goal is to reduce the size of the implants and close off the lateral pocket.  

 I think that your PS has your best interests at heart. The belladerm is quite expensive. Get another opinion or two.

Val Lambros, MD, FACS
Corona Del Mar Plastic Surgeon
5.0 out of 5 stars 8 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.