Sounds like you have a double bubble. I would have a smaller implant placed.

Published on Jul 11, 2012

The implants are too large, and this is why you keep experiencing complications.

Published on Jul 11, 2012

You seem to have a rather complex case that requires an in-person evaluation by an expert in breast augmentations. You could very well require the use of a special device known as ADM.

Published on Jul 11, 2012

You should ask your plastic surgeon who has experience with your body and the type of procedure done for you. It is important for continuity of care.

Published on Jul 11, 2012

It is difficult to tell what you should do without examining you and listening to what your concerns are and seeing what your plastic surgeon did. I would ask your plastic surgeon to explain things to you!

Published on Jul 11, 2012

There is a product I use in some cases called BellaDerm. It is tissue that can help give the implants support internally. It does increase the cost, but may be a solution for you.

Published on Jul 11, 2012

Thank you for asking. This is a breast implant revision situation that requires a full examination by an experienced plastic surgeon. The implants could be too large for your breast skin envelope or pocket and may require a support matrix. See a board-certified plastic surgeon. He or she will need to do a comprehensive breast history and exam. Best wishes!

Published on Jul 11, 2012

Good morning!
Sorry to hear about your issues with your implants. Three surgeries in six months is not normal. Your surgeon could be battling thin tissues that do not have the holding power to support an implant of that size- you may require additional help such as a Acellular Dermal Matrix (ADM) that can be used to build an "internal bra" for support.

Be sure your surgeon is well versed in revisional breast implant surgery- it requires a more advanced skill set than primary augmentation. I would also suggest a consult with another surgeon in your area to be sure you are getting the best care possible.
I hope this helps

Published on Jul 11, 2012

Thank you for your question. I'm sorry to hear of all the problems you've been having. It is difficult to say what your next step should be without examining you. With that being said, based on your history, it seems that you there are two variables causing the implant to bulge inferiorly. Firstly, there is insufficient lower pole support for the size implant you have. That means sutures alone are not enough to hold the implant. You may need to replace the present silicone implant with a smaller volume implant. If your implants are not under the muscle then they should be placed subpectoral. Additionally, the use of Seri surgical scaffold or Strattice acellular dermal matrix would provide additional support to the lower portion of your breast. Lastly, although extreme, you may as a last resort consider removing your implants for 3 to 6 months to allow your tissues to heal prior to undergoing any further surgery.

Published on Jul 11, 2012

Typically after capsulorrhaphy there are sharp pains near the rib cage that last for a few weeks. It is unusual to experience severe pulling sensations for longer. It is unclear whether the aesthetic goals were achieved this last surgery. If not, you may be a candidate for a mesh like Seri or an ADM like Strattice to re-support your implants.

Published on Jul 11, 2012

If you have failed suture repair internally, then the next step is to utilize some sort of additional support to help reinforce the tissues and secure the fold. This can be done with an acellular dermal matrix (ADM) such as Strattice that adds a layer of strength and helps set the fold. At the same time, decreasing the volume of the implant can take pressure of the area as well. Nothimg has a 100% success rate, but this would be the next step if you have failed multiple suture repairs. I hope this helps.

Published on Jul 11, 2012

It largely matters on the placement of your implants - subpectoral or subglandular. Also, it may be that your new implants are too large / heavy for your tissue to support.

Published on Jul 11, 2012

Thank you for your question.
Without an examination, it is difficult to give you accurate advice.
In general, I ask patients to wait until they they are 9-12 months post op surgery before having the internal suture procedure performed for pocket adjustment because the permanent sutures are placed in the capsule that strengthens with time. If the capsule is not strong enough to hold the sutures, the repair will not be successful.
Also, AlloGraft or mesh is sometimes helpful in providing additional support.

Published on Jul 11, 2012

Thank you for your question. You are likely going to need to use a combination of textured silicone implants with or without SERI for support of your implants. Sorry you're having this difficult issue.

Published on Jul 11, 2012

I'm sorry to hear about the problems you are experiencing. It is difficult to assess your situation without more information. It sounds as if you may have constricted breasts. There are many other potential causes as well and each will require a different solution.

Published on Jul 11, 2012