I am a little worried because I had a breast augmentation three weeks ago ( high profile silicone 350 CC's). they are too high , will they come down eventually? Should I consider another surgery, and if so, when? I have read that breast massages are very good to let them down, but I also read this is not recommended in texturized implants. Can you give me an advice?
Answer:
Implants may be slightly higher in the initial phase for several weeks, but they will come down if the pocket has been properly dissected. Many surgeons will use a compression band to combat this and also recommend downward massage efforts in the weeks following surgery.
It is often the case that after breast augmentation, the implants seem to be too high. Your breast size is larger now and this results in that the breast feel too high, especially with high profile implants. Without doubt, they will come down and appear more natural with time. This is objectively true as gravity takes effect and the weight of your implants settle in.
Since you are only three weeks out I would not begin to worry just yet
The native inframammary fold appears high with a short and (at least mildly) tight inferior pole. The markings on the chest wall suggest that the inferior pocket was created for proper implant positioning. Certainly at 3 weeks post-op it is common to have implants positioned high since they have not had enough time to settle into place. If smooth surface implants were placed, there is certainly a good chance that these implants would settle into a lower position over several months, with potential stretching of the of the inferior pole skin occurring afterward; and this could be enhanced by implant displacement exercises and the use of a compression band over the upper pole.
agree, your implants are too high on your chest wall. Having said that, I would be patient, the implants will "drop" or settle into place over time. I would wait at least 3 months and 6 months would be better. If the implants are still too high, than you will need to have them repositioned into a lower position.
It seems that you have a "high crease", the distance between your nipple and the inframammary crease is too short. The surgeon should have lowered your crease during the procedure, if it does not happened. I would be surprised if you do not need a secondary procedure to correct this.
Capsular Contracture ,What is the Best Way to Treat it at Home?
I would like to know if deep tissue massage regularly is the best way? using a massage machine that vibrates and pulsates at different levels regularly? also what about medicine? I appreciate any advice towards my question, thanks.
Answer:
Capsules form around breast implants within days of their placement. The capsules are basically scar tissue that surrounds the implants .The formation of scar around the breast implant is normal as a breast implant capsule.. When it is excessively thick and/or tight scar tissue around the breast implant tight it is known as a capsule contracture. We do not know why or how this happens. For a variety of reasons muscle like contractile cells can appear in the capsule wall. When they contract we see/feel a hard breast (capsular contracture) with variable degrees of surface outline distortion, from the outside the breast implant is deformed from the capsule that is progressively shrinking. That is usually seen at months or years after surgery. The longer the contracture has been present the harder it is to treat and the more aggressive the treatment/surgery that is required.
and the severity of the capsule can be assigned to one of three categories:
Category 1: Breast is more firm than usual, but not visibly different or painful
Category 2: Breast is firm and visibly different in shape or appearence
Category 3: Breast is firm, visibly different, and painful
The best way to prevent capsular contracture is to do breast massages both medially and superiorly 3x per day. You should do this for at least the first year after breast augmentation and continue it daily thereafter for the duration of the implants to minimize closure of the capsule. Massage is usually recommended immediately following the surgery and can be continued for months to years , but is absolutely no scientific evidence that it helps prevent contractures.
If the capsular contracture has only be present for a few days or weeks it may be amenable to non-surgical treatment such as deep massage. It really depends on how long you have noticed it…If it is just starting, then I have had patients have success with alternating deep massage. Home massage, however will not likely make a difference if the capsule is already significant or contracted.
Endermologie (the combination of rollers and suction pressure applied to the skin surface) can be a good way to get the massage movement deep enough under the skin to stretch and soften the capsule.
Singulair and Vit E can be used but likely have very little effect. Singulair is a widely used asthma medication that can sometimes help. This is an off label use of this medicine. but this does not necessarily work in every patient. Time likely will either help relax the capsule somewhat or keep it relatively unchanged
There is nothing you can do to treat established capsular contracture at home. Overly aggressive pressure maneuvers may cause damage to your implants. Finally surgery is an option to correct this by removing the capsule entirely or releasing it in areas to accommodate the implant.
BREAST LIFT
Many women, particularly those who have had children, will notice that their breast tissue will droop and “deflate” following breast-feeding. This phenomenon is not limited to mothers, however, as changes in weight as well as hormone fluctuations can cause these same issues. Some women, in fact, are born with breasts that may not be as “perky” as they would like. Many patients who complain of this breast deflation, or “breast ptosis” in medical terms, benefit from an elevation of the breast tissue, known as a breast lift or
mastopexy
Breast lift achieves the following:
Brings the breast to a more attractive position
Reduces the size of Areola
Helps the breast to become more perky .
There are several ways to go about providing true or apparent lifting of the breast tissue.
Wise Pattern Breast Lift:
The standard and effective technique to lift the breast is known as a Wise pattern mastopexy Classically, breast lifts were done through a pattern similar to classical breast reductions, resulting in a scar around the nipple, down the center, and underneath of the breast, which you can think of as an anchor type of configuration. While this operation works well for many patients, it provides a lot of scarring, and can, in certain patients, give rise to a breast that lacks proper projection. Efforts were subsequently made to try and improve the deficiencies of this operation, and a plastic surgeon named Dr. Lejour developed a breast surgery that eliminated the scar under the breast and improved postoperative breast form. This is called the vertical mastopexy.
Vertical Breast Lift:
The vertical mastopexy has become one of the mainstays of the breast lift here in my practice. This operation works well for most women who do not have massive breasts, and allows some degree in reduction of the size of the breast if this is what you are looking for. Alternatively, the vertical breast lift can be combined with a breast implant in order to increase the breast size. In either situation, the scars from this vertical breast lift look like a lollipop- around the nipple and down the center of the breast. The concept behind the vertical mastopexy is the rearrangement of the breast tissue itself to a higher position, rather than creating a skin sling to suspend the breast tissue. This breast tissue rearrangement is felt to give a more pleasing shape and a longer lasting result.
Benelli Breast Lift:
For those patients that require only minimal lifting and who may be adverse to the longitudinal scar of the vertical breast lift, an alternative may be what is called a purse-string, or Benelli mastopexy. This operation is performed by resection of an eccentric area of skin around the nipple, which can be thought of as an oval shaped doughnut where more skin is resected above the nipple than below it. Following a small amount of dissection in the breast tissue to strengthen the breast lift, this incision is closed with a purse-string suture that “cinches” the breast envelope centrally and upward to provide a lift. The scar resulting from this breast lift operation is only around the nipple along the transition between the pigmented areola and the skin of the breast. This operation does have the limitation of lifting the breast tissue only one to two centimeters, however, and so only patients with minimal ptosis may be candidates for this procedure.
The Use of Breast Implants With Your Breast Lift:
With any breast lift procedure, the result may be enhanced with the ancillary use of a breast implant to increase volume and fullness.
A breast implant may be used with the classic breast lift, the vertical breast lift, or the Benelli breast lift procedure. Placement of large breast implants during these procedures is discouraged because of the following safety issue. When dissection of the breast tissue is performed in order to achieve a higher and more youthful appearance, careful attention must be given to the blood flow to the breast tissue that is being rearranged. Large implants placed under this dissection can put undue tension on the lifted breast tissue, causing compromise of the nipple. breast implants that are not excessively large may be used at the time of your initial breast lift operation as a single procedure. Discussion regarding your individual anatomy and expectations will allow a plastic surgery plan to be tailored to your specific situation. The quality of scar can also be improved if your surgeon is committed and places deep suture to avoid widening of the scars
