Thank you for your query at DoctorSpring.com.
As far as I understand from your query, you had your first episode of breast augmentation around 13 years back in the subglandular plane and one had then dropped lower than the other owing to which you received a corrective surgery without any effect. You presently are in a 2 week postop period and want to know if you need not wait for a year to get a proper corrective surgery done.
The issue here is secondary breast augmentation. You have not mentioned through which route the corrective surgery was done: was it through the belly button again or was it through the breasts? This is extremely important as an earlier corrective surgery in your case would depend upon the access incision. Please remember that implants are foreign bodies and therefore earlier surgeries would be associated with more inflammation and an increased chance of infection if the same route is used.
If you would like to ask me what I would do, then I would simply change the plane of the implants and put them in a submuscular plane given your age (38 years). This would provide the best long term results. I would also prefer using another incision (since this is going to be a repeat procedure, a preferred one would be the submammary incision) and the ideal time frame would be at least after 2 months (a more preferable one would be 4-5 months).
You need not wait for a year to get revisional surgery done if the above points are followed. However, if you prefer the same access route then you would need to wait for about 8 months or so before a bigger implant can be put in.
Pictures of your present condition and also earlier post op pictures would be a great deal helpful!
Wish you all the very best!
Dr. Souvik Adhikari, MBBS, MS, MCh (Plastic Surgery)
Assistant Professor of Plastic Surgery
Institute of Post Graduate Medical Education & Research, Kolkata.
Consultant Aesthetic, Plastic & Reconstructive Surgeon.
Patient replied :
1st surgery 10-12 yrs through belly buttom. The 2nd surgery (corrective/implant replacement) which was done November 2012 (less than a year ago) was from under the breast. The 3RD surgery I just had 2 weeks ago, also under the breast. Same Doctor, same result. I can send pics. I was told that because my first implants were over the muscle and been there so long that it was not an option for me to have them under due to scar tissue build up. I would prefer under as I think it would help the rippling issues.
Ok, good! Whenever an implant is placed under the breast tissue, there is a capsule formation which is in fact a pocket where the implant resides. However, this is no contraindication to switch over of implants to the submuscular plane. The technique is very simple: incise the capsule, take out the implant and scrape off the capsule to healthy bleeding breast tissue. Subsequently a pocket can be made under the muscle and an implant put there. Please note that since the capsule is made of scar tissue, unless it is rigorously addressed and revised, the left sided implant would sit in its same position. That is why, I would still prefer the submuscular plane in your case because of the ease of creation of a new pocket which can be accordingly modified during the operation to ensure that the implant positions are similar.
If a submuscular plane is chosen, you can have the revisional surgery within 2 months of your last procedure.
Yes, you can send me pictures which would again help me in identifying the actual capsule that has formed and the likelihood that a bigger implant would succeed.
All the very best!