Case Details
Severe Bottoming Out with Implant Malposition and Traction Rippling due to oversized textured implants:
Age: 30 (no children)
Height: 5’5″
Weight: 115 lbs
Personal history: Periareolar Augmentation Mammaplasty with textured Mcghan style168, 700cc implants filled to 780cc’s, submuscular placement in 1993.
Complications: Inferior displacement, drop-out of the inframammary creases, severe bottoming, and traction ripples due to poor soft tissue coverage and texturing of an oversized implant. Causes of deformity: Much Too large Implant, textured shell, thin female (little body fat)
Treatment: In March 2000 — 7 years after initial surgery, patient underwent a restorative procedure which necessitated:
1. Bilateral periareolar removal of saline implants
2. Inferior capsulorraphy with multiple permanent sutures to correct severe bottoming out.
3. Overcorrection 30%
4. Replacement with style 45 high profile- McGhan 550cc smooth walled silicone-gel impants placed in partial retropectoral position
5. Elasto-foam taping of creases -2-weeks-
PHOTOS
Pre-op — Note Severe Bottoming Out – Note the position of the right breast relative to the mole below it. — note oversized saline implants with traction ripples
1 month post– note the overcorrection with redundant stretched, loose skin in the creases. The wrinkled, stretched, and redundant skin in the inframammary crease region contracted nicely over 8-10 months.
1 year post—- note the nicely positioned implants and tighter folds with little to no redundant skin and absent ripples despite a 5 -7 lb wt. reduction.
Important point – the dilemma — There is no need to remove the skin that has stretched ( and create unnecessary scarring ) – it will shrink nicely with time as long as the pressure of a heavy implant is reduced. this patient was instructed to remove the redundant skin by many physcians prior to consulting with me see attached
Photos courtesy of John M. Shamoun, M.D., Newport Beach, California
Before
After
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After
Before
After
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After
