Will Getting Breast Implant Replacements Increase The Risk Of Getting Rippling?
Q:Dr. Eppley, I had saline breast implants placed five years ago through armpit incisions. The left breast implant has always been too high but I let it go at that time. I now want to change my implants to silicone, increase my breast size and get the two breasts looking more similar. (attached are my current pictures) Do you think I would need to come in in person to discuss the breast operation and be examined? I know there are different types and shapes of silicone implants and so I want to ensure that we choose the correct implant. I prefer them to sit a little lower because I think it looks more natural. Basically I’d be happy if both my implants looked like my “good” implant, the one that was placed correctly. Also, I don’t think adding 75 CCs is a huge jump but if this greatly increases my chances of rippling or other issues, I’d like to weigh that in my decision. I’m really happy with the look and feel of my breasts, they feel natural and there is no rippling double bubble etc. So I am trying to avoid any of those issues in round two and honestly that’s kind of been my hesitation in getting them fixed, but the asymmetry does really bother me.
A: In answer to your breast implant replacement questions:
1) I do not consider a before consultation (coming in way ahead of surgery) to be essential. There will be one the day before surgery anyway. Your pictures show a left breast with a highly positioned implant with the associated higher inframammary fold level as well. This is not rare in the transaxillary approach for breast implants, particularly on the non-dominant side of the surgeon. (right handed surgeon often does not do an adequate inferior dissection on the left side of the patient) This is best treated by a small inframammary incision where the lower end of the pocket can be adequately released with the implant exchange. The implant size increase is already known (+75ccs) and there are only available smooth silicone implants today of which high profile projection is probably what you are seeking. (all textured/shaped implants have been removed from clinical use or should not be used due to the risk/concerns of ALCL) Your goal, besides volumetric breast size increase, is to have the left implant position look like the right…that is a given.
2) A 75cc implant increase is really minimal so don’t let the number fool you. As a general rule one needs at least a 30% implant volume increase to even see any change on the outside. For example, if one has 350cc one really need at least 450ccs (+100ccs) to tell any difference at all.
3) The size of a breast implant has no correlation with the occurrence of ripping. That is caused by different issues.
4) When in doubt about the increasing the size of the breast implants, you can always just adjust the left implant down as that addresses the most important concern to you
Dr. Barry Eppley
A detailed description and pictures of your concerns allows for the most informed response.