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Ask a Plastic Surgeon / Breast Augmentation-Lift-Reduction
Question 26
Question: 29 yrs old, 5'10", weight 135. Lost 50 lbs. 5 years ago. 2 years ago, breast augmentation: 300cc high-profile implants. Problem: left breast falls laterally when lie down. Obviously farther to the left than right breast's more medial placement when standing, but main concern is that breast nearly falls into armpit when lie back. Noticing stretch marks and feeling unhappy with results. Right breast is centered "perfectly". Question: my plastic surgeon is recommending stitches to hold left breast in place, saying that is my option since the cause is my anatomy and not implant placement. (Note: placement of implants through umbilical.) Also uncomfortable about a charge of $1000 plus anesthesia for stitches to be placed. Cost is a secondary concern, but it seems like a red flag when it could have been done at time of original surgery. Mostly wonder about durability of "stitches" to hold my breast in place. Unable to find much information on internet regarding, so assume uncommon. Also, why now and not recommended at time of surgery? Obvious to me following surgery, but became more pronounced with "fall" of breasts. Will stitches remedy my problem?
Response: The problem is that the pocket was made remotely by the umbilical route and that this is a problem with that manner of placing implants. The pocket must be remade and the area where the implant is migrating closed (with stitches) so that it heals. This will have to be done through a local incision. Most of us who perform a lot of implant surgery do not perform it through the umbilical route.
Question: Amy, Ohio
Response: 4-5-2007; Gregory G. Caputy, MD, Honolulu, HI Dr. Caputy's web site
Editor's Note: "Trans-Umbilical Breast Augmentation (TUBA). The incision and scar in this newer approach is through the belly button or umbilicus. A fiber-optic camera (endoscope) is tunneled from the umbilicus to a pocket under the breast. The implant is inserted through this tunnel into the breast and is then inflated with saline. It is important to note that using this incision, only sub-glandular placement is possible. Advantages of the TUBA include a less visible scar, and a faster recovery time. Disadvantages of this approach include a slight increase in the likelihood of damage to the implant, and the possibility of tunneling under one of the chest muscles (pectoralis major) during placement. Furthermore, complications that require additional surgeries for treatment may require a new incision closer to the breast. In addition, implant manufacturers frequently will not honor the implant warranty if the implant is placed through this approach." University of Michigan Health System, at page 11.
Breast Surgery Questions--Archive
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