Silicone implants

[imnyc]

Hi Dr. Rosenberg,

Thank you for your prompt response to my question regarding implant extrusion earlier.  I am sorry that I forgot to mention that my implant is silicone/memory gel already... so the knuckle that I felt right underneath the areola is a concern for me with respect to implant extrusion... (and I don't want to use alloderm)... I have lost 10 lbs since the augmentation.. and with my now thinner skin, I am worried about skin coverage where there is no pec muscle... when my surgeon goes in and take the implant out, will that tear out even more tissues and thin out the skin more for coverage and therefore have even a greater chance of extrusion when he reinserts the implant once he corrects the bottomed out problem?

I am 93 lbs and 5 foot 3 with a 275 cc mentor memory gel implant... my surgeon said using a smaller implant will have great assymetry...

What other options do I have since I already have silicone implant inserted subpectoral/dual plane already.... ?

[Howard Rosenberg, MD]

Of course I would need to examine you to provide the best opinion about your situation.  Since you have gel implants, the knuckle you feels is still likely to be a fold in the gel implant that is apparent through your thin skin (and in the thin area of the pocket where there is no muscle).  There are surgical techniques to use the existing capsule to elevate that implant and reinforce the pocket.  I agree with your surgeon that placing a smaller implant would lead to asymmetry.  If the capsule cannot be reinforced with the natural exisiting capsule, then the use of a collagen acellular matrix like Strattice may be appropriate.

[imnyc]

Thank you very much for your insight Dr. Rosenberg.