Medical expert witnesses serve an important role in the legal system. Specifically, they play an important role in determining medical negligence in the new US system of justice.
"Dr said there is a little of bottoming out. This is 12 months post op. He has advised to wait another 3 months. 2nd breast augmentation, previous was 10 years ago over the muscle 450cc. This time under the muscle 375cc. I’m not happy but don’t know how to approach my surgeon. Thoughts of revision surgery and do I do both implants again. "
DR. POUSTI: Bottoming out of breast implant?
I am sorry to hear about/see the problems you are having after breast augmentation surgery. I think your concerns are appropriate; your breast implant does seem to sit quite low on your chest wall, consistent with breast implant displacement (“bottoming out”).
It is possible that you are feeling the implants significantly along the lower poles of the breasts. Also, consistent with the breast implant positioning problem, the nipple areola complexes seem to be sitting relatively high, because the breast implants have settled too low.
I think you will benefit from revisionary breast surgery which will likely involve capsulorraphy (internal suture repair). This procedure serves to reconstruct the lower poles of the breasts and prevent migration of the breast implants too far inferiorly. Associated issues with positioning of nipple/areola complexes should improve with this operation.
In my practice, this type of repair involves a two layer, permanent suture repair (reconstructing the inframammary fold areas). Sometimes, depending on the clinical situation and history, the use of additional support materials such as acellular dermal matrix or biosynthetic mesh is also helpful.
I would suggest that you communicate your concerns again directly with your plastic surgeon. Working together you arrive at the best plan (for example to operate on one or both breasts) to achieve an outcome that you will be happier with.
I hope this, and the attached link (dedicated to corrective surgery for bottoming out concerns), helps.
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