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Michael C. Edwards, M.D., FACS
- Suite 214
653 N. Town Center Drive
Las Vegas, NV 89144 - Tel: Click for phone number
- Fax: 702-243-7923
- Send E-mail
- www.medwardsmd.com
Answered Questions
Q:
How can you correct a pointy bulge on the top of the breast (implant poking up) after having over the muscle silicone implants?
I had breast augmentation with over the muscle silicone implants. My left breast now has a pointy bulge on the top which is the implant poking up (ultrasound showed it is a folded implant). Is it possible to spin it around without surgery?
A:
Coverage of the breast implant is one of the many factors to consider when performing a breast augmentation. By placing the implant partially under the muscle to provide coverage of at least the upper inner implant, the implant is better hidden. There are alternatives to treat you that include performing a site change procedure where the muscle is lifted up and the implant placed partially under it. Also, a silicone implant behaves a bit better than a silicone implant in a thin woman so that may be something to consider as well. You will be best served if you see a plastic surgeon who can examine you and make suggestions for what your options are for treatment. I wish you well.
Dr. Edwards
Q:
When having a capsulectomy and replacing implants, how much breast tissue is lost?
If you have silicone implants and are having a capsulectomy, also replacing the implants with new ones, how much if any breast tissue is taken out and how long does this surgery take? Would a mammogram tell if breast tissue has to be removed with the capsulectomy? I am already small breasted and have heard that sometimes breast tissue is removed during the procedure. Will a mammogram tell how much tissue would need to be removed? How much time will I be in the operating room for the surgery?
A:
Our goal is to remove as little breast tissue as possible with a capsulectomy whether it be above or below the muscle. In general an imaging study such as a mammogram will be helpful in knowing if breast tissue will need to be removed. The duration of the operation will vary. Your plastic surgeon should be able to give you a ball park idea of how long your procedure will take.
I wish you well.
Dr. Edwards
Q:
If you have had problems with Capsular Contracture, will the battle ever be won or should I give up on having nice breasts?
I had a Breast Augmentation in August. Three weeks later, because the implant wouldn't budge during massages, the one breast was opened back up. My Plastic Surgeon said that I had a significant amount of scar tissue, that he hadn't seen in previous years experience. Four months later, the same breast still has issues. It seems to be riding high. I can see my scar because it hasn't dropped. I know I have scar tissue pushing it up, because I can feel it. I also believe the implant is stuck to my chest wall now. When I lean over, the nipple area is loose vs the other breast that is full of implant. My Plastic Surgeon will not touch it until we reach the year mark. I've been massaging more than ever and feel I've gained nothing. Is there any hope for someone with multiple issues regarding scar tissue. I assume scar tissue is what is holding it to my chest wall due to the previous capsulectomy. Am I fighting a losing battle against my scar tissue or can this be beaten? Also, is there a difference between scar tissue and capsular contracture. My Plastic Surgeon has only called it scar tissue.
A:
It is unusual that a capsular contracture would occur within 3 weeks after surgery but it can be that an implant does not drop or settle as much as we would like. Capsular contracture is most certainly an occurrence (not really a complication) that plastic surgeons want to avoid. There are techniques that can be tried if a capsulectomy (removal of the capsule) does not work. Softer capsules may respond to non-surgical modalities such as Vitamin E, external ultrasound, massage, and in some cases off-label use of Singulair (an asthma medication). If surgery is attempted, the use of an acellular dermal matrix such as Strattice can be helpful in addition to removing part of all of the capsule.
I hope this helps.
Dr. Edwards
Q:
Consultation with surgeon concerning high profile breast implants -
I recently had a consultation with a plastic surgeon regarding breast implants. I asked him specifically about high profile implants. He stated that he does not use them because they cause damage to the skin. Is this true?
A:
I'm not sure why your plastic surgeon would say that high profile implants would damage the skin unless he/she felt they were the wrong choice for your particular anatomy. There are low, moderate and high profile implants that allow us to place a given volume of implant into a given base width of breast tissue. You may revisit the question with your plastic surgeon or seek another consultation.
I hope this helps.
Dr. Edwards
Q:
Scarring and smaller nipple in one breast
I originally discussed with my doctor getting a breast uplift but I wasn't keen on the scarring. He suggested a breast lift and also getting small implants, as the technique he suggested of cutting around the areola would leave minimal scarring. Everything originally went fine except about a week after surgery, the stitches around my right breast opened and I was left with a gaping wound. I had two options, get it re-stitched or leave it to heal itself. We decided to leave it to heal itself; however, something happened with the healing process around the incision around the areola. The scarring is very red and thick around this breast. My other breast is perfect. It has been six months since the operation and it is slightly better. Instead of looking as if I have drawn a bright red circle around my areola, it now looks as if I have drawn a loud pink circle. It is very unsightly. Also, the nipple on this breast is smaller than the left one and is quite noticeable. I don't know what I can do now to correct this. Please advise.
A:
I would recommend you return to your plastic surgeon to see what your options are for revision of the scar around your areola. By allowing time for the scar to mature and soften, the widened scar can sometimes be removed leading to a better, less noticeable scar. Only after examining you can a good idea be given as to what your options are.
Dr. Edwards