AboutAlan M. Engler, MD, FACS Expertise Dr. Engler has answered over 2300 plastic surgery questions for Allexperts. His expertise is in cosmetic plastic surgery including breast surgery (breast enlargement with implants, breast reduction, breast lifts), liposuction, eyelid surgery, tummy tucks, facelifts etc.
Dr. Engler has been listed as one New York`s Top Doctors, and as "One of the World's Most Famous Aesthetic Surgeons" (Aesthetic Surgery, TASCHEN Books, Angelika Taschen, Editor). He is the author of 4 books, including "BodySculpture" (a best-selling plastic surgery book on breast surgery, liposuction and tummy tucks), "EyeScapes" (Plastic Surgery of the Eyelids), "Restylane," and "The Slim Book of Liposuction."
Dr. Engler has two US Patents for surgical instruments that he's designed, and has appeared on numerous television shows, including The Tyra Banks Show, The Ricki Lake Show (four times), and the Dr. Keith Ablow Show. Videos of his appearances are available on YouTube (SEARCH FOR "DR. ENGLER"). His website is www.bodysculpture.com.
Experience Dr. Alan Engler is a board-certified plastic surgeon in New York and the author of BodySculpture - Plastic Surgery of the Body for Men and Women (ISBN 0966382749) one of the top-selling plastic surgery books on amazon.com, barnesandnoble.com, etc.
Organizations belong to ASAPS (American Society for Aesthetic Plastic Surgery); ASPS (American Society of Plastic Surgeons); ACS (American College of Surgeons); Clinical Assistant Professor of Plastic Surgery at the Albert Einstein College of Medicine in New York
Question About 4 years ago I had a Coehsive Silicone - moderate height moderate projection Style 410 /Inamed/McGhan Implant
for reconstruction implanted behind the muscle after mastectomy. Now 4 years later swelling and pain has become
unbearable. I have gone thru physcial therapy for tightness and swelling over the past 3 years and it really didn't help. Is there any way I can reduce this swelling, about 30% above normal size. Implant has always been very painful and unconfortable, but within the past 6 months it has become debilitating, affecting my everyday life. I have consulted with my plastic surgen over the past 2 years, complaning about serious discomfort with this implant, and his answer has always been, "give it some time". Now my pain and swelling has gone beyond anything I can handle, and I need help. I have consulted with my surgen, and he has finaly agreed to remove the implant and says he knows about this condition concerning other patients with this type implant. He sugested no physcial therapy at this time. In you opinion can I reduce this swelling and eliveiate my pain without removal of the implant? If not, what are my risk of having my implant taken out with swelling present (fluid retention)
or do I possibly have other complications going on?
Thank you so much for you help
Deborah
Answer Hi Deborah,
I'm obviously sorry for the problems you're having.
It sounds like this is a capsular contracture and when this occurs it can typically be exactly like you describe - painful, distorted, etc.
There are two general approaches, but neither involves physical therapy since that has not been shown, to my knowledge, to helpful in a case like this. The first is to remove the implant, release or remove the scar tissue (or at least some of it) and put a new implant in. That may be adequate, even if scar tissue formed the first time (though it can again, unfortunately).
The other approach - and this depends both on your anatomy and your willingness to undergo this type of procedure - is to remove your implant and replace it with some of your own tissue, typically taken from the lower abdomen. There are several different variants in this case.
You can speak to your PS about this or, since not everyone does all of these procedures, get more opinions. That may not be a bad idea anyway, just so that you can try to find out as much as possible about your options BEFORE you undergo any more surgery. An opinion from someone who can examine is obviously more worthwhile than something online...
