Nicole’s ImplantInfo

Q: Questions about Scars and Healing
Dr. Edwards, I had a re-do to silicone after 9 years with saline about 18 months ago. My original incisions were transaxillary and invisible at 6 months. This time I have crease incisions. They are very slowly fading and are mostly pink on the sides of a very thin white line, but one area about 1 inch long is still darker red/purple and a little firmer/raised. How much change can I expect? Every other surgical incision that I have ever had has completely faded into a thin white line without assistance. This time I used 3M Micropore tape for about 6 months and then Mederma for another 9 months. Thank you for your help. I am trying to be patient.

Dr. Edwards:
It is hard to say why one scar or a portion of a scar heals darker than others. Someone will get a Nobel Prize when they figure out how really to modulate how scars heal. There are a number or treatments used in scar treatment but pressure therapy in the form of tape or silicone strips and some topicals seem to be the most common. In some occasions an injection with a low concentration of Kenalog (steroid) may help. I would discuss this with your plastic surgeon. I wish you well. Dr Edwards

Visitor Response:
Thank you Dr. Edwards. I was hoping that I just needed to be patient. I will schedule an appt. with my PS and see what he thinks. This is the first time that I've asked a question, but I have read many of your responses over the years. Thank you for all the help you provide!!!

Dr. Edwards:
You are welcome

Q: Do I need Straps?
Hello...I went on 2 consults and one of the doctors said that I would have a strap on top of my breast to help them settle in the pocket, the other said that I would not need a strap. What is the right way? Strap or not? Should or can you request to have a strap? A second question I have is about scarring. Do you use silicone sheets or micropore tap? Is one better than the other or is it personal preference? Thank you!!

Dr. Edwards:
I personally use a bandau strap for 2 weeks in most of my patients. It is a matter of personal preference between plastic surgeons.

Visitor Follow-up Question:
A second question I have is about scarring. Do you use silicone sheets or micropore tap? Is one better than the other or is it personal preference? Thank you!!

Dr. Edwards:
I like to have my patients treat their scars with either silicone gel strips or Dematix which is one of the newer topical applications. Dr. Edwards

Visitor Follow-up Question:
Thank you Dr. Edwards. If I decide to go to the PS that does not use the strap would it be alright if I asked for it? Can it do any damage with different PS techniques?

Dr. Edwards:
You would probably do best following what your plastic surgeon recommends but it would not hurt to ask. Best of luck. Dr Edwards.

Visitor Response:
Thank you for your help!!!

Dr. Edwards:
You are very welcome. Good luck.

Q: Capsular Contracture:
I keep reading about it and am curious what it is, how do you know if you have it and what can be done to prevent it? Sorry so many questions but it seems to come up a lot.

Dr. Edwards:
Capsular contracture is the result of the scar that heals around the implant (called the capsule) healing tightly around the implant. The prevailing theory is what is referred to as a low grade infection. It can also occur as a result of bleeding around the implant (blood acts as an irritant). Prevention starts with the surgeon’s technique in the operating room including the type of irrigation, the way the implant is handled and post-operative massage in smooth implants. This is a good question that you need to discuss openly with your plastic surgeon before your surgery. Dr. Edwards

Visitor Response:
Thank you

Dr. Edwards:
You're welcome

Q: Is Silicone Safe?:
If silicone is safe, does it really matter if it ruptures?

Dr. Edwards:
There are many women who have older generation implants that have leaked only into the scar that surrounds the implant and they do not know it until they have either surgery or an MRI. It is a good idea to have any implant that has lost integrity changed but other than local complications such as firmness, capsular contracture, etc. there are no documented systemic problems.
Dr. Edwards

Q: Pain near my Sternum:
Dr.Edwards: I am 7 days post op. I had 450 cc silcone under on my left breast which was the smaller of the 2. My right breast is 425 cc. My left is killing me right near my sternum, laying down I feel it pulling and I have a huge bruise in my sternum area. That is the most painful for me, did I break my sternum or is it just really bruised. It hurts so bad when I cough and sneeze, otherwise I am feeling pain free other than at night, I wake up throbbing. Is this normal?

Dr. Edwards:
The best thing to do is to see your plastic surgeon so that they can examine you and treat your pain. The reason you have bruised is bleeding under the skin. This in and of itself will make you sore. I really do recommend that you see your surgeon for evaluation and treatment. I wish you well. Dr. Edwards

Visitor Follow-up Question:
Thank you. Do you think that I may be bleeding right now still or should I give it a couple of days to maybe get better. It seems to be the only thing really bothering me besides feeling throbbing at night and occasional burning?

Dr. Edwards:
If the breasts appear to be the same size, chances are there is no on-going bleeding. You might also try some iced compresses with something to protect your skin. Also, if you had any surgery around your nipple and areola, talk with your plastic surgeon before you use iced compresses. Dr. Edwards

Visitor Follow-up Question:
I actually had a crease incision and the breasts are pretty close in size. The pain in the sternum area seems to be closer to the breast that was the bigger of the two with the bigger implant which was 450cc. My back also has been killing me due to sleeping on my back. It hurts to the point of a burning sensation getting up and laying down to go to sleep. Could it be broken?

Dr. Edwards:
Your back may be sore because you are protecting or guarding the sternum. If you are really unable to control your pain or breathe somewhat comfortably at 7 days after surgery, I think you need to call you PS. If you were my patient, I would want to see you. Dr Edwards

Visitor Response:
Thank you Dr. Edwards. I am going to call him in the morning. I was feeling great and now it really hurts me probably a 7 in pain and I am not taking any meds anymore. I appreciate it.

Dr. Edwards:
Best of luck. Dr Edwards