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Recommended for: Botox Brazilian But Lift +9
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Any foreign object and is introduced below the skin level will develop scar tissue around it. It doesn't matter if it's a breast implant, pacemaker or glass from a car accident, all will develop a capsule of scar tissue. The body doesn't like foreign objects and therefore wants to wall them off. A lot of study has gone into breast implants to determine rates of capsular contracture. What we know is that any implant placed above the pectoralis muscle has a relatively high rate of capsular contracture. However, the rate capsular contracture for textured implants is lower than that of smooth implants. That being said, when placed under the pectoralis muscle both the rate of textured implants and smooth implants drops significantly. The rate for smooth implants is about 5% and the rate for textured implants is about 4%. Finally, if the implants are placed fully under muscle, usually pectoralis and serratus muscles the rate is nearly 0%. Overall, it doesn't matter who the manufacturer is, saline or silicone, smooth or textured, round or contoured etc. if you've developed capsular contracture several times in the past you're likely to get it again.
Hypersensitivity after beast surgery is not an uncommon situation. If caught early on I have my patients massage the nipples for five minutes twice a day. This over stimulates the nerves and they essentially reset to their normal function. After four year I suspect this may not work. However, it is worth a try. At this point I would try a medication that is specific to nerve pain, namely Gabapentin. If this doesn't work you may need steroid injections into the nerves or a nerve ligation. This isn't an ideal solution as it will leave the nipples numb. Finally, there is no guarantee that removing the implants will improve the situation. In fact I suspect it won't help at all. I would suggest you see a pain management specialist.
So not sure why you want a breast augmentation as you have very beautiful natural breasts. However, let's discuss each option. First, round vs anatomic (teardrop). If you take a round implant and hold it by the edge what happens? Well, it turns into a teardrop. A smooth round implant is dynamic as it rolls around in the pocket and will always be in the anatomic shape when it's in the pocket. Anatomic implants are great for breast reconstruction after mastectomy. However, they give a strange, weak upper pole, look when used in augmentation. And, they don't move!! Breast implants should move to better emulate a real breast. Next, NO FAT GRAFTING!! Most fat that is placed into the breasts dies. When it dies it will either reabsorb or turn into hard fat masses that will give you lumpy bumpy breasts. I have had several patients get this done and it's not easy removing these lumps. Finally, the only time implants should be place over the muscle is in body builders or power lifters. Otherwise the risk of capsular contracture is so high it's just not worth it. And, visually under the muscle looks much more natural. Size is determined by trying on the implants. For my patients we use a VERY tight sports bra and a white tank top. They then put the implants in the sports bra. I don't tell them the volumes until they've chosen the size they want. It's a long process. If your surgeons are explaining all of this to you go to one who will.
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