Los Angeles Breast Lift doctors

Hello Simona,

Although I've not performed an true examination on you, your photos suggest that your skin envelope lacks elasticity. Further, it appears that your inframammary fold is quiet a bit above you nipple, which means you have a significant amount of redundant skin that will need to be addressed.  This is never a good situation for the circumareolar mastopexy.  May I remind you that the circumareolar mastopexy is the number one procedure listed in malpractice lawsuits for plastic surgeons.  This is because it is all too frequently misapplied to people that aren't good candidates for the procedure. We as surgeons are all too willing to give what the patient desires, even if it is not what is right for them. 

If you look at my website, you will see many with the circumareolar lift, but NONE of them look like you prior to their surgery.  That is because that procedure is excellent for people with minimal sag of their breasts with good skin elasticity.  This is NOT about a minimal, 'natural' appearance versus a perky one.  This is about obtaining a shape that is natural with the finest scars possible.  Ironically, many people choose the circumareolar lift because of fear of scarring.  However, the circumareolar lift when misapplied yields conspicuous and potentially thickened scars in the wrong candidate.  In addition, the other problems associated with this lift in the wrong person includes: recurrent widening of the areola, non-circular areola, pleating around the areola, flattening of the breast mound, and persistent sagging of the breast mound below the inframammary fold.

I wanted to touch on two comments made by other surgeons. There is no evidence whatsoever that a 'Lejour' lift is any better than a standard form of a anchor lift.  In fact, there may be evidence to the contrary in the December issue of Plastic and Reconstructive Surgery.  In that article, photometric analysis of breast lifts gave objective results (not opinion) suggesting that a anchor lift gave the most lift to the bottow of the breast.  Finally, regarding placement of your implant, there is no evidence that a 'cold sub-fascial' placement of the implant is any different than subglandular placement, which is not a good option in a thin person like yourself.

I hope you make the right choice, and not one that makes you 'feel good'.  What I mean by that is if you are really adverse to the concept of scars on your breasts, maybe you should not do anything at all, rather than do the wrong thing. 

Best of luck!

Based on your photos alone you may benefit from breast implants alone however this is difficult to say without examining you in person. Your nipple position looks fairly normal. I would say "possible " lift at this time because you really will not know until you are in the surgery and the implants (or sizers) are in place. I would consult with a few board certified plastic surgeons in your area for a more in depth exam and evaluation. Your overall breast shape is pretty good which is a good predictor of your outcome. Best wishes, Dr.Bruno

Hello Margarita,

I am sorry about your problems you are having with your breast augmentation.  Unfortunately, you are experiencing two of the most common problems women have after breast augmentation: capsular contracture and implant malposition.  I can tell you with absolute certainty that both complications could have been averted if a properly sized implant was chosen for you.  Plain and simple, 500 cc is too big for you, and if you have a revision surgery keeping the same sized implant, you will probably have further complications subsequently.

Your right implant is completely subglandular now that it has dropped to this unpredictable position, causing significant tissue expansion in the lower pole of the breast which is difficult to correct.  The internal capsule will need to be sewn together, possibly with a reinforcing material called acellular dermal matrix or ADM, which is more expensive than the breast implant. Your left implant is will need a removal of all the scar tissue to minimize recurrance of the capsular contracture.  ADM might be useful there as well, as it has been shown to decrease the recurrance of cc.

Your problems are not easy to fix and even in the most experienced of hands, you may not get a perfect result.  You should see a few surgeons with great reputations for revision surgery.  These doctors will of course be certified by the ABPS and also be members of the ASAPS.