Hi, I am 6 wks post breast lift w/ implants. Prior to surgery, I was a DD cup. I'm satisfied with the size, but not with the breast shape and asymmetry in the areola. I feel I'm lacking round/fullness in the upper pole that I thought an implant would provide. Areola size is also off by 1.5 cm. The left nipple also seems to be stretched out compared to right. I know I am early in the healing stage, but will time really make a difference in shape and areola size? What are my options for revision?
6 Weeks Post Breast Lift with Implants and Unsatisfied with Shape? (photo)
Doctor Answers (7)
Augmentation mastopexy and dissatisfaction with shape.
An augmentation mastopexy is the most complex common cosmetic breast surgery. Increasing breast size while simultaneously decreasing the breast envelope can lead to all sorts of issues. Not uncommonly, women find the shape is not to their liking or the nipples are out of position. For these reasons, revisions are highest with this procedure. In your case, it is difficult to tell which type of lift you had (around the nipple only, or a circumvertical lift). Also, with no preoperative photos and only a front shot, nipple position is difficult to determine. From the photos, you have a boxy breast with uneven nipple positions. This can occur from a circumareolar (donut-style) mastopexy with implants. Particularly if the implants are of a lower projection. The breasts appear flat and wide. To improve this, I typically recommend a circumvertical (lollipop) mastopexy and possible a higher profile implant to create more upper pole fullness and improve projection. The vertical seam in the circumvertical mastopexy is a very powerful maneuver to cone the breast, increase projection, and narrow the width to eliminate the "boxy" appearance and provide the youthful look most women are searching for. The scar is a small price to pay for the improved shape of the breast. All this being said, at 6 weeks, it is too early for a revision. I recommend waiting at least 3 months so that corrections are made after the healing changes have stabilized... no sense operating on a moving target.
Continued breast ptosis after breast lift/augmentation
Thanks for the picture. You are right in pointing out it is early, are you doing any massage or wearing a bandeau (strap) across the breasts to make the implants fall more? Ask your surgeon if he/she reccomends them. I would not reccomend a revision for at least six months.
It is still rather early to consider a revision so for now I would take a deep breath and let the healing process proceed. You will have a better sense of the final result in a few months. As the other physicians have mentioned, it appears that higher placement of the nipples/areolae would be optimal. Another consideration, however, is the fact that you were already a DD and you had placement of implants. I know that you want upper breast fullness but, honestly, sometimes this is very difficult to achieve. I have had some patients proceed with a reduction/augmentation when the breast is already large and they want the benefits of an implant without making the breast excessively fuller. In seems odd to consider a reduction and augmentation but the goal is to replace the drooping breast tissue with an implant that is more likely to provide upper breast fullness.
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Unhappy with lift and implants
Though your breasts will change more in the coming months, it is unlikely that these changes will improve your results. It looks like you need more lift and skin tightening which would allow the areolas to be more even and possibly accentuate the upper pole. Discusses this with your surgeon.
Unhappy With Breast Lift / Implants Result
Although you are still very early in the post-op period, it does appear that your breasts may require additional lifting to place the nipple in the optimal position. It is difficult to see clearly, however, the upper pole appears to lack in fullness as you described. This may be a result of your pre-op breast anatomy and that should be discussed with your plastic surgeon.
The areolar asymmetry you noted may improve over time. If not, it can usually be addressed easily in the office under local anesthesia.
It is important to share your concerns with your surgeon so that he/she can help you to fully understand what to expect and what, if anything, may be necessary in the future.
6 Weeks Post Breast Lift with Implants and Unsatisfied with Shape
Appears in the posted photo the lifting part of the operation was not adequately done. Best to obtain in person second opinions.
It is not easy to discern the upper pole on the straight on view you have sent with your question, although I do get some sensation of an upper pole bulge. I do see some difference in areolar size. Several things are likely to change hopefully for the better as the implants continue to settle into position. Areolar size may well appear more even. What is unlikely is to develop more upper plie fill.
Stay in close contact with your surgeon as healing progresses. If you contemplate a revision in the future, make sure your surgeon understands your expectations, and can verify what is realistic in terms of those goals. Equalizing the areolae is quite a simple procedure, and can often be done in the office with local anesthesia.
Thanks for your question.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.