Breast Implant Revision: Q&A

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Very Asymmetrical After BA; Any Recommendations for Revision Surgery? (photo)

Had BA/BL Oct 2012. 650cc Style 20 rt side; 420cc Style 10 on bigger left side; overs. Left is flat, and the breast tissue settled at bottom of implant. Feels like implant is attached to my chest wall–soft but doesn't move around. I can push my breast tissue up onto the implant when lying on my back. PS lollipop lifted left side; still saggy. Right is getting softer but is tight b/c skin hasn't stretched yet. I am happy w/rt side. PS picked out styles/sizes of implants. Any revision thoughts?

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sagging asymmetry over muscle

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15 Doctor Answers | Asked by pianoplyr88

Doctor Answers (15)
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Asymmetric breasts.

The results you have will not correct themselves over time. In order to improve the symmetry, you require a larger implant on the left and a revision of the mastopexy. A conversion to an anchor scar mastopexy is also quite likely. Sizers in the operating room are essential in a case with this much asymmetry. I would recommend waiting at least 6 months prior to a revision however.

David Bogue, MD

6 reviews

Boca Raton Plastic Surgeon

www.drbogue.com

Significant asymmetry before and after surgery

When a patients breasts are very asymmetric, the case is certainly more challenging and obtaining perfect symmetry may not be possible. I rarely use sizers during surgery but in your case I would have before choosing the implant size. I dont know if your surgeon did but it would have been helpful. Realize that this can add to the cost of the procedure. Once the correct implants are chosen, the lift would be done. It appears that you need more of a lift on the left side. The implants also... more

Paul Wigoda, MD

5 reviews

Fort Lauderdale Plastic Surgeon

drwigoda.com

Breast lift

Your left side was not lifted enough and needs to be lifted further. I also think the implant sizes chosen were too large. Will be easier to achieve symmetry if you stick with smaller implants, such as the mid 300 cc range. You should wait about six months after your first procedure before re operation.

Very Asymmetrical After BA; Any Recommendations for Revision Surgery? (photo)

I commonly use adjustable implants when correcting asymmetry , especially in revision cases You will also require a revision mastopexy on the left

Lift revision helpful

Thanks for your pre/postop pics. It is helpful in addressing the questions you pose. Because of the existing asymmetry preoperatively, this was very challenging. I'm concerned about the large volume on the right and the long term consequences of having this heavy device stretching your breast gland and skin. I agree with others' comments that the left could be revised to improve the position of the nipple areolar complex. The implant volumes need to be closer to improve the volume symmetry.... more

Very Asymmetrical After BA; Any Recommendations for Revision Surgery?

It appears that you have 2 issues. First, the left side is still sagging more than right side. Need to have lift redone on the left. Second issue is the size of implants - you have a much smaller implant (volume), on the right and also, they are different style implants. You will probably need to with a higher profile implant (style 20), to get the size more equal. You should dicuss both issues with your plastic surgeon.

Asymmetrical after augmentation

Thank you for your question and pictures. Your pre-operative photos demonstrate a significant difference in both the shape and size of your breasts. This difference creates quite a challenge when trying to make the breast match after an augmentation and a lift. At times, a revision of the lift may be required, plus or minus and implant exchange for a different size to add more volume. You will most certainly need a revision of the lift on the left side, the timing of... more

Postop asymmetry

Agree with the other PS here. Your preop asymmetry was very significant. the degree of ptosis ( sagging) would have been better served with a full mastopexy and possibly a mild reduction to help with the size mismatch. it's important to recognize that no one is perfectly symmetric and this degree of asymmetry may take a revision procedure to improve. Be patient with your ps and let him / her know your concerns. My preference would have been to use the same implant, with a reduction... more

Breast asymmetry after augmentation

Thank you for your question and pictures. I would recommend performing a full lift (Inverted-T) on your left side to lift the areola and breast to match the level of the right. I would also recommend changing to a larger and high profile implant on the left to match the projection and size of the right. I think the discrepancy between implant sizes and styles may have been too much. Please consult with your surgeon.

Revision of breast surgery for asymmetry

You had a marked degree of asymmetry prior to surgery. It appears that the asymmetry was not totally corrected with your initial breast lift procedure. In order to establish better symmetry you will definitely need a revision of the breast lift and there is a possibility that you may need a larger implant on the left. Your plastic surgeon is in the best position to determine what is needed as well as the timing of revision.

Breast asymmetry

At 4-5 months the breasts have settled and the ptotic left one is still too low. Looks like you need a revision lift on that side.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Revision of Lifting with Implants Results in Pre-Existing Breast Asymmetry

While your plastic surgeon made their best judgment about what your breast reshaping needs were, the challenges of breast lifting with implants frequently settles out differently than how it looks on the operating table.This issue is really magnified in breast asymmetry. Your preoperative pictures show that your left breast was going to be more potentially problematic than the right side. Your results now show that more of a lift is needed on the left side with a bigger implant size. more

Redo lift with bigger implant

While it sounds like your surgeon thought alot about your case the results are not very even and the left side would benefit from revision. In my hands I would rec wait til 3 months after initial surgery and redo the lift I would probably use the same implant as on the other side and excise tissue during the lift to create a better balance. Good Luck and please seek a board certified plastic surgeon.

Revision Lift on Left Side

In this kind of asymmetry, you must make certain that the right breast implant has settled to its final position before adjustments are made on the left. You also need to make sure that the volumes are close to the same. Even in the best of circumstances, you can only hope to get close to the right side. The left can be revised with a full breast lift in the future. Kenneth Hughes, MD Los Angeles, CA

Recommendations for Revision Surgery?

First of all, with as much asymmetry as you had it is not uncommon to require a secondary procedure. It would be helpful to know if the breast size is about the same in a bra. If not, a change in size of implant would be helpful. I think also a full anchor lift is needed, with some more elevation of the areola, and reduction of the lower breast skin along the breast fold. It may be that a more projecting implant would be of benefit on the left.(style 45)... more