BL/BA Done 5 Months Ago, Still Sagging & Uneven

I had a BL/BA done in May. I was uneven which was the main reason I had the surgery. I knew in advance that I would never be 100% symmetric but was hoping to be close. Doc used 210cc saline on L side & 300cc on right. They are still saggy & very uneven. I talked to my surgeon (board certified) & he agreed I need a revision. Have I bottomed out? He said he needed to revise the lift on both sides & tighten the skin on the bigger side. I thought he would take tissue to help even them out.

Doctor Answers (10)

Asymmetry

+1

Asymmetry issues are difficult to correct completely in many cases and it sounds like you have realistic expectations.  You do have some nipple height asymmetry and the vertical distance (the amount of breast visible under your areola) is certainly more on your left than on your right.  It's hard to fully asses from your photo as it's not taken in a standardized way- especially as your left shoulder is sitting lower.  I think this 'vertical distance' is the most important consideration during breast lift surgery and that's what I believe is your biggest issue.


New York Plastic Surgeon
5.0 out of 5 stars 25 reviews

Asymmetry correction

+1

based on your photo it looks like a good result and the need for further excision is not obvious. having said that given the apparent quality from the photo I am comfortable with your surgeon's assessment and would continue to work towards your optimal result. it is very common to need a tweaking of this complex surgery, in fact many surgeons do it in 2 stages for that reason. not me. i agree with your first best effort followed by a tweak as needed. good luck

Rafael C. Cabrera, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 1 review

Revision of breast implant augmentation and lift

+1

You do not have any evidence of bottoming out from your picture. Given the realtively modest size of your implants, my estimate is that your porblem is due primarily to the amount of natural breast tissue that you have. I would stick with your current surgeon and proceed with the plan. I would caution you that achieving a "perky breast" is not a realistic goal with the amount of tissue you have.  

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 48 reviews

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Asymmetry after breast lift and augmentation

+1

Some asymmetry is not uncommon after breast lift and breast augmentation surgery, and a patient's previous asymmetries may be difficult to correct completely. It is important for you and your plastic surgeon to both agree on the expected result before proceeding with any revisions.

Olivia Hutchinson, MD
New York Plastic Surgeon
5.0 out of 5 stars 5 reviews

Augmentation Mastopexy results

+1

As you know, there is no such thing as perfect symmetry. After Breast implants and Breast lifting, there are many dynamics going on in the breast, plus gravity, so that a good result on the table in surgery, can change and be imperfect. Revisions may be required, and if there is a minor "touch-up" procedure to improve your results, it doesn't mean surgery was unsuccessful. It sounds like your doctor is willing to improve things, so I would advise following their recommendations. It is hard to assess what is actually the best approach without preoperative photos and a physical exam. 

Hayley Brown, MD
Las Vegas Plastic Surgeon
5.0 out of 5 stars 21 reviews

Uneven result after Breast Aug/Breast Lift

+1

Dear Amy,

BA/BL is one of the most difficult operations to perform.  There are 2 operations with opposite goals. BA which enlarges the breast and BL which lifts and tightens (makes breast smaller).  It is judgement that guides the operation.  Sometimes asymmetries exists after surgery.  In your case revision is warranted.  I believe your surgeon's approach is reasonable.  He will tighten the skin on the larger side and very well remove a small amount of breast tissue.

Dr. ES

Earl Stephenson, Jr., MD, DDS
Atlanta Plastic Surgeon
5.0 out of 5 stars 9 reviews

Breast augmentation together with breast lift

+1

There is not enough information in your post to answer your question. In order to assess your situation we would need to know what you looked like before surgery, what type of lift procedure was done, and where the implants were placed. It is very difficult for even the best surgeon to plan and do breast lift and augmentation procedures at the same time. Everyone is reluctant to do it as 2 separate procedures for fear of losing the patient. The problem is that the markings for the lift are placed before the implants are in. Due to differences in skin elasticity though we do not really know how the skin envelope will respond over time to the presence of an implant. In fact each breast's skin may respond differently which makes it even harder. Therefore the incidence of touch up procedures after breast augmentation with lift procedures is high. It sounds like your surgeon feels the removal of additional skin from the left side will help i.e. further breast lifting on the left. From the photos this approach appears reasonable.

Aaron Stone, MD
Los Angeles Plastic Surgeon

Breast Asymmetry post augmentation

+1

Although breast ptosis (drooping, sagging) can be slightly improved with augmentation, and asymmetry with different sized implants, occasionally the end results desired are not achieved.  One cannot tell if you had any improvement from post- op pictures compared to pre-op.  However, your surgeon should be able to correct this.  You do state that he/she is a board certified surgeon, but by what board?  It should be the American Board of Plastic surgery.  You can check credentials by going onto plasticsurgery.org.  Be sure to discuss with your surgeon any additional scarring that may result from a lift and where these scars will be.

Theodore Katz, MD, FACS
Philadelphia Plastic Surgeon
5.0 out of 5 stars 7 reviews

Breast asymmetry after BL/BA

+1

From your distant photo, there are some asymmetries visible and it sounds as though your surgeon is paying attention to your concerns and will revise you to try to get to a better place.  Stick with him/her as they sound like they want to help you get your best possible result.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
5.0 out of 5 stars 51 reviews

Follow your surgeons advice for uneven breasts 5 months after lift and augmentation

+1

Thank you for your question and photographs. The asymmetry that you have can be improved with revision. I am happy your surgeon has agreed to do the revision and would follow his or her adviceand not solicit recommendations on the Internet.

Brooke R. Seckel, MD, FACS
Boston Plastic Surgeon
5.0 out of 5 stars 36 reviews

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.