Breast Augmentation CC or Something Else? Second Opinion? (photo)

Hello. I had a breast augmentation on Feb 24, 275 cc, silicone, with a inframammary incision. I had my 3 month post op last week and my plastic surgeon is concerned because of my asymmetry. My right breast has dropped and is soft. My left has not dropped and is somewhat firmer. He said it could possibly be cc and wants to see me in 2 to 3 months. Is there anything this could be besides cc? He is only recommending using a compression band and massage for now. Any other recommendations?

Doctor Answers (11)

Your Right Breast Is Too Low

+1

Thank you for these excellent photos.  I am not sure why the left breast is a little firm, but when I look at your photographs, the inframammary fold on the right is below the inframammary incision whereas on the left, the fold and incision are at the same points.  Assuming that your plastic surgeon placed the incisions on the crease on both sides, then it would appear you are having a little bottoming out on the right and the left one is correctly positioned. 

Your plastic surgeon is the one person who can answer exactly what is going on.  Because of your interesting situation, I don't think it would be inappropriate to share with your plastic surgeon the many helpful comments made by the Real Self team of Board Certified Plastic Surgeons.


Honolulu Plastic Surgeon
5.0 out of 5 stars 227 reviews

Breasts Asymmetry After Surgery

+1

Hi,

 

Thank you for sharing well-taken photos.

Looking at the 4th (last) photo, it seems that you elevate your left side more than your right one; a trait that is not well detected in other photos but it is present.

This means that you have a deviation in your spine that is causing your to see that the left breast is higher than the right one - it did not drop.

Capsular Contracture cannot be ruled out and physical examination is important.

I recommend that you keep your surgeon in the loop of your progress and to follow his/her instructions pretty well; your surgeon knows the full details of your surgery.

 

Thank you for your inquiry and the best of luck to you.

Dr. Sajjadian

Ali Sajjadian, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 125 reviews

Asymmetry after breast augmentation

+1

Breast asymmetry is very common.  Most women have some degree of asymmetry and in many cases there is more to it than differences in the breast shape or size.  Many women have differences with their ribs or shoulders or their spine creating secondary asymmetries with the breasts.

You do have a difference at this point and I would follow the recommendations of your plastic surgeon at this point.  You should be guided not by the fact that there is a difference because I would bet that there was some difference before surgery but by whether or not you notice it in clothes or a bathing suit.  If you have to cover it up then I think a more aggressive treatment may be necessary.

I agree with massage, I don't think the band will help.  There is some evidence that the drug singulair may help.  I noticed another physician recommended Motrin and I think that is OK to try as well.

Thank you for the pictures and best of luck.

Ralph R. Garramone, MD
Fort Myers Plastic Surgeon
4.5 out of 5 stars 24 reviews

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Implants and appearance

+1

It is difficult to comment without knowing how you started out.  Was there significant asymmetry before?

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

Firm high breast implant

+1

You are three months out from your surgery. The left breast is still higher and firmer. I wonder if you had breast asymmetry before surgery. Either way, I think your plastic surgeon is giving you the right advice. message, compression and time will help. It may take up six months and sometimes longer for the breasts to settle.

Moneer Jaibaji, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 6 reviews

Your shoulder asymmetry is contributing to this breast asymmetry.

+1

Thank you for the question and the excellent images.  They clearly illustrate your situation.  I would agree that there could be some degree of CC especially if the two implants have different firmness, different ROM etc.  Another major contributing factor is that you have significant shoulder asymmetry (likely related to scoliosis) that was present pere-operatively.  The left shoulder is far higher than the right.  You need to loosen the shoulder strap on the left side so that the left implant is not held as high.  This will decrease the support of the implant and allow it to fall into a more symmetrric position.  The goal is to have the implants look like they are more level (and soft and natural) not equal distances from your shoulders.  Loosening the bra on the left significantly, wearing the compression band and doing regular ROM exercises will likley improve your situation.  If not improved, medications and lastly surgery will create better symmetry.  All the best.

Scott Barr, MD
Sudbury Plastic Surgeon
4.5 out of 5 stars 15 reviews

Breast Implant Asymmetry Causes?

+1

Thank you for the question and pictures.

Besides encapsulation, differential breast implant “settling” and/or pocket dissection may explain the breast asymmetry that you are experiencing. Either way, I would agree with your plastic surgeon that it is too early to consider revision breast surgery at this point. I would continue to follow his recommendations as you are doing.

If this degree of breast asymmetry persists, revisionary surgery may be necessary depending on exactly what the situation is several months from now.

Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 781 reviews

Asymmetry issues

+1

The pictures you submitted are better than most. Look at them carefully. Look at the tops of your shoulders. Put a ruler to it. Then put a ruler to your nipples. Finally, put a ruler to your infra mammary fold. What you may find is that you have a crooked spine and you hold your left side higher. The pictures with your hands at your sides show that to me. I bet it shows on your pre operative photos as well. Capturing the tops of your shoulders is key to seeing the origin of the problem. As far as firmness, early daily use of singular and Motrin may be of benefit. I wish you well.

David Janssen, MD, FACS
Oshkosh Plastic Surgeon
5.0 out of 5 stars 5 reviews

Breast asymmetry, possible capsule contracture

+1

A Preoperative photo would also be helpful to answer your question.  It looks like your right nipple may have been slightly lower than your left before surgery and now the asymmetry is magnified.  I would continue with the displacement exercises and compression band on the left side while giving things more time to heal.  If it is not capsule contracture, you may still need to have the fold lowered in the left side.

Leonard T. Yu, MD
Maui Plastic Surgeon
4.5 out of 5 stars 20 reviews

Capsular Contracture?

+1

Dear NewGirl11.  This could be a capsular contracture or asymmetric pocket dissection on the day of surgery.  Massaging and elastic bands may help.  Taking antioxidants may also help.  Some surgeons prescribe the same medications taken by asthma patients for capsular contracture, but I would warn you that these drugs have side effects including liver damage which could be fatal.  We purchased a laser made by Erchonia that can help soften early capsular contractures. The laser energy penetrates the skin and weakens the scars.  It's a painless procedure. You may want to see if someone in your area has this type of laser. 

Victor Ferrari, MD, FACS
Charlotte Plastic Surgeon
5.0 out of 5 stars 21 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.