Deformed Breast Implant 3 Weeks Post-op

I am exactly 3 weeks out from a breast Augmentation, and crescent lift on my Right Breast. I did submuscular saline, 550cc on Right, and 600 on the left. My concern is very obvious, as I am attaching a photo. Please provide your best advice. I am doing my massages, and taking Vitamin E 400iu bid. I am extremely concerned as the right breast has not changed since my surgery, and not seeing any improvement. I am so upset I don't even want to look at them right now. Thank you

Doctor Answers (17)

Reasons for Disappointing Breast Augmentation with Lifting

+3

Most of us would agree that to get the best result, a worker needs to
- clearly understand and plan the job before him
- select and use the proper tools
- Use the ideal technique for THAT situation

While your pictures are useful, they were taken in a mirror (are flipped R=L) and we are missing the crucial BEFORE pictures. You are ABSOLUTELY right that your " concern is very obvious". One of the breasts shows a VERY high breast implant (from your wall comment, I am assuming it is the right). But - the photograph to the left shows a mild crescent lift marking on the breast closest to us (? Left breast) suggesting this was given to you as an option AFTER the surgery because on the same photograph the overly high implant (?R) is clearly present.

Without your description, 9 out of 10 surgeons would assume you were demonstrating a capsular contracture on the right(?) in older implants rather than a 3 week result of breast augmentation with a crescent lift. If this is the case, barring any other information, I think using a crescent lift in you was a miscalculation because such a lift CANNOT remove close to the excess of breast skin you have. Instead, you SHOULD have had a lollipop type breast lift AND the breast pocket could have been better dissected.

It may be best to get a second opinion from a respected American Society of Plastic Surgeons member to get to the bottom of things. This will either sway you to having a corrective procedure in a few months OR, you may find out that I am wrong and that waiting things out will correct things.

Good Luck.

Peter a Aldea, MD


Memphis Plastic Surgeon
5.0 out of 5 stars 60 reviews

To lift or not to lift (the breast), that was the question...

+2

Patients often come to the office looking for breast augmentation thinking that a big implant will give them a bit of a lift and augmentation. The truth is that if you have a sagging breast and put a large implant in, you will end up with a bigger sagging breast. It seems that you and your surgeon chose to try a very small lift and large implants when the amount of sagging probably would have been better corrected with a more complete lift.

Now that you find yourself in this situation, the question is what to do about it. In my opinion, no amount of massage (or any other intervention) is going to get that left implant into a good position. Also, it is hard to tell if the breast will look good even if the implant is in the right place. Without examining you I can't really tell you what exactly would be needed to improve things, but I can say that it is very likely that you need a lift and probably repositioning of one or both implants for the best result.

I host a radio show every Saturday and next weeks show is about Mommy makeovers. On that show we will talk a little about breast lifts and augmentation. In the next few weeks we will also do a whole show on breast lists and augmentation. You may want  to listen in. You can catch the show on the network website voiceamerica.com or in iTunes under podcasts. The show is called New Reflections.

I know you are disappointed about your results at this point. Breast surgery can be very challenging and often doesn't work out exactly the way it is planned. It's not uncommon to need a revision. But don't worry, you CAN achieve very nice results. Just try to remain patient and know that things will be better at the end of the process.

I hope this info helps!

Adam Rubinstein, MD
Miami Plastic Surgeon
5.0 out of 5 stars 10 reviews

Your crescent lift didn't solve your ptosis problem.

+2

At 3 weeks, you are still early in the healing process, and I would hope to see some implant position improvement as time goes by. But that assumes you didn't have much bleeding inside your pocket (to cause early capsular contracture), that your surgeon performed adequate inferior pocket release, and that your implant size is adequate to fill all your loose breast skin.

That is a fair number of assumptions!

Any one of them could cause your result to continue to be bad, and revisional surgery to be necessary. I am concerned that the first error in judgment occurred when you were advised by your surgeon to have a crescent lift when in fact he drew on your left breast (photo in mirror reverses the sides, as your bandage on the right breast identifies clearly) what he planned and presumably did on your right breast. The crescent he drew shows that all you got for your "lift" was about 2-3mm of upper areolar stretch and likely NO change in nipple position at all. And this was advised for a breast that has at least borderline grade 3 ptosis or full grade 3 ptosis for which a modified or a full Wise (anchor) lift should have been done.

For now, there is nothing to do but decide if you want to have this surgeon revise your breasts, or start doing research on who IS experienced, ABPS-certified, and would be willing to see you about a revision. It's too early now for any kind of touch-up (or major revision) surgery; you should wait a minimum of 3 months (6 would be better). Continue to follow your doctor's advice unless all trust has broken down. If so, see several ABPS-certified plastic surgeons now who can advise you on he best options for correcting your situation. This will be an expensive undertaking, so be prepared. I'm sorry that your experience has been so difficult--please let us know how this came about so other patients can perhaps avoid your situation, just like my patient in the link below. Good luck!

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
5.0 out of 5 stars 123 reviews

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You will need revision

+2

The pictures shows that your implants are under the muscle and your breast tissue falling off the implant. I would say that you had the wrong surgery. You have moderate ptosis and your surgeon tried to give you the lift and enlargement at the same time and it failed. I see a lot patients with same pre op issue and when I discuss the need for the lift,patients do not want scar and they find another surgeon to do the surgery.They usually  come back to me with same problem as yours later . You will need to have your implants replaced with smaller implant and you will need mastopexy. 

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.5 out of 5 stars 56 reviews

Breast implant results

+2

Thank you for including pictures.  I'll do the best I can with the pics provided.  You may consider posting preoperative photos.  These are essential in analyzing results if available.   It looks as though the left breast has the classic "Snoopy Deformity".

the term "Snoopy Deformity" is used to refer to the profile appearance of the patient’s augmented breast, when the breast tissue is sagging or ptotic, the nipple is too low and there is excess skin. The implant is correctly located but the breast tissue sags over the inferior edge of the implant.

Most plastic surgeons agree that submuscular implants lead to the most favorable long term outcomes by reducing the risk of capsular contracture and providing a more favorable breast contour.  In this case, the submuscular implant is high and the breast tissue remains ptotic (droopy).  This usually occurs when no mastopexy (or an inadequate one) is performed.  My best advice would be to keep massaging and giving this time.  The implants will likely descend more.  If at six months you are still unhappy, you will have to re-evaluate your options.  It is too early to be thinking about revision surgery, but this may be necessary in the future.  Keep in close contact with your surgeon and do not be afraid to address your concerns. 

Hope this helps!

 

Jason R. Hess, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 7 reviews

The key is close evaluation

+1

I agree with your assessment. The substance of the breast tissue needs to be lifted and potentially augmented rather than a simple augmentation and/or cresenteric lift. I am not optimistic that time will solve this issue. You should visit with your plastic surgeon and communicate your displeasure. Best of luck on solving this issue.

Raj S. Ambay, MD
Tampa Plastic Surgeon
4.0 out of 5 stars 14 reviews

Likely Solution: Smaller Implants Plus More Involved Breast Lift

+1

Hello,

You have distortion from too large a pair of implants and inadequate lifting. Crescent lifting is only a minor touch and will not change shape much. It looks like you probably had tuberous breasts and have had correction with a technique that didn't do much for you. I'd need to examine you to be sure but would likely down size your implants and perform a more involved lift to improve your appearance.

 

Best Regards,

 

John Di Saia MD

John P. Di Saia, MD
Orange Plastic Surgeon
5.0 out of 5 stars 23 reviews

A revision is more than likely to be necessary.

+1

Based on your postoperative photos, I see why you are concerned. The implants are in poor position. The left breast is essentially falling off the implant. Also, these are large implants and appear too wide for you breast width. BEFORE photos are imperative in a case such as yours to understand what the initial concerns were and what you needed for them to be corrected. The bottom line is, although some improvement may occur, a revision surgery will be required to correct this.

David Bogue, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 12 reviews

Post aug

+1

You are only 3 weeks out and they may drop.i would wear a breast strap across the top of my breast and massage a lot.they may drop.

Robert Brueck, MD
Fort Myers Plastic Surgeon
5.0 out of 5 stars 17 reviews

Breast implant issues

+1

It would be nice to see pre-ops and examine you in person. You should go in to see your doctor and discuss your concerns. It is still early post-op.

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