I have recently had two consults and received two VERY different opinions. I have nursed two children and have ptosis on the left side, with pectus excavatum. The first doc recommended a full "anchor" lift on the left side and saline implants ranging from 325-375cc placed inframammary. Second doc advised a Benelli lift on left, silicone 425-450cc, high profile. Concerned about nipples pointing in and high profile implants. Would like to be small, natural looking D. Any suggestions?
Breast Lift/Augmentation - with Pectus Excavatum and Asymmetry
Doctor Answers 8
Breast Asymmetry with Pectus Excavatum
I would agree 100% with the vertical or anchor lift on the left. The size is up to you. I would have you try different implant sizes in your bra in my office and find what combination gives you the symmetry and size you are seeking. Implants can exacerbate the appearance of Pectus Excavatum. This can make your breasts look "cross eyed" It's tough to tell how bad your Pectus is in the photos. If it is bad enough, correction of your pectus excavatum with a chest wall implant to fill in the depression of your chest wall, may be a reasonable option at the same time as the breast implants or as a staged procedure.
Aug with pectus
I think there is no question you should use gel and not saline.Yes your left breast is sagging and i would do a donut mastopexy around the areola and do silicone gel.
Breast asymmetry - uplift and augmentation
The two opinions are not very different really, both are recommending a lift on the left and implants, and both are reasonable. The size of the implant is dictated by the base diameter of your chest. Looking at you, I would be more inclined towards the smaller implants, although it is difficult to say without examining you.
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Breast Augmentation In Significant Asymmetry Often Requires A One-Sided Breast Lift
Despite the seemingly discrepant recommendations, they are actually more similar than they seem to you. Whether you have a vertical or circumareolar lift on the left breast is not as significant as the fact that you need one. They are two breast lift methods wherein the result will not be that different with the exception of the scar locations. While it is a more noticeable scar (vertical limb), the vertical lift would probably produce better symmetry given the amount of ptosis on the left breast that you have. The decision of saline vs silicone implants is not a matter of how they will look afterwards but whether you understand their feature differences and how they will eventually fail. The size of the imlants between those two recommendations is about 25%. If your goal is a D cup, any implant in the 300 range will not get you there.
You definitely have significant asymmetry and you could use a lift on the left. A Benelli or circumareola lift may be beneficial. I would avoid very large implants because I think the right looks a bit tight. An exam would give more clarity.
Thank you for the question and photos.
I would also recommend a breast lift and probably silicone gel breast implants.
In my experience, breast implants tend to help “camouflage” the concavity, making the cleavage area look deeper. Often times postoperatively is hard to know that the patient initially presented with pectus excavatum.
Often, patients with pectus excavatum have medially sloped chest walls ( sloped towards the cleavage area); care must be taken during the breast implant pocket dissection to avoid the implants coming together too close in the sternal area.
Also, patients with pectus excavatum may have their nipple/areola complexes relatively medially positioned on their breasts; without intervention this inward leaning appearance of the nipple/areola does not improve with breast augmentation surgery.
I would suggest that you meet with well experienced board-certified plastic surgeons; asked to see lots of examples of his/her work.
Breast implants, pectus excavatum
Pectus excavatum presents its own problems in addition to the droopiness of your breasts. I would suggest a more conservative approach with doing a peri-areolar uplift, more on the lower side, and then placing the implants, silicone, on top of the muscle. Please email me if you would like to communicate to a recent patient of mine that had a similar problem. Your appearance should be improved but it unfortunately will not be perfect. Inquire about our unbeatable all inclusive special price for breast enlargement. Watch my videos.
Lift/Augmentation with Pectus Excavatum
I feel that you are the appropriate person to decide on the size of your implants (by trying on different sizes). Your pectus does complicate things a bit. Any augmentation will probably make it somewhat more apparent. I am not a fan of Benelli mastopexies and would vote for a vertical lift of some sort.
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