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Do My Breasts Post-BA Look Uneven, Deformed and Too High?

asked 8 months ago by petitegirl5
Latest answer by James McMahan, MD
Question viewed 5,283 times
Tags: under muscle, 5 months post-op, moderate profile, unhappy

I had moderate profile Mentor 325s placed under the muscle through the armpit almost 5 months ago. I am very petite (Size 0) and have firm tight skin. My range of motion is still only 90%. Pre-surgery, I was a 32A with slightly droopy nipples (shrunk from a 32C after children. During pregnancy I grew to a 32F and my breasts looked nice, even and not droopy.) My doctor is saying I look normal, which is obviously not the case. How do you think I look? Do you think I will drop and fluff more?

24 answers to Do My Breasts Post-BA Look Uneven, Deformed and Too High?

OOPS!! Implants too high

Without seeing your pre-operative photos, I can only speculate on your appearance before the surgery, but it appears that you have a "high crease". The distance between the nipple and your inframammary crease was (and still is too short). It is an optical illusion that makes even small breasts look droopy or ptotic. The breast implants need to be placed in a lower position on the chest wall and create a "new" inframammary crease. Also, I... more

David Finkle, MD
Omaha Plastic Surgeon

Breast augmentation -getting it right the first time

Your photos show high implants, square shaped breasts and symmastia. I suspect the implant base diameter is too large for your "very petite" frame and the pocket and the muscle was not adequately freed up on the inner lower quadrants of the breast. The smooth round moderate profile style 1600 325cc has a base diameter of 12.6 to 13cm. I suspect your frame will not aesthetically hold a base diameter of more than 11cm. You can wait a year or 10 years but I do not think this will... more

Aaron Stone, MD
Los Angeles Plastic Surgeon

Breast implants too high after surgery

Based on your photos it appears your breast implants are too high and should have "dropped" by five months. You could have capsular contracture which is preventing your implants from settling. I would discuss this with your plastic surgeon to see if you need a revision to lower the implants or to downsize the implants. If you have capsular contracture (hard scar tissue) you may need this scar tissue removed as well. Best wishes, Dr.Bruno

William Bruno, MD
Beverly Hills Plastic Surgeon

Implant position too high can be the result of an under-released muscle

Hello, There is a good chance that the lower border of your pectoralis muscle was not sufficiently released thereby maintaining the implants too high on your chest. An unreleased or underreleased pectoralis muscle is more likely to be seen with implants placed through the armpit particularly when this is done blindly (a scope is not used). Fortunately, correction of this issue is relatively straightforward. It can be done through the arm pit again but I suggest having... more

Remus Repta, MD
Phoenix Plastic Surgeon

www.aaaplasticsurgery.com

Implant Malposition

Hello Pettitegirl5, Your re-posting yielded more responses this time. Please review mine again: Both of your implants are sitting too high, especially the right implant, to be considered normal. It is very difficult to make truly accurate assessments with only photographs and not conduct an actual examination, but it looks like there may be an element of capsular contracture to the right implant, and neither look like they are sitting against your natural inframammary fold,... more

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon

A combination of implants that appear to high post-operatively, and a shortened distance

Between the nipples and the inframammary fold can occur when implants are placed through the transaxillary approach. I would not be surprised to hear that you can see the implants migrate upward when you tighten your pectoralis muscles. Occasionally the implants can migrate downwards with massage and time, but more commonly your surgeon will have to go back and release the lower pole muscles to allow the implants t e re-positioned further down on the breasts. This is much... more

Michael H. Rosenberg, MD
White Plains Plastic Surgeon

plasticsurgeryweb.com

Implants too high and result is less than ideal - revision indicated

Your implants are clearly situated too high and their position will not improve with additional time. A revision is clearly indicated for you tin order to obtain a more desirable result. It is my opinion that the implants that you have right now may not be the right size or configuration based on your breast shape and body configuration. A revision using these same implants may give you a result that still falls short of being satisfactory.

Steven Turkeltaub, MD
Scottsdale Plastic Surgeon

www.turkeltaub.com

Are my breasts uneven after breast augmentation?

It looks as though you have high riding implants or "malposition". At five months after breast augmentation, the position of the implants could improve, but not dramatically. This is a common ocurrence when having a breast augmentation done through the axilla, although it is avoidable. You may require a revision either through the axilla, but more than likely, through an incision in the inferior breast fold.

Frank Agullo, MD
El Paso Plastic Surgeon

www.elpasoplasticsurgery.com

Breast implants are too high

Your breast implants are too high and at this point I would not expect them to change much. There are often subtle changes in the position of breast implants over time but by 3 months I would expect them to have settled more. I would discuss with your surgeon about breast implant revision surgery. In this case I would make an incision in the lower breast crease and further release the lower pole tissue in order to allow the implant to fully drop. The goal is... more

Jason E. Leedy, MD
Cleveland Plastic Surgeon

Breast implant position

Yes the implants are too high. i generally give 6 months before talking about revision. i think a revision may be necessary and a muscle release may be apprpriate as well in order to get your implants to the right level. good luck

Jonathan Saunders, MD
Newark Plastic Surgeon

Wait it out

You are 5 months out from surgery. My suggestion is to wait before deciding if you need a revision. They change up to 1 year. They still may become softer and drop, make sure you massage them. At one year if you decide to go ahead with a revision it might be better to use the incision in your breast natural crease, this will help the surgeon create a pocket for your implant and pull the implant down easier if that's necessary. Wish you the best!

Michael A. Fiorillo, MD
New York Plastic Surgeon

Answer to RealSelf.com for high implants

While there may be some further improvement in the position of your implants, it is unlikely that it will occur to a significant degree 5 months after surgery. I would probably advise waiting a few more months and then proceed with a revision. You also need to be evaluated for possible capsular contracture. Good luck.

Eric T. Emerson, MD
Charlotte Plastic Surgeon

www.seplasticsurgery.com

Implants are high

I agree that your implants are too high for five months after surgery. You will need another procedure to enlarge the pockets at the bottom as well as the sides. The revision can be approached either by way of the axillary incision or an incision placed in the crease under the breast mounds. Talk to your surgeon to get his input regarding the approach he/she feels more comfortable performing. Good luck!

Joseph N. Togba, MD
Oakland Plastic Surgeon

Breast implants sitting too high

Your breast implants do seem to be sitting high. If this was right after surgery I would advise you to be patient and to massage them downward, however at 5 months you most like need to talk to your plastic surgeon and consider a capsule release to allow them to descent properly. Sincerely, Martin Jugenburg, MD

Martin Jugenburg, MD
Toronto Plastic Surgeon

www.torontosurgery.ca

Axillary augmentation

The photos of you show why I do not do breast implant surgery through the axilla. I find that it is very difficult to get the implants low enough. If all I had to go on was your photos, I would remove the implants and replace them through a circumareolar incision so I could release the medial head of the pectoralis muscle and make sure that they were low enough. Actually, most of the time, I put silicone implants over the muscles which is where your breasts are.

William B. Rosenblatt, MD
New York Plastic Surgeon

The too high breast implant

The point of projection on your implant should be centered on the nipple, and it is evident from your photo that the implant is projecting above, and yes, the implants are too high. After five months there is little chance the implant will 'drop' and if you are quite unhappy you may have to consider a revision. Best of luck, peterejohnsonmd

Peter E. Johnson, MD
Chicago Plastic Surgeon

www.peterejohnsonmd.com

Not much more change is expected

I agree that the implants are high. Although the implants may drop a little more, I doubt that they will end up in the best position. A revision will probably be necessary and should be fairly straightforward. Good Luck!

Brian Klink, MD
Sacramento Plastic Surgeon

Breast implant position

1. The implants are sitting too high. I disagree that it is looking 'normal'. 2. After 5 months I would not expect the implants to drop much. This is a known problem with operations through the armpit - you get a hidden scar, but creating the pocket at the right place is more difficult. It will be very reasonable to ask for a revision/re-positioning.

Anindya Lahiri, MBBS
Birmingham Plastic Surgeon

Results after 5 months

I think the implants are too high. Not by much though. I think there is a tendency for this when BA is performed thru the axillary approach because it is more difficult to adequately release the lowest part of the muscle. Speak to your surgeon. Make sure he/she is comfortable with doing the revision thru the axilla or you may need an inframammary incision. Good luck.

Ronald Schuster, MD
Baltimore Plastic Surgeon

I think you will need a revision

Although it is possible that your implants will soften and drop after 5 months, it is not likely. Most of the time, the muscle is stretched or "torn" with this procedure, but not divided directly, unless an endoscope is used. This can result in "bands" of muscle that hold the implant up too high, I would guess that this is what has happened to you. It would be a fairly simple procedure to lower your implants into a more natural position. This could be... more

Daniel Sherick, MD
Ann Arbor Plastic Surgeon

Breast implant revision?

At 5 months post-op further changes to the breasts are possible. I have seen implants, assuming there are no problems with excessive scar formation (encapsulation) “drop and fluff” for up to a year postoperatively. On the other hand, generally speaking, I think that implants placed through trans axillary or trans umbilical incisions have a higher likelihood of malposition compared to other approaches. If revisionary surgery becomes necessary here... more

Tom J. Pousti, MD
San Diego Plastic Surgeon

www.poustiplasticsurgery.com

Implant malposition after breast augmentation

Although it is possible for your implants to drop five months after surgery, it is unlikely that they will move down far enough to make you happy with your shape. Based on your photographs, your implants appear to be too high and too close together. It is certainly OK to wait, but unfortunately, I think that it is likely that you will need some sort of revision surgery in order to obtain that look that you want.

James McMahan, MD
Columbus Plastic Surgeon