Is a revision needed for my desired look, or will my implants continue to drop and give me fullness in time? (Photo)

5'9 135p 25yr Aug 2013-380cc hp saline unders armpit incision. Implants very high with too much upper pole fullness. Revision Dec 2013 510cc sientra gummy bear unders, crease incision. 7 months from 1st aug and 3 months from 2nd. Should I wait a year to lower my breast fold to better position the implant? Will I then have a visible scar across breast from last surgery? I told my surgeon to raise nipple an inch but have same positioning as first breast aug! Sad. I just want a high centered nipple

Doctor Answers (9)

Need to Wait for Now

+2
I'm sorry that you've had these problems.  At this point, it wont be safe to have another surgery until at least 6 months after your most recent procedure.  Your implants may settle a bit more, but they appear too large for you, and too high.  Looking at your pictures, you certainly had an attractive breast prior to your first surgery.  I don't think it is appropriate to comment on other surgeons work on this forum except to say that you need to consult with a surgeon who has significant experience in revision breast surgery.  There are excellent board certified surgeons in your area that could help.  I do not think you need a lift, you would definitely benefit from a better size implant and revision of your pocket.  

Best Regards. 

Dr. Schwartz


Thousand Oaks Plastic Surgeon
5.0 out of 5 stars 5 reviews

Sientra Implants

+1
Hi Luvit,
I see what you mean.  You have some very big implants, too, so that definitely plays into your profile and contour.  Yes, give it a good year from your last surgery before doing an enhancement.  Keep your PS in the loop.  I already know you are seeing a board certified plastic surgeon because Sientra only sells to BC plastic surgeons (by ABPS - The American Board of Plastic Surgery) who are members of ASAPS (The American Society for Aesthetic Plastic Surgery) and or a member of ASPS (The American Society of Plastic Surgeons). So that is great!  Perhaps an implant repositioning alone can center your nipple on the overall breast mound.  So perhaps check that idea out also with your PS.  All the best, "Dr. Joe"

Joe Gryskiewicz, MD, FACS
Minneapolis Plastic Surgeon
5.0 out of 5 stars 36 reviews

REVISION OR NOT AFTER BREAST AUGMENTATION

+1
The only way to placed your nipple in a much higher position  was using a Breast Lift incision : Periareolar (circle around the areola),  Lollipop (from the areola to the crease) or Inverted T .

You should have discussed your wishes and options with your surgeon before undergoing the 2  surgeries mentioned. 

It seems to me you could have avoided those 2 procedures and your looking for a 3rd. pending  good diagnosis and procedure  of choice from the start.

I do not know you,  but I think it may be that you have ignored   your surgeon recommendations for correction, or  you two  have no good communication at all.

Adolfo Sesto, MD
Dominican Republic Plastic Surgeon
5.0 out of 5 stars 11 reviews

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Still to high after a revision

+1
I'm sorry to hear of your plight as most revisions do tend to resolve the problem.  As yours hasn't, you should do your absolute best to help your implants settle more, unless you really like the upper pole fullness you now have.  If you do, then you're looking at having a lift down the road. Regardless of what you prefer, its suggested you wait until your implants are  well healed before considering anymore surgery. 

Curtis Wong, MD
Redding Plastic Surgeon
4.5 out of 5 stars 16 reviews

Is a revision needed for my desired look, or will my implants continue to drop and give me fullness in time?

+1
Thank you for the question and pictures. Given your relatively recent revisionary surgery, I think you'll be best off waiting at least an additional 6 months before contemplating additional surgery. If the nipple/areola complexes remain relatively low on your breast mounds, adjustment of the breast implant capsules of the lower poles of the breast may be helpful in improving your situation ( achieving a higher sitting nipple/areola complex on each breast mound).  I hope this, and attached link, dedicated to revision breast surgery concerns, helps. Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 708 reviews

Implants settle?

+1
Thank you for your question and photos.  Implants tend to settle over time as tissue stretches out and gravity works on the implants.  You have very large implants at 510cc.  This may be part of the reason you have a lot of upper breast fullness.  The position of your nipple is quite reasonable.  It should sit at the point of maximal projection on the breast.  If your nipple is too high, you can have nipple show above a bra or bikini top.  The position you are pulling the nipple up to looks to be a bit too high.  You are only 3 months out.  Give your breasts time to settle and recover.  Stay in close contact with your surgeon and they can help guide you through the recovery process.
Best of luck.

Brian C. Reuben, MD
Salt Lake City Plastic Surgeon
5.0 out of 5 stars 11 reviews

Implant position

+1
Textured implants tend to not change position, but they can a bit, and I would wait. As for fold lowering vs nipple position, if the nipple is low, then it stands to reason your probably need a lift. This may be as simple as a circumareola lift.

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

Implants dropping and nipple position

+1
Given that your last surgery was only a couple months ago, and depending on the type of implant (smooth vs textured) and the technique, you may have more settling of the implant with time.  Your surgeon may want you to do some focused massages to help this along - ask your surgeon.  The scar may rise more onto the lower breast skin, but it should be above the actual fold anyway, so you shouldn't really worry about that.  More settling of the implant will give a better relationship between the nipple and the implant.  That said, breast implantation shouldn't ever be thought of as "raising" the nipple, certainly not an inch.  If you want the nipple truly raised an inch, you need a breast lift (mastopexy). 

Douglas J. Mackenzie, MD
Santa Barbara Plastic Surgeon
4.5 out of 5 stars 19 reviews

A lift could help

+1
You are actually pulling your nipple up higher than the normal position.  We try to get the nipple complex facing off the peak of the breast from.

In breast augmentation I have chosen to spend time reviewing photographs with patients to fully understand their expectation of size and shape. Many times this simply raises more questions. I will make measurements and use the implant guides to allow the patient to understand exactly the sizes that are reasonable for their body type and measurements.

Please find an experienced Board Certified Plastic Surgeon and member of the Aesthetic Society using the Smart Beauty Guide. These Plastic Surgeons can guide you on all aspects of facial surgery, breast augmentation and body procedures including tummy tucks or mommy makeovers!

Robert Whitfield, MD, FACS
Austin Plastic Surgeon
5.0 out of 5 stars 12 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.