I had Saline breast implants under muscle with a benelli lift over 2 yrs ago. I am not happy with the results. My breast implants go flat in the center and fall into my armpits when I lay down, They also tend to move a lot and are not as firm or tight to my chest as they were or as I would like them to be. My areolas are quite stretched and misshapen and the scar is clearly obvious. Short of a miracle, what can be done to fix? Would an internal bra or changing to smaller silicone implants help?
Can This Be Fixed? Had Saline Under Muscle With Benelli Lift Over 2 Years Ago. Unhappy? (photo)
Doctor Answers 10
Predictable surgical changes can be accomplished...
Although no surgical procedures (as it is with life) are without risks, I believe one can make predictable changes in your breast situation. It appears that there are a few different issues occurring.
1) Your breast implants can be placed more medially (toward cleavage) by sewing the lateral 'pocket' closed. This usually only requires good placement of sutures without need of a gortex or alloderm patch.
2) The current ptosis/droop/low position of your breasts may have been present preoperatively but can be improved with an internal lift combined with an external full lift (mastopexy) to tighten and lift the lower breast pole.
3) The flatness of your breasts can often occur with a circumareolar (Benelli) lift and should also be improved with the full lift (mastopexy).
4) The type and size of implant can also affect the contour of the breast and one would have to look at the type of implant you currently have and consider other types that may improve your appearance. For example, a smooth MP+ gel filled implant may be preferable to an overfilled saline implant.
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Best Breast Revisionary Operation for Me?
Thank you for the question and pictures. Based on your description, you may be a good candidate for breast augmentation revisionary surgery. This operation, in your case may involve the use of internal sutures (capsulorraphy). Adjusting the breast implant pockets will serve to keep the breast implants in better position, when you are in different positions.
Areola reduction surgery or more formal breast lifting may be necessary to improve the appearance of the areola etc.
When the time is right, seek consultation with well experienced board-certified plastic surgeons who can demonstrate significant experience helping patients in your situation. You may also find the attached link helpful to you as you learn more.
Implants and a lift
You may need to have the pockets made smaller and possibly need a more formal breast lift. Best to be seen in person.
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Breast revision after mastopexy, augmentation, breast lift
breast revision after mastopexy, augmentation, breast lift
- changing to a lollipop would help
- consider silicone implants such as Sientra
- internal suturing to close the pocket
Doughnut mastopexy is often a poor choice.
The doughnut mastopexy is an overuse procedure. Correction of your areola can be accomplished with a more conventional mastopexy. I can't comment on the implant issue as it's unclear what's going on.
Can This Be Fixed? Had Saline Under Muscle With Benelli Lift Over 2 Years Ago
I believe that converting to a lollipop mastopexy will benefit the breast and areola shape. As far as the breasts falling to the sides, you will need a capsulorraphy, this is a procedure to narrow the pocket on the sides and possibly the fold area, as your breasts appear to have some asymmetry when you are laying down. The size of the implants can either remain the same, or you can downsize, that is a personal choice. Good luck!
Problems with a Benelli dought nut mastopexy
The main problem with the Benelli or doughnut mastopexy is as you describe a central flattening of the breast and displacement of the implant laterally as well as long term stretching of the areola. To avoid this problems and to correct your problem most would recommend a vertical mastopexy with an internal bra type inferior suspension and possible tightening of the breast implant capsule. Smaller implants will help as well.
Unhappy with augmentation/Benelli periareolar lift. Can it be improved?
Thank you for yor question and photos. This is the classic problem with the Benelli lift/augmentation. It flattens the central breast (where you want more projection) and the areolae are stretched out. The large areolae are partially due to the surgeon's technique. A permanent suture needs to be used to resist the surrounding skin's pull on the areolae. Now, breasts even in a woman who is not augmented, will tend to go towards the lateral chest wall in a supine position. In you frontal photo, it looks like you need a breast lift and a reduction of the areolae. Many times patients do not want scarring and they get this type of lift with which they are unhappy with. In theory it sounds attatrctive, but in real life this is what happens most of the time. To fix this, I personally would do a vertical breast lift and depending on the breast volume you have, might change the implants to silicone gel. Talk to your plastic surgeon or seek another opinion. Good luck.
Can This Be Fixed?
A number to things can improve this outcome. The implant position can be improved with capsulorrhaphy--closing off the outer parts of the pocket with sutures or with Strattice, or perhaps by moving the implants to under the muscle.
The areolas can be reduced, but better and more reliable would be to convert the lift to a veritical (lollipop) lift.
Too many possibilities to discuss in this forum. See your surgeon. All the best.
Breast implant revision
From your photos, you'll most likely need to have an areolar reduction or lift to help fix your areolae. To help prevent the implants from falling the side, I have a lot of experience fixing this with Strattice placement into the outside portion of the breast pocket to help keep the breast implants toward the middle. Thank you for your question...Dr. Schreiber, Baltimore plastic surgeon