Revision for Breast Lift & Revision Done 5 Months Ago

This is a repost w/updated pic. I am scheduled for revision bl on 10/20. My breast are not similar in size or shape. My surgeon agrees that I need a revision & has decided that my skin on the right side needs to be tightened to make the breasts more even. He also said he would lift both sides a little more, using an anchor incision on both sides this time. I have diff implants 210cc &300 & am worried that by having 2 diff implants my breasts will never look similar.

Doctor Answers (12)

Revision breast lift with placement of same size breast implants

+2
Thank you for your question.  I agree with others that you need to discuss your concerns clearly and honestly and openly with your plastic surgeon.  Be absolutely certain that your surgeon understands your goals before proceeding with your operative procedure.

I agree that a revision breast lift should place your nipple higher and provides the opportunity to establish a similar breast envelope on both sides.

The marked asymmetry between the 2 sides may well be due to the larger breast implant on the left side in the photograph.  A larger breast implant will have a larger width at the base and it appears that that is enhancing or increasing the asymmetry.  The opportunity to have a breast lift revision also provides the opportunity for your surgeon to place similar sized breast implants and adjust the tissues accordingly.


Boston Plastic Surgeon
5.0 out of 5 stars 37 reviews

Biologic "Tug of War": Augmentation mastopexy (breast lift and implant enlargement)

+2

A breast lift and augmentation procedure is a complex procedure that essentially involves doing procedures that fundamentally oppose each other creating a biologic "tug of war". In one procedure you are tucking and tightening the skin envelope whereas in the other proecedure you are placing an implant that stretches the skin envelope. It requires the surgeon to overcorrect the lift as it commonly falls and settles. This combination carries a higher than average rate of revisions due to the complex interaction of the healing forces effecting the final result. This has lead some individuals to recommend a two stage approach. Others believe both should be performed in one operation with revisions used to finely tune the outcome, IF NECESSARY.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 48 reviews

Revisional Surgery For You

+1

                  Unfortunately when breast augmentation and breast lift are performed in combination, revisional surgery is sometimes necessary. This is a complex procedure with a large number of variables that need to be addressed. When baseline asymmetry is added to the equation, the problem is even more complicated.

                  Your pictures suggest several areas of concern. Your left breast appears larger, has more sag and has a greater base width than the opposite side. There’s also asymmetry of the nipple areola position with the right side lower than the left side and as a result the distance between the infra-mammary fold and nipple is greater on the left side than the right side. Both breasts appear to have residual sag as well.

                  When implants of different size are used, it can be very difficult to obtain symmetry for a variety of reasons. For instance, breast tissue and breast implants behave differently. When larger implants are present there’s more upper breast fullness. In addition, larger breast implants have larger base dimensions and often give a wider appearing breast.

                  Under these circumstances revisional surgery is probably warranted and should consist of several maneuvers. It’s probably reasonable to use symmetric implants since this is the platform that the breasts are built upon. This will also address breast width issues as well. Volume can be adjusted by removing breast tissue at the time of the bilateral breast lift which will be necessary to correct nipple areola asymmetry and residual breast sag.

                  It’s important that you discuss your concerns with your plastic surgeon. Your surgeon should be able to formulate a treatment plan that addresses your aesthetic goals and corrects your residual deformities. 

Richard J. Bruneteau, MD
Omaha Plastic Surgeon
5.0 out of 5 stars 89 reviews

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Communication is key....

+1
A combined Breast augmentation/mastopexy surgery is a complex operation. The best option at this point is to communicate your concerns and goals with your plastic surgeon who knows you well. I wish you the very best.

Dhaval M. Patel, MD
Hoffman Estates Plastic Surgeon
4.5 out of 5 stars 5 reviews

Breast Augmentation/Mastopexy Revision Concerns?

+1

Thanks for the question and pictures.

Breast augmentation/mastopexy surgery is a complex operation;  you will be much better off discussing your concerns and goals with your plastic surgeon who knows you well.  No online consultant  can come even close to giving you good advice without direct examination etc.

Again, please make sure you discuss the breast implant size issues very carefully with your plastic surgeon prior to surgery.

Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 792 reviews

Revision of breast lift and implants

+1

It is hard to commend without seeing how you started out, but no two breasts are exactly the same.,and they wil not be after the revision.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 18 reviews

Revision breast lift and augmentation

+1

Breast lift with augmentation is a complex procedure which requires matching the shape and size of the breasts and the breast implants to create fuller, uplifted and symmetric breasts. You should discuss your concerns with your plastic surgeon before undergoing any additional surgery.

Olivia Hutchinson, MD
New York Plastic Surgeon
5.0 out of 5 stars 5 reviews

Breast Revision

+1

Full Anchor R Side and Lollipop L Side Bl/ba Done 5 Months Ago. Need Revision
This is a repost w/updated pic. I am scheduled for revision bl on 10/20. My breast are not similar in size or shape. My surgeon agrees that I need a revision & has decided that my skin on the right side needs to be tightened to make the breasts more even. He also said he would lift both sides a little more, using an anchor incision on both sides this time. I have diff implants 210cc &300 & am worried that by having 2 diff implants my breasts will never look similar.

I typically try to perform the same type of lift if I have to do a lift on both sides.   This is because each lift gives a different look to the breast.  As far as implant sizes go, there are occasions that different size implants need to be used.  However if I am doing a lift they I try to remove some breast tissue so that I can try to place similar sized implants bilaterally.

Hope that helps.

Farbod Esmailian, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 46 reviews

Augmentation Mastopexy Revision

+1

Improvement in your sagging condition can be addressed by more tissue tightening on both sides, which commonly requires a full anchor scar pattern. Volume discrepancies can be adjusted with implant volume and potentially resecting more tissue on a larger, saggier side. I typically pick the implant sizes by focusing on the base width of the breast. As the implants get bigger, they get wider. It is ideal to have the implant diameter correspond to the width of your breast and chest. I find that this provides me with the best shape, fullness, medial cleavage, and symmetry.  For the other differences in shape or size,  I typically adjust that with the overlying breast tissue and skin envelope. If you are unsure about the surgical plan for your revision, you might want to get second consultations, and maintain an open, honest discussion with your plastic surgeon. There is no rush and hearing what a few other doctors have to say might give you the confidence you need to proceed. 

Hayley Brown, MD
Las Vegas Plastic Surgeon
5.0 out of 5 stars 21 reviews

Revision Balance Often Needs Differing Implants

+1

It is not unusual to need differing implants on each side when trying to achieve symmetry.  The goal is to try and balance out the widths by using different profiles of implants, and adjusting the amount of skin and breast tissue that gets removed.  An anchor lift gives the best chance of really shaping the breasts into a desired size and shape.  I would not worry about the visual difference from different sized implants - based on your pictures, you have a fair amount of breast tissue that will mask any difference.  I hope this helps.

Christopher V. Pelletiere, MD
Barrington Plastic Surgeon
4.5 out of 5 stars 28 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.