What is Wrong with my Breasts? There Doesn't Seem to Be Much of a Change? (photo)

I am 7 wks po. I had a donut mastectomy, breast augmentation with silicone, round, under the muscle 425ccs. My PS and I had agreed on 425ccs for the left and 375 ccs on the right. when I awoke from surgery he decided on 425 ccs for both. Was the mastectomy even performed. Was it a mistake to not use the smaller implant in the saggy one? Also with the lift should my aerola be smaller than it was originally? There doesn't seem to be much of a change. It has not dropped like the left one.

Doctor Answers 11

Too early to see results

You are too early on in your recovery to see the true results of you surgery. Wait a few months, but make sure to follow up with your surgeon if you still don't see an improvement. Read more about breast augmentation tips on our google plus page.

Toronto Plastic Surgeon
5.0 out of 5 stars 108 reviews

362 Fairlawn Avenue
Toronto, Ontario M5M 1T6

Breast change after donut mastopexy and breast augmentation

In the overall scheme of things you are very early in the recovery phase.

A donut mastopexy temporarily tightens and flattens the skin envelope of the breast and it takes months for the final breast shape to become apparent.

I think you should allow six months for your breasts to settle in. I think you will be pleasantly surprised at your long term result.

Douglas McManamny, MBBS, FRACS
Melbourne Plastic Surgeon

759 Burwood Road
Hawthorn East, VIC 3123

Breast Asymmetry after Breast Augmentation/Lifting?

Thank you for the question and pictures. Some degree of breast implant pocket asymmetry and differential “settling” of the breast implants is commonly seen after breast augmentation surgery. Whether or not this will be a long-term issue that may benefit from revisionary breast surgery will need to be evaluated anywhere six months to one year after the procedure was performed.

In the meantime, I would suggest continued patience and continued follow-up with your plastic surgeon.

Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,053 reviews

8851 Center Drive
San Diego, CA 91942

Donut mastopexy

I think you meant a donut mastopexy which is basically a nipple areola lift. It looks like it was done.

Steven Wallach, MD
New York Plastic Surgeon
4.5 out of 5 stars 20 reviews

1049 Fifth Ave
New York, NY 10028

Donut Mastopexy and areola size

In general the donut Mastopexy has the tendency to increase not decrease areola size unfortunately.  At 7 weeks it is still very early in your recovery and things may settle out just fine.  I usually recommend not judging the results until about 6 months post op.  Good luck.

Sacha Obaid, MD
Dallas Plastic Surgeon
4.5 out of 5 stars 41 reviews

415 E. Southlake Blvd.
Southlake, TX 76092

What is Wrong with my Breasts? There Doesn't Seem to Be Much of a Change?

Comparing the posted before and after photos I must say the result though asymmetric is better than the before. Additional revision surgery is needed. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 77 reviews

6330 Manor Lane
Miami, FL 33143

Asymmetry Resembles Pre-Operative Appearance

While it is still too early to tell for sure, it appears as if your breasts have the same shape and characteristics as they had before the surgery.  Both implants need to "settle more" so that the implant goes down and your areola go up...you should be wearing a Breast band 24/7.  Ultimately, you may need repositioning of the right areola to better match the left but first let things heal.

Eric Sadeh, MD
Manhattan Plastic Surgeon
5.0 out of 5 stars 39 reviews

140 W. 58th Street
New York, NY 10019

Asymmetry following a doughnut mastopexy and breast augmentation

At this point it is difficult to assess the if your breast volume is appropriate but the obvious problem is asymmetry.  The right implant is higher than the left and there is some degree of pseudoglandular ptosis.  This is when the implant, placed under the muscle, is held in a high position and the breast tissue sags and falls off of the implant.  It is still very early in your post operative course and with time the right implant could drop allowing the nipple to rotate into a  higher position.  If your symmetry does not improve over the next 2 - 3 months then you may need a revision.   This could include either a release of the capsule on the right side or a revision of the mastopexy.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 13 reviews

3096 Peachtree Industrial Blvd
Duluth, GA 30097

You mean

You've asked about a couple different things your PS did, and I presume because you're not satisified with the result.

First you have significant pre-op asymmtery, so persistent asymmetry is an expectation not a complication. It is your surgeons job to identify and explain this pre-operatively so you have realistic expectations of surgery.

Second although the breasts look different, I think the overall volume is similar so don't think implant size is the issue.

Last, you have circumareolar incisions, so a "donut" or circumareolar mastopexy was indeed performed. The areolar size can be adjusted based on your desired size, and this should have been discussed pre-operatively.

The question is did you need a larger, circumveritcal or inverted T/Wise pattern lift on the right, a dual plane release, lowering of the IMF or a combination of all of the above. This is hard to asses without an exam and measurements, but can help camoflague your asymmetry.

Overall, I beileve the real mistake made was inadequate pre-operative counseling about the options, your pre-existing asymmetry and your expectations/realistic results. Your surgeon is now behind the eight ball with a reuslt that doesn't match your expectations. I spend more time with my patient's pre-operatively discussing all of the above issues, as then our expectations are aligned and my post-op visits tend to be very smooth with both the patient and myself satisfied.

Evan Feldman, MD, FACS
Texas Plastic Surgeon
5.0 out of 5 stars 44 reviews

4690 Sweetwater Blvd
Sugar Land, TX 77479

2 months post-op is still on the early side

Although 2 months post-op is still on the early side, I agree with you that there is some asymmetry still.  Furthermore, your nipples still appear low.  The right breast implant is still higher than the left, and unless this changes, it will lead to persistent asymmetry too.  My best suggestion is to make your surgeon aware of your concerns early, open the dialogue and hear him out, then wait about another month or so to allow things to fully settle.  If there is not a change by 3 - 4 months post-op, I would consider a revision to reposition implants/change implant size if needed to improve symmetry.  Good luck.

Joseph L. Grzeskiewicz, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 39 reviews

9333 Genesee Ave
San Diego, CA 92121

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