Your should definitely speak with Dr. Khouri about your concerns. If you wish to seek a second opinion after that be sure to see a board certified plastic surgery that has experience with major breast fat grafting cases, including revisions.
It is the usual professional standard to refer patients back to the original surgeon for revision as they know what was done and may have knowledge to correct an unsatisfactory result. However, it is also very common to see patients who have lost faith in their original surgeon, and so, reconstructive techniques may be offered in their best interest. Fat grafting is sometimes offered in stages to build desired volumes over time once the previously grafted fat has survived and stabilized. Please submit additional pictures to better evaluate your symmetry and issues for correction.
It will be difficult to give a very meaningful answer to your questions given the limited information and single image that you have provided. As a general rule of thumb one should always consult first with the surgeon who did their original surgery and let him or her evaluate the results and provide a plan to improve things if needed or possible. Dr. Khouri will know best what he did in the operating room, and he should be able to provide answers to your questions. If by some chance you feel as though your relationship with him is no longer good, then you should find another board certified plastic surgeon who can provide objective opinions about your results and what might be possible to satisfy your desires. Good luck!
No one knows your situation better than your original surgeon. And the vast majority of surgeons will want you to be happy with the results, and will work with you to try and improve the outcomes, if there were issues.
I'd suggest going to see Dr. K., and tell him about your concerns. Let him suggest what might need to be done to improve things...and then you can decide if another opinion is necessary or not.
All the best!
Pictures from different perspectives would be necessary to provide useful commentary. Fat grafting has its own set of benefits and drawbacks, and I would return to your initial surgeon for feedback.
Kenneth Hughes, MD
Los Angeles, CA
Fat transfer is still not as predictable as we would like in large volumes, which is one reason why it is important for patients to keep in touch with their primary surgeon about long-term results. A general rule of thumb is that the primary surgeon is in the best position to discuss revisions and usually wants to do what he or she can to make it better.
Unfortunately, without a physical exam, it is not possible to to tell what further breast procedures would be in your best interest. However, with regard to your second question, it is almost always better to work with the surgeon that did your original surgery than to shop around for another doctor. All plastic surgeons, regardless of their high skill or training, occasionally have surgical results that their patients are not happy with, and the result does not necessarily imply that the surgeon did something wrong. You will be much better served to discuss your concerns with your surgeon in a non-confrontational manner and work with him to see what would be your best option. Best wishes.
You should speak to your surgeon about your result!
Fat grafting is a valuable tool in breast surgery. This technique has gained more popularity
over the past 7 years. There are many
techniques used to harvest the fat, process the fat and then re-inject the fat.
Conventional suction lipectomy is performed with a small diameter cannula,
processed by separating the liquid and fibrous tissue from the fat, and then
placed into syringes for re-injection or through a closed system.
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!
There really isn't any way to answer this without front on preop and postop photos unfortunately. Please see if you can get these from Dr Khouri's office and post them.
I recommend that you voice your concerns to your surgeon. It is hard to see what is going on with only one view and no comparison with the other side. I'm sure if there is an issue that he will address it and advise you toward correction. It may be a temporary issue as well. Good luck!