Hi, I had breast augmentation on dec 27th 2012, so 12 weeks now. right breast: 400cc mod+ smooth the surgeon lowere the crease, this breast was a bit smaller and a bit saggier, left breast: 375cc mod+ smooth At 3 months post op my right has dropped, even though it has the bigger implant and my left is still very high. I wore the strap (still wearing now) and been massing my breast religiously, my left is souple, I m wondering if i have CC or the pocket has not been done properly
My Left Implant So High at 3 Months Post Op. Why? (photo)
Doctor Answers 9
Early asymmetry following a breast augmentation
Symmetry is the curse of plastic surgery. You seem to have a relatively minor difference in the shape of the breast implant capsule. I would continue to massage your breast as directed for the next 3 months. If your problem does not autocorrect then you may need a revision. This may include a release of the lower portion of the capsule.
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Unfortunately, even when your surgeon positions them correctly at the time of surgery, implants can heal with a mind of their own. It looks like your left implant is high and medial. Usually a simple revision in the office is all the is needed to reposition the implant.
My Left Implant So High at 3 Months Post Op
The breasts look pretty even in the before photo, so that cuts down on the possibilities, which include--
- capsular contracture. You don't mention if the left implant feels firmer than does the right. If so, that might be the explanation, and treatment for CC should begin.
- implant hasn't settled. It is not uncommon for the implants to be high riding for the first few months, and to settle and the pectoral muscles relax to accommodate the implants. This can take up to 6 months. The arms up view seems to show the implant pockets are even, so this is my likeliest guess.
- pocket dissection was uneven. I think you had crease incision, and it is hard to make the pocket not low enough with this incision--too low, yes. And again, with arms up the lower part of the implants seem even.
All this is hard to analyze on photos alone, so a discussion with your surgeon based upon an actual exam will be more productive.
All the best.
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Left implant still not dropped
Thank you for all the photos. Sometimes implants do not fall into the pocket as well as we would like. It does look like it is higher. I would give it a few more months( 3 maybe). If it does not come down by then, then you may need a capsule release to bring it down. Good luck.
High Riding Implants
Yes I agree that your left breast is higher than your right one. Without examining it is difficult to tell you why but there are really only several reasons. 1. You are forming a capsular contracture, ie scar tissue formation around the left breast which is squeezing the implant and causing to sit up high. If this is the case, it seldom get better without surgery and may even get worse with time. There are some medications that you can TRY but they have never really been shown to work. 2. The left pocket, that is the location where the implant sits, was poorly or inadequately created so the implant isnt sitting down at the bottom of your crease. 3. Lastly you may, although by 3 months its unlikely, still have swelling and need more time to settle. I'd give it another month or two and if its the same or worse you likely have capsular contracture and you need corrected.
Hope that helps
Higher position implant
As mentioned the higher ridding implant may need to be released later in the course as long as it is possible with out causing a double bubble deformity. A 6 months period since surgery should be the earliest for it to be done. Continue massage for now.
Breast Implant Too High
It usually takes up to 6 weeks for breast implants to soften and settle (drop). If one or both implants haven't dropped by 6 months, surgical revision may be necessary.
Under the supervision of your PS, continue massage and the breast strap as directed. There's still a chance the left implant will settle more.
Regardless of the skill of the PS, the implants sometimes settle unevenly. Pre-operative asymmetries, often subtle, can be a contributing cause.
Thanks for your question and good luck!
Asymmetry in implants?
Your left implant appears to have had a capsule that has held it up from falling fully. Continuing to massage the implant may help, as you are doing, as there is still some time left for the implant to fall. You may need a small revision surgery to lower the implant for symmetry, which is very straight forward and the recovery for this is quite minimal.
Pablo Prichard, MD
Pocket release should fix the asymmetry
Thank you for the question and the photos. It sounds and looks like the pocket on the higher breast needs to be further released. At three months there is still time for some improvement but I suspect that you may need a capsulotomy (pocket release) to achieve ideal symmetry. In the meantime I would continue to take photos periodically and massage the higher breast downward to see if continued improvement occurs. Release of the pocket can be quite straight forward and can even be done under local anesthesia.
All the best,
Dr Remus Repta
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