I am day 21 Post op and my right breast fold is lower than my left breast fold. I can also feel the implant in the bottom of the breast. I have 290cc saline in the right and 270cc in left. My PS is going to place an incision in muscle to move breast crease up next week. I will be 27 days post op. Do you think this is something that could correct itself in time or is this the right course of action to take?
My PS is Placing Incisions in Under my Right Breast to Move the Fold Up, Would This Be a Normal Course of Action? (photo)
Doctor Answers 14
Breast Asymmetry and Moving an Implant Pocket
Breast asymmetry can never be completely corrected, but sometimes pocket change can improve symmetry.
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Natural Breast Asymmetry and Breast Augmentation
I would not proceed with any surgery at this point. Waiting at least 3 months to allow time for the tissue to recovery would be advisable. The issue is that you have a different nipple to crease distance on each breast that was present before your surgery (natural asymmetry). This is enhanced by enlarging the breast with implants. We (PS) try to recognize these asymmetries prior to surgery and develop strategies to improve the symmetry if possible. If the patient decides to proceed and there are no prudent solutions to the natural asymmetry then the asymmetry must be accepted after the augmentation.
I would definitely wait. Your photos do not adequately show the asymmetry you describe, but regardless, I would not perform any revision for at least 3-4 months, because it takes that long for tissues to stretch and to get your final result. You may not need anything done.
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Pre-operative asymmetry vs. Post-operative asymmetry.
Hello, and thank you for the question.
Short Answer: You pre-operative asymmetry can be dealt with in two ways:
1. Same surgery with a nipple/small breast lift.
2. Two surgeries with first being an expansion procedure to make your left breast skin equal to your right, followed by the augmentation as the secondary procedure.
From you photos I can see that you have asymmetry in you breasts. Nothing to be ashamed of as most women do have asymmetry. This is something we deal with all the time. In your case, your left breast envelope (the skin and soft tissue of the breast) is longer and more stretched out than the right. This should be addressed pre-operatively in that a simple augmentation will retain the asymmetry that you already have, if nothing else is done. I would offer you one of the above two options as a fix to your preoperative asymmetry. In option 1, your left breast envelope is made smaller and at the same time as the augmentation. The advantage is its one operation, but the disadvantage is you will have scars around your areola and possible below the areola from the breast lift. In option 2, we are making the right breast equal to the left by stretching it a bit with a 'tissue expander' which is a balloon type implant placed in the area that needs to be stretched (the skin above the nipple in your case) to make a symmetrical starting point, and thus have a symmetrical result after the augmention. This is a far more natural look, but the negative is it requires two procedures.
Pablo Prichard, MD
Thank you for the question and for the photos. In my opinion I would not be performing a revision of this sort this soon after surgery. Do you see some difference that you want addressed or has your plastic surgeon offered this for a problem that he or she sees? Remember no has perfectly symmetrical breasts. Your before photos show a difference which I would expect to see after a breast augmentation. There is nothing to be lost by waiting a bit longer.
At about 3 weeks, it is a bit early to do anything. If the fold has been over dissected, then sometimes a bra or band below may help. Best to be seen in person.
Don't Do Anything Impulsive
It's way too early to consider revisional surgery...you have to let your tissues heal. One option may be to tape the infra-mammary fold under a surgical bra for a few more weeks in order to allow the tissues to "stick" and re-establish the fold of the right breast. If this doesn't work, internal sutures can be placed through either an areolar incision or incision in the infra-mammary fold to correct your situation.
Be careful, operating too soon in a non-emergency situation can lead to a specific type of infection that will make your situation far worse...be patient.
My PS is Placing Incisions in Under my Right Breast to Move the Fold Up, Would This Be a Normal Course of Action?
Based upon the posted photos I see not only asymmetry in volume but N/A location. Why not do a donut lift on the right to even out the levels of the N/A first?
Revision Surgery 3 Weeks After Breast Augmentation
Although pictures can't take the place of an actual examination, I don't see a major asymmetry. Regardless, in my opinion, 3 weeks is too early to go back for a fold revision. I suggest allowing 3-6 months for things to "settle" and then make a decision based on your satisfaction with the result.
A second opinion with another PS in your area may reassure you.
Thanks for your question and good luck!
Revisionary breast surgery on fold
It is difficult to be sure on the pictures where the fold is on the right side, but it does appear low, which would be due to over dissection of the implant pocket on the right side, and would almost certainly not correct itself over time. However, 3 weeks after surgery, the inflammation from the original surgery would make the outcome less predictable, and in general I would wait 3 months before revising.
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