- You have a double bubble and need the crease of the breast re-created.
- You need to plan for new implants although often the original ones can be reused.
- I do not think fat implants will make this better - they may partially conceal but will not fix the problem.
- The fee you are quoted may be fine for fat transplants but it seems high for what you need done, since it is a revision of your first surgery. Best wishes.
but if you like your size and breast location, focus on the fat grafting. Many surgeons would consider this a 'revision' unless you were told about this before your procedure and would come with reduced costs. Otherwise the other options mentioned by the others could be pursued but would require returning to the OR, new smaller implants, and surgery that is unpredictable (elevating implants). Round implants of the same size would have created the same result. When my patients are faced with the possibility of a double bubble, they are asked to choose between being the size they would like or be smaller to avoid the crease. In my opinion, the upper pole being level is much more important than the appearances of the lower pole since that is what the public sees, unless you always exposed.
It appears from your pictures that you have implant malposition.This problem will not resolve over time without treatment. There are several options that are available to correct this problem. Capsulorraphy , tightening the pocket around the implant would be one of the most common procedures to reduce the double bubble. Capsulorraphy is the option that I would recommend for your case. Another option would require changing the location of the implants from sub-muscular to sub-glandular. Fat grafting is also another option. However, it is possible to get fat necrosis or scaring from the fat grafting. This problem isn't related to the shape or style of implant. While I personally don't charge for revisions this is something that should be discussed with your surgeon.
Your surgeon sounds like someone who is experienced with breast surgery. Style 410 implants are implants that not every surgeon is comfortable using because there are a few more technical challenges during planning and the surgery than with round implants. Fat grafting to correct double bubble deformity is also a newer technique, some might even say "cutting edge". Other options are available too, like changing from under the muscle to over, or revising the scar tissue capsule internally. As far as paying for revision surgery, this type of situation is handled differently by different surgeons depending on the discussions and educational process that take place prior to surgery. While the experience has probably been disheartening to you, probably the main thing for you to do at this point is have clear and consistent conversations with your surgeon. Only by understanding the options, the risks, and the benefits will you be able to make choices that work best for you, and your surgeon should help guide you during this process.
More history is necessary but if the implants are sub muscular the vector of force from the pectoralis muscle can push the implants in an inferior direction. This can be corrected with silicone gel implants in a sub glandular position. I personally do not charge my patients for revisions.
I am sorry to hear about the concerns you have after breast augmentation surgery. Based on your photographs, you seem to be experiencing some degree of breast implant displacement ( breast implants sitting somewhat low on your chest wall and low in relation to the nipple/areola complexes). Revisionary breast surgery may be helpful in improving your situation. Although there are often several ways to approach a specific “problem” in plastic surgery, the approach I would use in your case would likely involve internal sutures (capsulorraphy) to “reconstruct” the inframammary fold areas. This procedure involves removal of a segment of breast implant capsule among the inferior/lower aspect of the left breast implant pocket. The 2 edges of capsule tissue are sutured to one another. This procedure reduces the size of the implant pocket and prevents the descent of the implant on the left side. This procedure will improve the symmetry of the breasts and the positioning of the nipple–areola on the breast mound.
I hope this, and the attached link (dedicated to revisionary surgery concerns), helps.