Overdissected Pocket? Uneven Implants

I am 7 weeks post BA. My lefty has dropped below the scar, whereas the other sits perfectly in the crease. I am currently wearing a strap underneith my boobs, holding them at the same level and think I may have noticed an improvement. If I maintain the pressure underneith my implants, will the left pocket close backup and kind of adhere, or will i need further surgery?. My surgeon would rather lower the righty to match the left, but I really am not happy with my left side. I only have 200/220cc

Doctor Answers (7)

Adjusting breast implant position after surgery.

+2

In the first few weeks after breast augmentation the implants are malleable so that applied dressings or wraps can change the implant position and have lasting effects. The caveat is you have to do it before the capsule around the implants has matured. 7 weeks may be a bit too late for that to work but is certainly worth a try especially when the implants are not too large. You will need to give it some time to work though. The question then is if it does not work what do you do. Lowering the other side to match is easier but not optimal. For the most natural look you want to maintain the original position and contour of the fold under the breast.


Los Angeles Plastic Surgeon

Uneven breasts

+1

Hi,

  It is possible that the creases will even out but the strap at this point is questionable as far as its effectiveness.  If your plastic surgeon likes to use it and has hope for it, then use it as directed.

  Sometimes the creases have a discrepancy that needs to be adjusted.  Considering that the discussions have taken place as to the movement of one crease or the other, this might be in the works.

  Lifting a crease is less predictable than lowering of one.  The lifted crease needs to be sutured in place and can be somewhat tricky for the match.  If the lower crease is the target crease, then it is easier to do technically. 

  Discuss all of this with your plastic surgeon and you will come up with your options.

                Steven M. Lynch, M.D.  Albany, New York

Steven M. Lynch, MD
Albany Plastic Surgeon
5.0 out of 5 stars 8 reviews

Treatment of Breast Asymmetry?

+1

 Thank you for the question.

Using  the upward pressure/support that you are currently doing on the left breast may or may not be effective at 7 weeks post op. It certainly will not hurt to do so but I  have  not had great success with this method at this stage in your recovery.

Regardless, I would suggest waiting at least 3 to 6 months after surgery to evaluate the symmetry of your breasts and the potential need for further surgery. If the breast asymmetry remains significant left inferior permanent suture repair of the breast implant pocket (capsulorrhaphy) may be indicated.

I would suggest continued follow-up with your plastic surgeon in patience  as the healing process continues.

I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 794 reviews

Breast implant revision for uneven implant height

+1

IF you wear your garmetn 24x7 for 6 weeks after surgery, it is possible to influence the shape of the pcoket. However, by 6 weeks the pocket has generally formed and it is difficult to have much influence on the pocket. IT is possible that the dissection was similar and the right may drop with time, so I would recommend that you wait the 6-9 months prior to considering revision in order to perform a surgery on a stable result on BOTH sides.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 48 reviews

Uneven breasts - pocket problem?

+1

I wish I had the opportunity to see some photographs. With that said, there could be a couple of things going on here. Was the left breast initially after surgery in proper position and then dropped below the scar? I will assume that that is what happened. You have fairly small implants, however, I don't know what your breast tissue and size was like. Let's presume you are petite and had small. tight breasts (most likely the situation here). The problem may be that you have what is called "inferior pole stretch". In other words, the implant was placed in the correct place during surgery and the pocket was correctly dissected. However, your tissues reacted somewhat differently between the right and left sides. The lower part of the left breast skin has stretched more than would be anticipated for this implant. This is why the implant was OK initially and now is falling. This is a phenomena that both your surgeon and you can not control. You can minimize the risk by properly fitting the implant to the breast, but not eliminate it completely. Wearing a strap below the breast will probably not fix the problem. If it is what I am describing, then generally revision surgery is needed to reform the crease to match the right side. I would not suggest lowering the right crease based upon what you are speaking about.

Mark D. Epstein, MD
Stony Brook Plastic Surgeon
5.0 out of 5 stars 158 reviews

Surgical Options with an Over-Dissected Breast Implant Pocket and an upward moving Under the Breast Fold

+1

Regarding: "Overdissected Pocket? Uneven Implants
I am 7 weeks post BA. My lefty has dropped below the scar, whereas the other sits perfectly in the crease. I am currently wearing a strap underneith my boobs, holding them at the same level and think I may have noticed an improvement. If I maintain the pressure underneith my implants, will the left pocket close backup and kind of adhere, or will i need further surgery?. My surgeon would rather lower the righty to match the left, but I really am not happy with my left side. I only have 200/220cc
"

Without an examination, much less a good quality photograph, it is impossible to answer your question as it applies to you. However, I would like to offer you a few generalities and some advice.

There ARE NO perfectly symmetrical breasts in nature. Just as our eyes and faces are slightly asymmetric in the best of circumstances, so are the breasts where asymmetry can be hardly noticeable to most women and becomes visible only when it is extreme. There are often asymmetries in the position of the breast on the chest, the height and tightness of the under the breast fold, the position and size of the nipple and areola, the volume of the breast and the slope of the chest, among others. Breast implants often magnify a pre-existing asymmetry.

Breast REVISION Surgery begets more revisions. Each surgery has a set of inseparable potential complications and the ability of each surgery to correct a deformity decreases making more operations necessary. Do NOT undergo surgery unless the deformity is really significant because there is no guarantee that the result would not be worse.

I would bet your surgery was done via a breast fold incision. One of the draw backs of such access is that it weakens the soft tissue hammock the implants sit on making it easy for the weight of the breast to move inferiorly.

You have several options
- Do nothing and wear the strap for as long as possible - it may work
- In an office procedure put outside stitches through the skin fold under the breast (with the implant pushed up to prevent puncturing it). This will increase the contact between the chest and the skin and provide more of a chance the put the fold where it belongs
- in a few months have surgery on the left, in the operating room to repair the inferior capsule, CAPSULORRAPHY, in which the bottom is reefed and the fold is attached to the chest wall (this can be done through the same scar or through a periareolar scar
- I would NOT lower the normal breast fold on the right unless it is absolutely necessary. It easier to do but it may result in ongoing breast sagging and asymmetry.

Good Luck.

Dr. Peter Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 67 reviews

Implant position may still change over the next few months

+1

It is possible that your implant position(s) may yet change over the coming months.  I wouldn't count on that lower implant ending up at the level of the breast crease in the long-run, but it's certainly worth giving both implants a full chance to finish healing.  That can take up to 6-9 months, so give it time.

Carmen Kavali, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 23 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.