I had a peri-areolar lift in September 2010 and not happy with the results. First the nipples are stretched too wide and are unattractive. There is still too much gathering also. Second, the size is too large. I asked for a full C and ended up with DD's. I was told that the size would decrease after swelling went down. After 6 months, i'm still too large and very unhappy with my nipple appearance. Should I allow the same doctor to make corrections or find a new surgeon? Healing timeline?
Should Original Surgeon Carry Out Implant Revision?
Doctor Answers 12
Revision Breast surgery
Most plastic surgeons are extremely sensitive to getting the best results for their patients. Yours is a difficult situation but can be fixed. In my opinion, you needed a circumvertical or a wise pattern mastopexy augmentation to get to a C cup. This is what I would recommend even at this stage. The original surgeon should discuss and fix this issue with you. Good luck.
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The origanal plan was probably not the best best. There is no question that this should have been originally approached with a circumvertical pattern and definitely will need to be revised. As far as should you use the same surgeon. Look critically at his or her work and examine the pre and post op results of their other patients that have undergone similar lifting procedures. If that surgeon can show you at least 8-10 pictures that you would be happy with, then give them another chance, otherwise move on.
Breast surgery revision.
When a revision is needed after surgery, the logical choice is your original surgeon. This person knows you well, understands what issues arose during surgery, and will often give you a financial incentive for revision that a new surgeon would not. Having a poor outcome after elective surgery is obviously difficult for the patient, but many people are surprised to hear that their surgeon is just as upset. Most plastic surgeons take a lot of pride in what we do and we are very critical of our own results. I recommend having a straightforward discussion with your surgeon about what bothers you regarding your breast outcome. If you feel that your concerns are being pushed aside, then seek a second opinion. There is a benefit in giving yourself more time to heal as the breasts will certainly change significantly over the first 3-6 months. This often results in resolution of some concerns, and makes any revision surgery more predictable.
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Revisional breast surgery
This is a very, very tough revision case. I would consult at least two other plastic surgeons and make sure you see examples of their work. You want a "go to" surgeon for breast revision. I wonder if your surgeon was "talked into" a periareolar lift, maybe against his/her better judgement? The indications for a periareolar lift are very, very limited in my opinion. I often see patients who flip out at the thought of a vertical scar on the lower breast but that is often what is needed for the best shape and I think shape should almost always take priority over scars. So be upfront with your surgeon and get a couple of second opinions. Your surgeon will want you to be happy regardless of who does the revision. Good luck.
Lisa Lynn Sowder, M.D.
Benelli mastopexy, breast uplift,breast implant revision
A benelli breast uplift or one where the scar goes around the areola may cause spreading ot the areola like yopu have experienced. It usually does not reshape the breasts but actually may flatten it. Your implants can also be reduced in size. Whether you go see your present Plastic Surgeon or another is if you still have confidence in him/her to give you what you want. Fortunately, I do not revise many of my breast implant patients for we decide together what can/cannot be done and talk extensively about the sizing.
Get second opinion before revision
This is always a difficult question. It is always a good idea to get a least another opinion. Second, what was your original experience in the office? Were all your questions answered, were the pros/cons of different approaches discussed, did you feel respected and informed by the physician and staff, was there pressure to commit to the surgery right away, were your concerns minimized? If you have a good relationship with your plastic surgeon, if he/she is not defensive and is open to discussion, if you trust their skills, then consider having the original surgeon perform revision. However, if in retrospect, things don't seem right or you would have chosen a different surgeon, I would recommend a second or third opinion and possibly consider another surgeon to perform the revision.
Tracy M. Pfeifer, MD
It may be helpful for a second opinion
If you have not lost confidence in your plastic surgeon, it would be best usually financially, and also because he knows what he did, to stay with your original plastic surgeon. If you have lost confidence in your plastic surgeon, you should look for another opinion. In looking at your photos, there may be a few things worth addressing for best results. Of course you need to come in to see what needs to be changed. If it is doing a lift and removing some skin or some lower breast tissue, there are some things that need to be changed. As a general thought, I would say that you "to do the same things and expect different results is insanity". Good luck in your efforts
Dan Mills MD FACS
Breast implant revisions
If you are not happy with your size or shape you should express this clearly to your plastic surgeon. I would recommend you seek out a second opinion or even a third opinion to have a different perspective.
Give your surgeon an opportunity to help you, but if you have lost faith in him/her, then a second opinion may be needed.
Revisoin breast lift
If you have faith in the doctor, then absolutely let him try to correct your concerns. I do not know of a doctor that would not want to make their patient happy with their results.
I would suggest talking with your original surgeon about your concerns. I agree that you need a revision to maximize your results. While you would need an in office examination to make specific recommendations, I would like recommend a conversion to a traditional mastopexy and placement of a smaller implant under your muscle to achieve a more nature result. The peri-areolar incision only and large implants more often than not leads to the look that you received.
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.