Hi, 56yrs old,quite good breast tissue mass,now over 12 mnths post and would like to retain the sub placement.Advice from one doctor has been to remove and place subglandular but am hesitant as I understand submuscular age better. 1.Is it worthwhile to try and release the implant/reposition it or 2. perform crescent lift around nipple to teak the droop. I believe the implant is a little high.My original doctor will only do a crescent lift for me and wont consider anything else?Thankyou all.
How Do You Recommend Releasing Submuscular Implants? (photo)
Doctor Answers (6)
Breast Revision Options for High Implants and Lower Breast Tissue
When breast implants sit high and the breast tissue and nipple sit low, the aesthetic appeal of the breasts is less than optimal. A revisional procedure which combines lowering of the implants and lifting of the breast tissue would be of real benefit. For heavier breasted patients, I would recommend a vertical type lift for the majority of patients. This will allow a very good uplift of the nipple, areolar reduction if desired, and a tightening of the lower breast with reshaping.
Revision breast lift will make things better.
1) It is true the implants are too high (and a little too large, in my opinion). The pockets can be lowered.
2) But the main problem is the lift. The nipples are too low, and the left breast has a square shape. It looks like you need a real revision of the lift. The crescent lift alone will not do much.
Replacing implants or lift
Although a formal examination is necessary, it seems you simply have a mismatch in implants size/style and overlying breast. Your nipple is above the fold and the distance between the nipple and the fold appears "short" or at least not excessively long. Any periareolar lift will accentuate the size of the areola. The nipple is not centered over the underlying breast mound so it looks "droopy". I would consider re-analyzing the remeasuring the landmarks as I think a resizing of the implant or changing the style to one that is longer than it is wide would reduce the droopy look.
Robin T.W. Yuan, M.D.
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Implant Size May Be Root Of Problem
I agree that you result will not improve by moving your implants to a subglandular location. However, I think your implants are probably too large (would need exam and pre-op photos to state with certainty). I would, therefore, recommend replacing the implants with smaller implants and performing some sort of short scar lift.
Specify your aesthetic goals
G'day Marfa! I agree that you should maintain the implants in the dual plane/subpectoral pocket, as this plane is preferable for mammographic surveillance. The photo shows superior displacement of the implants (under the collar bone), a narrow intermammary distance (= tight cleavage) and nipple position asymmetry as well as low position. Without the benefit of additional photos and exam, my response is limited however like Dr. Pousti, I wouldn't recommend a crescent lift, because such limited skin excisions don't consistently and predictably correct nipple position, diameter with acceptable quality scars.
Assuming that your breasts are soft and mobile (i.e. no capsular contracture), a circumvertical lift would reduce the diameter of the areolar complexes as well as provide the "illusion" of higher, more symmetric nipple position. I know that there are some very good PS in Perth and am sure that you will find a local expert who may be able to help you. Good luck.
Breast Augmentation Revision Options?
Thank you for the question and picture.
I am in agreement with you that keeping the breast implants and the submuscular position may be in your best interest for several reasons.
Also, I am not a fan of the “crescent lift" ( incision above the areola) because it tends to distort the areola and not provide much of a breast lift in return.
Based on your physical examination, if there is enough laxity of tissue along the lower poles of the breasts, it may be possible to “lower” the breast implant pockets. If you wish downsizing of the breast implants may also help to solve the problem of the implants being “a little high”.
Again, it is difficult to give much more precise advice without direct examination.