4 month post op. Plastic surgeon agrees that right breast needs to be fixed on bottom and left breast needs to fix on bottom. He said that he can stitch to make breasts higher but he said then my nipples would point downward. I went for another opinion and the other Plastic Surgeon said he would stitch the crease up and my nipples would not point downward. Before implants I was borderline pstosis grade b. I have 304cc under the muscle. Which one do I believe?
Differing Opinions on Breast Augmentation Revision
Doctor Answers (8)
Revision breast augmentation requires sophistication.
1) I would respectfully disagree with both opinions.
2) Your nipples will definitely not point down after revision breast augmentation.
3) Your left breast needs very little work. Just a few stitches with "capsulorrhaphy".
4) Your right breast needs a lot of work, and will not be corrected just with stitches. There is a "slash"- like deformity on the lower inside of your right breast which requires quite a bit of dissection to correct. Plus some stitches. Before the end of the operation, we put the patient in the sitting position (you are still asleep, of course) to make sure the new shape and symmetry are perfect.
5) Your right breast appears smaller, and may need a slightly larger implant. During surgery, we put sterile disposable implant SIZERS into the breasts before deciding on the permanent implants. This takes all the guess work out.
Better is ALWAYS the Enemy of good with Cosmetic Surger
Wait to Revise Your Breast Augmentation Then do it right if you do indeed need a revision!
All the best,
Rian A. Maercks M.D.
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It is difficult to comment fromt he single photo. If you had some ptosis before and the surgeon lowered your fold, it can lead to double bubble. If a patient needs a lift then she should have a lift procedure, because double bubbles are harder to deal with.
Consider revision options carefully
No one can give you specific advice baed only on a picture, especially in cases like yours. One reason you have heard different opinions is that there are more factors involved than it may seem at first. These include any pre-existing asymmetry, implant size and diameter, the degree of sagging, and more. Stitching the crease up will shorten the distasnce from the crease to the nipple and move the implant up, so this affects the nipple relative to the breast mound.
Correction of breast asymmetry and persistent sagging (ptosis) Photos/Pics
My guess is that you want something other than just correction of asymmetry, It appears that putting a slightly larger implant on the right will produce diminshed asymmetry. However, from your description, it sounds more like you want "perky breasts". This will require a vertical scar with slight overcompensaiton and the likelihood of early downward pointing of the nipples.
Breast Implant Revision for Asymmetry
I agree with the opinions put forth by Drs. Rand and Aldea. All you would need to do to get a more symmetric and natural appearing breast is to enlarge the right breast pocket where it appears flat and this should produce a more round appearance without major surgical work or recovery.
Discuss this with your doctor and see if you can agree on a plan.
Best of luck.
Vincent Marin, MD, FACS
La Jolla Plastic Surgeon
Breast implant revisions through the axilla
From your photo it looks like all you really need is to release the lower inner crease on your right side where it looks a bit flat. I don't see the problem on the left side but all I have is this one photo. From a tough starting point maybe you should keep the revision simple and try to be happy with the improvement you got.