4 weeks post op, my left breast is noticeably smaller, harder, and 'stiff'. Do I Need Revision Surgery? (photo)

I am 4 weeks post op and as you can see by pics my left breast is noticeabley smaller and harder and 'stiff'. My right breast almost feels like my own and moves around quite freely. I had 350cc in left and 325cc in right texture mentor silicone moderate plus implants. My surgeon wants me to go back for a revision surgery soon. Do you think this is captular contrapture or something else from the surgery? I would appreciate your feedback.

Doctor Answers (10)

Do I Need Revision Surgery

+2

Yes, if you want a better and more symmetric outcome. The left breast looks smaller before surgery, and still looks smaller despite the 25 cc differential. There seems to be an incomplete dissection on the lower middle part of the left breast. This is clear on the four day photo, so that aspect cannot be from capsular contracture. 

At revision surgery the pocket dissection should be made more even, and a larger implant on the left should be considered. Usually we advise holding off for 3 to six months, but I doubt this will resolve. However, it may be more reliable in terms of choosing the correct implant size to wait until all swelling has resolved and the implants have settled. 

Thank you for your question, and for the photos, which were well chosen and helpful. All the best. 

 


Seattle Plastic Surgeon
4.5 out of 5 stars 34 reviews

Revisional surgery probably indicated in this one

+2

Although I can't comment about any volume disparity right side versus left will it appears as though the pocket on the left side has thumb printing on the infero medial portion due to inadequate release of the tissue. A revision will be necessary.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 10 reviews

4 Weeks After Breast Augmentation

+1

    At 4 weeks, the left breast can be massaged and can help stretch the medial breast.  The left breast had more constriction and less medial fullness before surgery, so this should be expected to some extent after surgery.  Continue massage and give at least 6 months.  Remember that you and your surgeon both are asking for more fullness of the left breast medially where it did not exist before. 

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 237 reviews

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Breast asymmetry

+1

It is too early to tell for sure.  It will take 3-6 months before you know the final result.  You had two fundamentally different breasts before surgery, and it takes a while for the tissue to stretch and settle.  Follow your surgeons post-operative instructions.

Dennis Dass, MD
Beverly Hills Plastic Surgeon
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Revision of breast surgery

+1

It appears that you will require a capsulotomy to revise the fold under the  right breast and a larger implant to create more symmetry.

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Talmage J. Raine, MD
Chicago Plastic Surgeon
4.5 out of 5 stars 8 reviews

Implant revision

+1

It does appear that you may need further surgery, although it may be a litttle early at this point. Also your surgeon may have underestimated your size difference and you may need a larger size on the left.

David Nicholas Csikai, MD
Jacksonville Plastic Surgeon
5.0 out of 5 stars 40 reviews

Left Breast Implant Revision Needed

+1

Clearly the pocket on the left implant is underdissected and developed. That is not an issue that more time is going to change or potentially expand out on its own. Thus I can understand your surgeon's desire for earlier revision rather than waiting. What is not clear is whether opening up the left pocket to match that of the right may reveal that the left breast implant is too small. Your revisional surgery should be approached with the possibility that a new larger implant is needed, regardless of the timing of the revision.

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon
4.5 out of 5 stars 32 reviews

Do I Need Revision Surgery?

+1

I agree with your assesment that the surgery was not completed with full understanding of the breast issues. Your before photo demonstrates an asymmetry of volume, shape, and N/A complex position. Each of which needed to be determined before the operation. On your left the dissection was limited medial-inferiorly, the size was to small that was used. You have options.  Leave alone for total of 6 months to see the final result. Re operation by more medial dissection and using larger implant. Or use of fat grafts to try to even out volume and shape on the left. Or a combination. Best to you. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
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Revision

+1

I think it is too soon to do a revision. I try to wait a minimum of 4 months before any revision surgery, because things change with stretching and relaxation.

Gregory Sexton, MD
Columbia Plastic Surgeon
5.0 out of 5 stars 28 reviews

Implant asymmetry

+1

At four weeks it is too soon to tell.  It looks like you are still smaller onthe left side, and your implant needs more time to settle.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 18 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.