I am 5 1/2 mo. post op with smooth silicone gel (unders) 475cc implants. My right implant has not dropped as much as the left. My right breast has always been smaller, however, I would like to see it drop as much as the left did. I have tried massaging and a strap (although I am not sure how I would strap only one breast). Any advice on how to make it drop? Should I keep waiting? This is not noticeable without clothes on, but when I flex I can definitely tell. I don't want another surgery.
Right Breast Still High 5.5 Months Post Op? (photo)
Doctor Answers (8)
Asymmetric breasts several months after augmentation with one having more contraction distortion
suggests that your right pocket is not exactly the same as your left side. This does happen and you have to decide if you're willing to have surgery in an attempt to correct this (at the risk of overcorrection) or continue with displacement exercises that focuses on your right side. If you wish to continue with exercises, a sport or leisure bra (no underwire) can be used to help push down the right and at the same time support the left. You would put on your bra normally then pull the lower band of the right side OVER the top of the mound to help push the right side down so your right breast is completely exposed and your left breast still covered and supported a little by your bra. This will not change the difference in muscle contraction you demonstrate and if this is a concern, surgery and further release of the muscle is your only real option. Botox can be used but is only temporizing.
Thanks for your question. I think it's not very likely that you will have a significant drop at this point in time. While its true that you will still have some minor changes in swelling until more time has passed the overall appearance of your breasts at this point is fairly static. You have a slight contracture on the left side now compared to the left. It is a fairly simple procedure to release the left side with a capsulotomy but that would require further surgery. I would recommend that you talk to your surgeon about the timing of any further surgery and see if that is warranted. Although perfect symmetry is the goal there are never any guarantees that this will be the final outcome as a portion of the final result is dependent on your healing and has nothing to do with the actual surgical procedure. Hope this helps.
Asymmetry After Breast Augmentation
It is unlikely that you will see any significant change in implant position at this point postoperatively unless there is a capsular contracture. In that case the implant may appear to be getting fuller on top. Otherwise, your options are to accept what is a relatively minimal asymmetry or to consider surgical revision. The fold under your right breast may be somewhat higher than that on the left but I would be careful about attempting to lower the fold as proper positioning can be difficult to maintain. Possibly widening the pocket somewhat will give the implant some room to descend. You state your right breast was smaller preop and this may have something to do with your appearance as well. Discuss your concerns with your plastic surgeon.
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Implant too high
Yes, it looks like the implant stayed too high. It did not come down like the other one, and jsut as you stated, the narrower breast may just be tighter and perhaps needs to be released more to allow it to come down.
Hight breast implant after several months
From your photos we can see that the implant is slightly higher, and with flexion the implant pushes high up into the pocket. To us this indicates the the pocket might need to be released below to get it centered in the breast and reduce the animation effect.
Right Breast Still High 5.5 Months Post Op?
Thanks for the posted photos and description. Only a surgery can improve the appearance and even out the levels by opening the inferior pocket.
Changes in breast position at nearly 6 months unlikely
Thank you for the question. In general, a change or settling of a breast implant pocket is unlikely to happen after 3-4 months and would be more doubtful still after 6 months. The scar capsule surrounding the implant is becoming quite mature at that point in time. I agree with using massage and the push down strap until this point although I'm not sure that it will matter now. There isn't really much else you can do that is not a surgical adjustment. Having said that, there is no urgency especially since you mentioned that you essentially look symmetric with clothes on. In general, I try not to reoperate on a breast for a revision unless there is a significant issue until 6 months or more have passed so that I can be assured that there is no significant inflammation or swelling of the tissues remaining that will have an impact on the revision. If this pocket position is a persistent problem, then you may want to speak with your surgeon about revision surgery. This may just be a mild malposition of the implant, but it could also represent a bit of capsular contracture especially if that breast feels more firm. Your surgeon could best make that call based on physical exam. Sometimes the breast most benefits from removal of the entire scar capsule if contracture is the reason that breast appears more constricted and higher.
HIgh implant after breast augmentation
Thank you for the questions and photos. Without seeing pre-op photos, it's hard to know if you had some degree of asymmetry before you started. If one side hasn't dropped fully, then massaging and wearing your elastic strap at an angle over the higher breast may help. I also have my patients lay on the carpet and put a little weight on each breast individually so the scar tissue can stretch in all directions at the same time. This maneuver should be somewhat uncomfortable, but never painful. If it's painful, you may be tearing the scar tissue capsule which could lead to internal bleeding or formation of more scar tissue. We also have a laser that can penetrate skin and weaken scar tissue, but it works best on early scars (typically within3-4 months of surgery). Hope this helps.
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