Uneven Breasts After Lift and Augmentation? (photo)

I had a breast lift 3 and a half months ago, with an augmentation of 180 on the left side and 200 on the right. Although I have healed nicely, my left breast is still very droopy, and a different size and shape. The implant seems to be sitting higher than it should be. My Dr tells me that I must wait for 6 months for the final result, and that a small revision may be necessary.

Doctor Answers (11)

Uneven Breasts After Lift and Augmentation?

+1

Toni:

Preop photos would be helpful in planning from here on out, but the photos you attached do describe the current status.

Although the left implant may be riding a bit higher than the right one, the main difference I see is more ptosis, or sagging, the left breast. When I can't tell from just these photos without an actual physical exam is whether the left implant is firmer and therefore might have a capsular contracture accounting the difference, and whether it is higher because the entire breast may have been higher before surgery. These factors might affect what can be done to give you best symmetry.

Most surgeons to ask the patient to wait a reasonable amount of time for healing before considering a revision. Depending on the situation some ask for 3 months on for 6 months. The idea behind this as many of the problems self correct during that period of time averting the need for a second operation.  In this setting however I think it is clear that a revision of a left mastopexy will need to be done possibly with conversion to a full anchor pattern type lift. because of that I feel a revision could be done at that time. If the implant is riding high is a simple addition to the procedure to open up the lower portion of the pocket and reposition the implant to achieve better symmetry.

 

Thank you for your question and for the photos. Best wishes.


Seattle Plastic Surgeon
4.5 out of 5 stars 32 reviews

Uneven Breasts After Lift and Aug? (photo)

+1

I agree with your observations. It does seem that the left implant is higher riding at this point. It may or may not drop with time. I would wait another 3 months at minimum to see if the implant will drop. I would consult with your surgeon for ideas on how to encourage the implant to drop. Many of us use an elastic band across the top of the breast to help the implant drop. If you were asymmetric before surgery many times it is apparent after surgery as well. One thing I can see in your frontal view picture is that your left breast crease appears to be lower than the right crease evidenced by it ending lower on the chest where it meets the breast bone skin. It looks even more evident on your side view. If this is indeed true that can account for your left breast riding lower then your right breast. You may need tightening of the left breast when this is all said an done, but I would wait and give this time because you may find you will be happy if that left implant drops more.

Richard J. Brown, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 21 reviews

Your surgeon is giving you good advice.

+1

The timing and advice your surgeon is giving is appropriate, and more time may indeed change your appearance--perhaps enough to suit your goals, perhaps not.

A periareolar (donut) breast lift generally does not lift the breasts much, and when everything is settled and softened (which is why you wait 6-12 months), you and your surgeon can assess your results and determine if revision (dropping the implant pockets a bit, or only the left side) or switching to a full breast lift is what might be the best recommendation. Each option has its own set of scars, costs, and pros/cons that will need to be considered.

If you were "sold" on the idea that a donut breast lift would make you "perky" or youthful in appearance, then this was not a reasonable expectation. You may well require a full lift at increased cost and more final scars to achieve your desired result. But if you are OK with a natural look and like how your right breast looks, simply dropping the implant pocket on the left side may well be "enough" to achieve a similar look on this side.

An elastic bandeau worn above your left breast and below the right may help your left pocket to stretch downward. Ask your surgeon. Best wishes! Dr. Tholen

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
5.0 out of 5 stars 138 reviews

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I agree with your plastic surgeon. A revision is probably necessary but you should wait.

+1

I don't think time will correct the low left areola,so a revision is probably indicated at some time in the future.  Waiting will allow all healing issues to declare themselves and allows for all revisions to be done at one sitting.

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

Revision of augment/pexy

+1
I agree that there is asymmetry and that correction may be appropriate but that you should wait another three months before scheduling as the breasts will continue to change in shape.

Robert L. Kraft, MD
New York Plastic Surgeon
5.0 out of 5 stars 13 reviews

Breast implants and lift

+1

Yes, you are very accurate that one implant is a bit higher, and I agree that you should wait a few more months before considering any type of revision.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

Asymmetry may be fixable but may also depend on your breast tissue

+1

Asymmetry is one of the most common problems patients have before and after surgery.  Most women have some asymmetry to their breasts.  Some asymmetry can be addressed by surgery (i.e. by using different sized implants), but others are very difficult to fix no matter what.  Your photos do indicate that you have some asymmetry.  It typically takes up to 6 months for the implants to fully settle in some cases so you still may hold out some hope.  Any revision that is necessary is typically scheduled at least 6 months out from your original surgery to maximize the chances that all of the inflammation has subsided and for the tissue to to be healthy and recovered so that the revision will be a success.

Richard H. Lee, MD
Newport Beach Plastic Surgeon
5.0 out of 5 stars 15 reviews

Breast revision surgery

+1

Thanks for your question. I believe your observations on your asymmetry are accurate and clearly your plastic surgeon seems committed to you being final success and happiness.  I also agree with he/she that you should wait several months before performing a revision. Good luck.

Vishnu Rumalla, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 85 reviews

Uneven breasts after augmentation/lift

+1

Your photos demonstrate a slightly higher-riding breast implant on the left compared to the right.  This may be correctible with massage and/or medication (Accolate).  Otherwise you may require a minor revision, but this should wait until you are completely healed - six months.

Robert Stroup, Jr., MD, FACS
Cleveland Plastic Surgeon
5.0 out of 5 stars 6 reviews

Breast Asymmetry after Breast Augmentation/Lifting?

+1

Thank you for the question and pictures.

The breast asymmetry that you are referring to is visible in the pictures you post. I think your plastic surgeon is advising you correctly in that ongoing patient/observation is indicated. You may find that the breasts will continue to change over the course the next few months.  Ask your plastic surgeon if he/she has any recommendations to help the higher breast implants settle into position.

 Continued follow-up with him/her is important to rule out complications that may lead to ongoing  or worsened breast asymmetry.

 Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 781 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.