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5 months post op, What is Wrong with my Left Breast? (photo)

Hi, I am 5ft 4 and 114lbs. I had a BA and tummy tuck 5 months ago. My PS felt that the optimal implants for me were the Allergan Silicone 335HP. He also said that I did not need a lift . I am quite happy with the outcome but one thing bothers me. The breast tissue on my left breast tissue droops over the implant. It has gotten better over time but has not resolved completely. Will it keep improving with time or is this the final result? What needs to be done to fix it?

Doctor Answers 11

Post Operative Breast Asymmetry

Thank you for the question and your picture. Looking at the photo you have provided it appears that you have what is known as a double bubble deformity. This is a crease that is formed when your implants rests below your old inframammary (lower breast) crease. You will most likely require a revision of your left breast by releasing the lower edge of the muscle and/or reducing the skin envelope of the breast.

While no-one can be sure as to how much more improvement you will see in time, it would not be unreasonable to continue to massage to try and get the band to stretch, much as it did on the right side. Continue to follow up with your plastic surgeon to further discuss your available alternatives.

I hope this helps. Good luck.


Tampa Plastic Surgeon
5.0 out of 5 stars 7 reviews

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Mommy makeover - opinion

You have a double- bubble deformity.  The breast implant you have inserted was either too big for your breast or has slid inferiorly with time.  I don't see where your incision was made, however I repair these with an incision along that fold under your breast.  I remove the implant, reestablish the pocket by suturing the fold into position and reinserting the implant.  I add additional sutures to support your implant to prevent recurrence.  You may also consider using a smaller implant. 

Persistent Inframammary Fold and a Double Bubble Deformity

It’s not unusual for patients with mild to moderate breast sag to present for breast augmentation surgery. When this situation arises, these patients are often eager to avoid scarring which is associated with breast lift surgery. Various strategies have been utilized to accomplish this goal, including biplanar breast augmentation. Unfortunately, these techniques aren’t always successful and patients are left with persistent breast sag, persistent inframammary folds and a resultant double bubble deformity.

Although it would be helpful to have preoperative pictures and be able to perform a physical examination, your post-operative pictures suggest the presence of a persistent inframammary fold and a double bubble deformity.

In patients who have had biplanar breast augmentation, this problem often improves in the immediate postoperative period. Under these circumstances, the weight of the implant stretches and expands the tissue that has been recently released. Unfortunately, after six months, further expansion of the soft tissue is unlikely and this deformity becomes more or less permanent.

Under these circumstances, revisional surgery would probably be necessary. This procedure would require a unilateral breast lift. In addition, the position of the inframammary fold could be adjusted downward to match the opposite side. This would require pocket revision as well.

It’s important to discuss these issues with your plastic surgeon. Your surgeon should be able to formulate a plan to address these issues.

Concerned 5 months after surgery

The implant on your left side looks a bit higher than your right. I don't think it will change much from this point. I would massage downward. If it doesn't change in another few months you might need a revision. Stay in contact with your surgeon.

Left Breast--double bubble

Overall I am looking at a nice result, though not seeing pre-op photos makes it hard to say mow much improvement there is!

It looks like you have what is called a "double bubble" on the left. Looking closely on the right it looks as if there might have been one there too but it may have stretched out during the post-op period.

This indentation is from the original breast fold. There are a number of things that your surgeon can do to improve this if it bothers you enough, and these include revising this band, (which could require an external incision), dividing the lower muscle end which could be contributing, and doing a lift on the left side to take up the skin excess that contributes to the fold.

By five months this is probably as much improvement as you will get, but do keep up massage. Check out your options with your surgeon.

Thanks for the question, best wishes.

Breast augmentation revision

The left implant sits higher than the right and the left fold looks higher than the right. Correction will require lowering the implant and fold and releasing the lower half of the breast mound so it can wrap around the implant.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Aaron Stone, MD
Los Angeles Plastic Surgeon

What is Wrong with my Left Breast?

The posted result looks good. As the "slight" asymmetry of the left breast and your very excellent description stated you will need i my opinon a left lift to improve the dropping off effect. 

Fold issue

It is difficult to comment without poperative photos , but it appears the fold on the left was lower but the old crease is intact.  This may improve with time but may also need revisional surgery to correct.  Continue aggressive massage.

 

Gary A. Tuma, MD, FACS
Princeton Plastic Surgeon

Hello

 

 

From your picture its looks like you have what’s called a double bubble. It’s your old breast crease. It can be addressed with a breast band and some pressure. If that doesn’t correct it your surgeon might have to do it surgically.

 

Stuart B. Kincaid, MD, FACS
Beverly Hills Plastic Surgeon
4.0 out of 5 stars 9 reviews

Options for Revisionary Breast Surgery?

Congratulations on having undergone the breast augmentation/tummy tuck operations. Given that your concerns have gradually improved with time, I would suggest  continued patience at this point.  At some point however, you may benefit from revisionary breast surgery to improve the situation.  Definitive advice will best be provided after direct examination. Options may include modification of the breast tissue that “droops” over the breast implant ( for examples circumareolar breast tissue excision/lifting).  The breast implant pocket may also be amenable to manipulation to improve the appearance of the breast tissue–breast implant junction.

 Keep in mind, that if the left breast is  change significantly,  surgery may be necessary on the contralateral side to maintain/improve symmetry of the breasts.

 At this point, I would suggest continued patience and continued follow-up with your plastic surgeon.

Best wishes.

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.