I live in Louisville, KY and just finished my second treatment. The procedure was performed at Dr. Julene Samuels office. Her office also uses the Vaser Shape on my tummy for 15 minutes prior using the Ultra Shape machine. Evidently the Vaser will tighten the skin once the Ultra bursts the fat pockets. They also use the Vaser for an additional 5 minutes at the end of the Ultra treatment. For both my treatments the Ultra treatment took about 45 minutes, so I was there a little over an hour for both the Vaser and Ultra treatments. I didn't see any results after my first treatment, but can definitely tell a difference after my second treatment. I'm scheduled for the third and final treatment next week. I can't wait to see the final results. I didn't take a before picture, but they did at Dr. Samuel's office. I will ask them for copies of pics once I've finished my third treatment and try to post for everyone to see.
I'm a 39 year old mommy of 1, and full time RN. I have decided that my birthday gift to myself this year - I'm turning the big 4-0 - will be a breast revision. I had my first BA in 2000, a few months before I turned 24. I was always very self-conscious about my breasts and the "weird" appearance they had. Although I did not know it at the time, I had PCOS. My breasts didn't develop the way most women's do, and they had kind of a tubular/constricted appearance to them. I basically had no development or fullness to the lower part of my breasts. I hated them. I had to stuff my bra or use silicone breast enhancers to give myself a normal appearance underneath clothes. I finally expressed my concerns to my doctor, and she referred me to an excellent PS here in Louisville. At the time, saline was the only option available for breast augmentation. So I started the journey to re-shape myself and boost my self-esteem. My PS did an amazing job. We decided to go under the muscle, and she said she would release some of the constricted tissue that was preventing me from having that fullness and normal shape to the lower part of my breasts. I don't remember what size we chose, but I told her I didn't want to appear to be much bigger. My priority was just looking more normal clothed as well as nude. My incisions were in the breast fold, as I told her I hoped to breastfeed someday and wanted to keep the nerves around my nipples intact. The outcome was better than I could have imagined. Granted, I knew that I'd never have [RS bleep] star boobs, but that was never my intent anyway. Fast forward almost 16 years and here I am. Since my original BA, I've gotten married, had a beautiful daughter, gained & lost a good amount of weight, and completely switched careers, becoming a nurse. Breastfeeding didn't work out, as I had no milk production. This was likely due to my PCOS and probable insufficient glandular tissue, something that kind of goes with PCOS anyway, and not a result of my previous BA. I decided a few months ago that I'd like to do something nice for myself for my 40th birthday. I started researching surgeons, implant types, and all the other details that I'd need to decide on. I was having trouble tracking down my original PS, so I started to look into some others. I called one and made an appointment for a consultation with her (which is this Friday, 2/12). My "homework" was to get a current mammogram (something I'd need this year anyway since I'll be 40), try to get my original medical file from the other PS, and to at least get a copy of the operative report from my first surgery. The mammogram was a breeze. The other stuff, not so much. Let me tell you, it has been like pulling teeth. I found out yesterday that my original PS has in fact retired, and may or may not still have the files from 16 years ago. My state board of medical licensure gave me an address where I could write to her and request my files. I'm not holding my breath on that one... Anyway, I am excited to begin on this journey again. My wish for this time is to get a bit more fullness and shape to my breasts. Again, I don't want to be huge, I just want to have something that is proportional to my frame. I'm not a tiny girl. I'm 5'6" and currently weigh about 190. One of the things that has been bothering me a lot recently is the fact that my breasts are spaced very far apart (at least I think they are). I have no cleavage, and the only way I can get cleavage is to push the girls together with my hands! I still feel like certain clothes look bad on me because of the amount of space between my breasts. I'm hoping that can be somewhat corrected by selecting the right kind of implant. I'm looking at doing silicone unders, maybe one of the cohesive gel (gummi bear) styles. Not many people outside of my family and very close friends know that I've had a BA done in the past. I am not really the type to advertise something like that, but as I get older I find that I don't care as much about people knowing. It's my body, and I'm doing this for myself. That's the most important thing about all this. I'll update as I go along. I'm going to work on a list of questions for my consultation on Friday, and hope that I feel comfortable with the PS and her plan for me. Updated on 16 Feb 2016: I had my initial consult with my new PS on Friday. My first PS actually trained with her, and was in practice with her for a while. Anyway, we discussed my options and what surgery would be like. Since I will be a revision, she will put in drains that will stay in place for about 10 days. She recommended smooth round silicone for me. We still aren't certain what size my current saline implants are, as I have completely struck out in obtaining any of my previous records. I can't even find my warranty card from my first surgery. While examining my breasts, she said they are probably about 375 CCs. If I still can't find any info from the previous augmentation by the time I get my revision done, she can at least measure the amount of saline from my current implants during surgery so she knows what I had before. She also said I have a small Baker II capsule on the right side, and that my left side is slightly lower than my right (something I didn't even notice until I took my before pics). I checked out the silicone rounds, and I think I might want to go with around 450 or 475. My surgeon does intraoperative sizing, so she will have some pictures of my "ideal" size (along with "too small" and "too large" references) and choose what looks the most proportional to my frame while in the OR. I trust her judgment, as she has been doing this a long time, and she does a lot of revisions on other surgeons' patients. I'm looking at doing this in early June, after my daughter gets out of school for the summer. The PS said there is no restriction on when I can go back to work, as I do not do a lot of heavy lifting or difficult patient care in my line of nursing. In the meantime, I'm going to try to lose a few pounds (something I'm always trying to work on anyway)... I'll probably try to schedule the actual procedure sometime in the next few weeks, since summer is a high demand time. I'm excited about the prospect of my new and improved "girls"! Updated on 3 Mar 2016: After more than a month, and numerous phone calls to the health information office of the hospital where my original procedure was performed, I finally have a copy of the operative report! Looks like I have Mentor smooth rounds, with a fill of 300cc on the right and 275cc on the left. It's so nice to know, once and for all, what size I'm starting out with. My next step is to get this info to my surgeon, and to go ahead and get my procedure scheduled. I'm now looking at somewhere around mid-May. I googled more "ideal" sizes and found some pretty good ones that I will give to my surgeon. I tried to look for girls with larger frames like mine, so I'd get a better idea of true proportions. I'm definitely getting more excited about this! Updated on 14 Mar 2016: Finally!! I know when I'm getting my upgrade! Thursday, May 19 is the day. Kind of funny, since it will be exactly 15 years and one day since my first BA (done in 2001, not 2000 as stated in my first post). The procedure will begin at 8am at an outpatient surgery center, a sister facility to the hospital where I work. I'm really excited, and a little bit nervous, but I am very much looking forward to this "new" part of me. I've decided I'm going to apply for FMLA to cover a few shifts post-op. I don't really want to go to work with drains in place. The higher susceptibility to infection is not something I'm comfortable with, so I will most likely take off 4-5 shifts before going back. I'll have drains for about 10 days, so being off for that length of time will ensure the drains are gone by the time I go back to work. That will also help me get over the initial hump of recovery. Pre-op will be about 2 weeks before surgery. Hooray for new boobies! :) Updated on 10 May 2016: I'm nearing the one week mark until my revision surgery. I met with my surgeon again last week to sign all the consents, get my prescriptions, go over post-op info and wound care, and to get a better idea of what size I will be after everything is said and done. Since we are doing intra-operative sizing, Dr. Samuels is going to be bringing several different size implants into the OR with her. I could go as big as 500cc. My current size is 275 (right)/300 (left). I'm excited about getting everything done, and can't wait to see what the new me will look like! Updated on 19 May 2016: Surgery was this morning. I'm a little sore and pretty tired, but feel pretty good considering everything! Compression bra is on and drains are doing their job. Post-op appointment on the books for tomorrow. Really can't wait to see what these girls look like. More to come after my appointment tomorrow! Updated on 21 May 2016: Here I am, post-op day 2, and feeling pretty well. I had my post-op visit with my doctor yesterday and everything is going great. Dr. Samuels ended up going with 650s. She tried 500s and thought they still would be a bit small on my frame. For a while she and her assistant were stuck between 600s and 650s, but ultimately went with the larger size because they looked better on my frame, they would help my nipples look more centered, and would give me a nice amount of cleavage (something I've never really had). I can't wait to see how they look once they start settling into place. I'm still pretty swollen up top, but I know that will resolve in time. Showering with the drains won't be fun, but I know they won't be there forever. Dr. Samuels told me I don't have to wear my bra continuously, pretty much only when I sleep. I'm getting around pretty well, and have my husband, my mom, and my 7 year old daughter all helping me with things. As a nurse, it's hard to be the patient, but I'm taking it easy as much as I can. I've had absolutely no trouble sleeping, no nausea, and am taking my muscle relaxers more than my pain pills. I'll post some pictures in a few days most likely. Updated on 26 May 2016: Can't believe it's been a week already since my surgery! I'm feeling great. Absolutely no pain meds since Sunday night, and haven't taken a muscle relaxer in a couple of days either. Drains are my biggest nuisance at this point. Less than a week until I get them removed! My daughter has been such a great helper to me this week. Mom and hubby have been going the extra mile for me as well. Haven't attempted driving yet, but may go a short distance tomorrow. Don't want to overdo it or go very far until the drains are out. Excited to go shopping for new stuff and can't wait to see how some of my clothes that used to look awful in the chest area will look now that I have some cleavage! Going back to work in about 2 weeks. I think I'll be more than ready at that point! Updated on 26 May 2016: There are two products I am so happy I bought before surgery: a pouch to hold my drains, and a wedge pillow for sleeping! I can't sing the praises of the mesh drain bag I purchased from Brilliant Contours. This thing is a life-saver! Since I am a revision patient, and my surgeon places drains in all her revisions, I knew I'd have two drains to deal with. I did not want them to be dangling the entire time, so I decided to get the mesh pouch to keep them better protected. When I went for my post-op day 1 checkup with Dr. Samuels, she was very impressed by the pouch and thought it was a great idea! Well worth every penny of the $24.99 I spent on it. Brilliant Contours has a website, as well as an Etsy shop. The wedge pillow I bought has made it so much easier to sleep in an elevated position without having to mess with placing a bunch of random pillows behind me. I got it on Amazon. The one I purchased has a 1" layer of memory foam, which makes it much more comfortable, and it came with a 400 thread count Egyptian cotton cover that is washable. The dimensions are 25" x 24" x 12" and the level of incline is about 25-30°. Kind of pricey, but hey, I haven't had to use any of the Ambien prescribed to me by Dr. Samuels. Anyway, just my two cents about things that make the immediate post-op phase a lot more bearable! Updated on 26 May 2016: Here I am, 1 week out. Still high and tight, but hey, I'm not complaining. They will look fab once they've settled! Updated on 1 Jun 2016: I've never been so happy to go back to the doctor as I was today. After almost 2 weeks, I got my drains removed! I feel so much more human with them gone. And I'll finally be able to wear some of my other clothes again! I was also given the thumbs up to get a good, supportive bra, something that wouldn't irritate my incisions. I went with some wire free bras from Bali that are both comfortable and supportive. Bye bye ugly white surgical bra! My boobs look fabulous in them too! Feeling great. It seems like the girls are starting to soften up a bit already. Dr. Samuels was very pleased with how they are looking. She started me on Singulair for 3 months to help prevent capsular contracture. Back to the office in one week to check the drain sites, and in two weeks I'll check in with Dr. Samuels again. Updated on 2 Jun 2016: Just did a comparison shot of before and now, 2 weeks post-op. Still have a lot of settling and evening out to do, but holy cow! Me likey!!! Updated on 9 Jun 2016: I am noticing changes every week! Still on the hunt for the perfect bra to help push the girls together and give them the right support, but I think I'm on the right track. Drain holes are getting smaller & smaller. Doing great & loving what I'm seeing! Updated on 19 Jun 2016: Today I am officially one month post-op. I'm feeling fabulous! So happy with my decision to do this! Updated on 19 Jul 2016: Can't believe it's been 2 months since my surgery. I feel great, and I absolutely love my results. Can't believe how much they've changed since the procedure. I am so happy I decided to do this! Dr. Samuels is the best! Updated on 19 Aug 2016: Today marks 3 months since my surgery. I'm feeling great, and I love my girls! I've started to do some light exercise, and most of it feels fine. Sometimes I'll avoid certain things if it feels like I'm not ready for it. All in all, I'm still able to do most of my workouts. I couldn't be happier with my outcome or my decision to have the surgery. Updated on 19 Sep 2016: Can't believe I've had these girls for 4 months already! I love them!! Updated on 3 Jun 2017: It's been a little over a year since my revision, and I couldn't be happier. My surgeon & I are so pleased with the outcome and how they have healed. I'm so happy I decided to do this for myself! ????
I had a previous breast augmentation when I was younger and more slender. As I aged I gained weight and my breast were getting bigger. They become heavy and my back was hurting, not to mention how they were beginning to look saggy. I decided to get smaller implants with a lift. I also wanted smaller nipples to match the smaller breast. A lot of skin had to be removed. I'm amazed they turned out as well as they did. I am completely satisfied and very pleased with the results. Scars are very minimal and I have no numbness anywhere. Many women who used other surgeons told me their scars were wide and they couldn't feel their nipples. I feel normal sensations all over my breasts. I couldn't be happier. I feel much healthier.
I have small breast A cup, wanted to fill out a bath suit top. I'm just the right size a small C cup and i love it ! Now I don't have to always wear a swimsuit cover up. I always want nice perky breast now I feel like a lady. My husband lovers them too. I showed my girlfriends they can't believe that my breast look so natural .
I just recently had this procedure done on Wednesday the 17th of September and Dr. Samuels does the 'rapid recovery' and it is Saturday the 20th of September and I feel wonderful. Super happy with my results. Will post more in the coming days but have been off of my pain meds since yesterday and just taking tylenol. Already I feel like my self confidence is through the roof! Updated on 22 Sep 2014: These are just a few of my before pictures. I wore a 34B most of the time but found that my upper pole did not fill them out. I am not a skinny girl, more so athletic build varying between 145 and 150 so my breasts never matched my body and I wanted to look a whole lot more proportionate. I have wanted to get a breast augmentation for a long time but could never find the justification to spend so much money to change something that didn't really need to be changed. My self confidence was never low, I was never embarrassed by my boobs.. I just wanted them bigger. Once my friend went and got hers done and talked about how much she loved them, that is when I really started to seriously think about getting mine done. My husband was very supportive and I began looking for surgeons in the Louisville, Kentucky area. He is some more of my before pictures. I will post some more about my surgery and how I have been feeling the last few days. I am post op day 5 today and doing good. Drove 7 hours back to my parents house just to visit family for the week since school is slow this week and I am feeling tight and sore today but I may have over done it a little bit yesterday. Updated on 24 Sep 2014: Well ladies I am one week post op today and feeling good. I have been off of my pain medications since day 3. Drove to my post op appointment day 3 and hour from my house and even showered that morning, washed my hair and did my hair and makeup! I will have to post some more pictures but overall I am feeling good. They are changing and getting softer every single day and I could not love them more. I still feel tight at times and a bit heavy when I am bending over but not bad at all. I will continue to update. Updated on 18 Nov 2014: I am feeling so amazing (other than gaining a few lbs from not being able to workout)! I am finally back to working out and so happy with my results. I cannot imagine not having this procedure done. I feel like everything is back to normal, while some things are strange, (having breasts actually bounce around while running/cardio) they feel like they are just a part of me. No pain at all and I know I will be able to get back to where I was before I had my BA. He are some recent pictures of my 375cc. I am so happy I went with this size.
After having 4 children I wanted my body back. I felt like I was still young enough to be able to enjoy having a good body even though I had 4 children. My oldest being 17 and youngest being 3 I was ready to be me again. After going to several consultations with other doctors I knew the moment I met Dr Samuels that she was the one. I couldn't of made a more perfect decision. I had a full T-incision tummy tuck with lipo and vaser. I can't even explain how it has changed my life and I'm so glad Dr Samuels and her staff has been there every step of the way.
To feel better about my appearance and working out didn't correct the issues.
I'm going for my third consultation for breast reduction surgery this coming Thursday. The first time I went it was with my surgeon of choice when my first child was one. I had started struggling with back, neck and shoulder pain and was clearly top heavy. At that time, I weighed somewhere around 150 or so and only one breast qualified for insurance coverage so it was denied by insurance and I could not afford to pay out-of-pocket. I went again to another PS near my then office in 2012, after dealing with more back and shoulder pain and shoulder deformation from bra straps. My kids were then 11 and 5 and I weighed around 190. That PS told me I absolutely would meet any insurance criteria and she would send in the info for a prior auth right away. After three weeks, I called and was told they forgot to send it in. After four more weeks and multiple attempts to get someone to call me back with an update, I received a letter from the PS stating my ins plan did not have a benefit for such surgery. I felt defeated an gave up. Here I am now at 42, around 215 lbs and have been battling severe back pain that recently landed me in the ER then to a spine MD. I finally have the funding to pay for the surgery myself if need be and I'M GOING FOR IT! My kids are almost 16 and 10 and can manage with the help of my husband and mom while I recover. So the stars have aligned... EXCEPT, I'm very worried about my body beyond my breasts. It's been quite something in my late 30s and early 40s trying to lose weight and change my body while being extremely limited by very large breasts and a very touchy back because of them. It's been kind of a vicious cycle of one thing making the other worse and vice versa. I only wear extreme minimizer bras and have for many years now. Contraptions without underwire laugh at my breasts! I won't even wear a bathing suit without also wearing a minimizer bra. Not a good look and since I usually only own one "wearable" bra at a time, that leaves little time for the bra to dry before I need it again. Needless to say, I don't attend many gatherings with my friends in the summers. (Sad, but true) I'd like to end up pretty small in the bust. I'm guessing for maybe shooting for a C cup and then if my life can become more active without the limitations of large breasts and I lose a little weight, maybe I'll be a B cup. I'd love some thought from others on this! With my weight where it is today, am I being unrealistic? Anyway, Thursday's consultation is with the original surgeon that I know and trust. I'm sure she'll tell me what will be best. I'm just really hoping she doesn't say weight MUST come off before she will entertain doing the surgery. I really feel like the time is now. I'll keep you updated on what is to come!! Updated on 4 Aug 2017: I met with my PS yesterday. I immediately remembered why I think so much of her. She and her staff are the nicest, most personable medical professionals I've ever encountered. And if you're anything like me, the consultation is a pretty tough (emotionally) appointment to get through. After putting on a very pretty robe (that didn't have enough material to close across my breasts), then measuring, lifting, taking pictures, sweating under the girls, talking through everything I find embarrassing about the girls, etc. Dr Samuels gave me the news - we are a go! And I will feel a lot of relief when all is said and done with chest heaviness, back, neck and shoulder pain and the shame I feel (for some stupid reason) related to the monster boulders hanging from the front of me. The only thing that really threw me for a loop is that she recommended free nipple grafts rather than attempting to keep them attached. She was wonderful about explaining the process and asking me how I feel about it. It's so nice when, as a patient, we get a chance to think things through and have a meaningful discussion with a provider rather than being talked AT about what is going to happen. After really thinking about this option I hadn't even considered before, talking it through with my husband and taking into account the doctor's explanation related to my nipples currently living so very far away from their blood supply, I have decided to in fact have the FNGs and am at peace with that decision. About my weight... I had to bring it up. And that was after she told me we are a go. I told her I thought she might say I had to lose X pounds before we could schedule or something like that. She said her only concern related to weight would be if I planned to lose a very large amount in a very short time after the surgery because that would result in significant sagging. She said she would be fine with any weight loss I prefer after surgery if I do it slowly allowing the skin to stay caught up. Whew, what a relief on this topic. I'm private pay and the total price is a little more than I had set aside but not because the price is high, I just hadn't done this before so I was off on my guesstimate. It was just under a thousand more than what I had saved so I looked at my budget and moved things around so that I could make up for the difference. It might be tight for a month or two (sorry kids, no eating this month - hahaha [just kidding by the way]) but I know I would kick myself if I did not seize this opportunity now. I honestly do not think it will happen again for me. So we've picked a few possible dates. 8/21, 9/11 or 9/18. Now just waiting to hear back as to which of those dates the surgical center has available. Of course, I'm really hoping for 8/21! I'm ready to get this party started! :) Thanks for the comments!!! It's so good to not be alone on this journey! I have great support in my family, friends and even my bosses but there is nothing like sharing back and forth with others who have some of the same struggles. Updated on 10 Aug 2017: I had my pre op appointment with Dr Samuels and her staff yesterday. Once again, was reminded of how terrific they are!! We thoroughly reviewed meds, supplies, consents, questions, size preferences, etc. In the few days prior to this appointment, I found myself more and more worried about having a free nipple graft. Dr Samuels was so great about really listening to my concerns and my preferences. She detailed again why a graft might ultimately be necessary but we agreed that she will attempt the pedicle procedure first and will change to a graft if it necessary. She did stress that a graft might still be needed though. I feel so much more at ease with the nipple topic now! So I'm a little over 10 days out from my surgery date and getting more and more excited (and maybe a little nervous too) every day. I guess it's a good thing I have a ton going on that will keep my very busy until then! Another thank you for the support and comments so far!
From the picture, it looks as if the problem leading to the asymmetry may be in the upper pole of the left breast - unless you had a significant degree of breast volumetric asymmetry to begin with, or a significant difference in the locations of the nipple-areolar complexes to begin with. Â Without those pre operative photos for comparison, it is hard to be certain about the causes of the current asymmetries, but you should return for a post operative visit with your surgeon to discuss this and to rule out a fluid collection in the left upper pole as a starting point. Â The left breast also looks larger, but fluid in the upper breast could cause that as well as cause the left nipple to look lower. Â If the left upper pole feels abnormal, an ultrasound to rule out a fluid collection above the implant (seroma) might be helpful. Â If present, it could be aspirated under ultrasound guidance safely. Â If there is no upper pole process on the left, then the current asymmetry might have to be resolved surgically, although I would recommend waiting an appropriate period of time (3-6 months) after the primary procedure to avoid re-operating too soon. Â Good luck with your continued recovery. Â
Typically surgical fees are determined according to time estimated that the procedure will take. The general complexity of the case may also figure into the final amount. Additional costs may pertain to the use of specialized equipment - as with ultrasonic assisted liposuction, which requires an ultrasound device to emulsify fat prior to its removal. The addition of ultrasound to a liposuction procedure increases the cost due to the equipment used, but also due to a small amount of additional time that this technique of liposuction requires. The results may be improved however due to a better skin redraping effect (smoother skin) and quicker recovery, as well as more fat taken out. For nonsurgical procedures, it really boils down to whether a physician or "physician extender" does the treatment and cost of the device used (not all BBL lasers are of equal quality), and then a time consideration.
Way to go on the weight loss! Don't be discouraged about the excess arm tissue, as plastic surgery will definitely help, and I never want patients to regret the healthy lifestyle change just because there is some "clean-up" to be done. You will probably want to investigate several body lift procedures to help you "get your body back", but they will be worth it. Massive weight loss patients are usually very happy, but need to remember there may also be some maintenance involved to stay tight as you age, as I always tell patients that we have removed some of the bad skin but haven't given the patient a new kind of skin that is more elastic. Having said that, it looks like you would benefit most from both the axillary and long inner arm lift incisions as well as a little liposuction for the back of the arm. When you have your arms down at your side, this incision won't show, but it will be revealed if you raise your arms, so you need to make sure you are shown some representative B & A photo's of this procedure to ensure that you are okay with the scars that will result. Scar products used in the first 6 months after surgery can really help, but it may be necessary to do scar revisions if they widen after 12 to 18 months. Insurance in my state does not cover any portion of the cost of this procedure.Best wishes to you as you review your options!
I agree with either of the above mentioned options in the two previous answers. Yet another option (and a bit simpler of a procedure), is to maintain the subglandular pocket that your current implants are in, but replace with a textured shaped device and of course, add a nice lift (removal and replacement of implants with a mastopexy). This is a very common procedure in my practice when I see patients with old saline or especially silicone implants (since most saline implants were placed under the muscle). Maintaining the subglandular space (I use a subfascial plane of dissection) eliminates the possible "double-bubble" deformity if you have sufficient breast tissue of your own that might droop with time in front of the muscle (even with a lift). The submuscular implants under the muscle do not settle to the same degree as your loose tissue will, especially now that it has been separated from the muscle by an existing subglandular device. The dual-plane technique of switching your implant into the submuscular space would be an important addition to that plan if you decide to switch to under the muscle, and I would probably use a smooth high profile device for best positioning of implant to tissue over time, as those implants settle better under the muscle with gravity. However, a double-bubble shape ("snoopy breast") may still occur and you should be aware of that possibility. If that happens, revision lifts may be necessary more often to correct it and to place the ptotic tissue back in front of the muscle and higher projection point of the submuscular device which doesn't settle as quickly as the tissue will. The alternative I suggest eliminates this "disproportion" of implant to muscle, the textured surface reduces the slightly higher incidence of capsular contracture of implants in the subglandular space (although you have not demonstrated that as a problem with your current devices), and the textured surface and firmer gel of these devices kind of "holds the tissues" to itself and gives a very natural shape in the subglandular space. No implant prevents future sagging, and it would be important not to choose an excessively heavy or large replacement device, but this approach may provide the best longterm shape as the breasts continue to age. I like the shaped higher profile gel implants for the subglandular space, and although the gel is firmer, the breasts still feel naturally soft (youthful breasts ARE slightly firmer to touch). In the end, all options have pro's and cons, but this option had not been mentioned previously and is often advantageous for the revision patient like you. The subglandular space has many benefits - all implants do not have to be placed in a submuscular pocket - and revision patients with a subglandular device currently, in particular, might do better maintaining that space for the replacement device for the reasons I mentioned. Best of luck to you,Julene Samuels,MD
From the pictures it appears that you have contour irregularities from a combination of a little loose skin as well as residual uneven fat. This can result from liposuction in an area that might have needed simultaneous skin tightening, or from uneven fat resection, or both. Depending upon how loose the skin is (best determined in actual consultation), I would either recommend further liposuction utilizing the "High-Definition" Ultrasound Liposuction technique (VASER Lipo 2.0), a tummy tuck to tighten the loose skin, or possibly a nonsurgical series of VASER Shape ultrasound treatments to tighten skin (if it is more minimal than requiring a tummy tuck). The advantage of using ultrasound liposuction (Vaser Lipo) for the primary treatment is that the heat of the ultrasound waves beneath the skin provides a bit of indirect skin tightening during the fat removal process and helps me prevent these kinds of contour irregularities. Good luck!
