Matthew S. Kilgo, MD

Hello and thank you for your question. It is difficult to provide specific recommendations without a breast examination. However, based on your photographs, it appears you have a "double bubble" deformity and an elongated distance from the nipples to the inframammary fold, which can create the appearance of a "high riding nipple". Surgical options depend largely on physical findings and may involve a change of plane ( from submuscular to sub fascial) and/or pocket modification with a reduction in the distance from the nipple to fold by removing breast tissue along to lower breast, resulting in an "inverted T" scar. If you decide to seek another opinion, be sure to consult with a plastic surgeon certified by the American Board of Plastic Surgery with extensive experience in revisional breast procedures. I hope this helps. Good luck.

Hello and thank you for your question. If an ultrasound suggests an implant rupture, further imaging is usually recommended. An MRI is a more definitive test with greater sensitivity than an US. I would suggest contacting the physician who ordered the ultrasound to order additional imaging. If a rupture is confirmed, you should seek consultation with a plastic surgeon who is certified by the American Board of Plastic Surgery to discuss a treatment options. Good luck. I hope this helps.

Hello and thank you for your question. Based on your photographs, you appear to have tuberous or constricted breasts. Tuberous breasts describe a congenital breast shape variation that develops during puberty when the breast tissue’s growth is restricted by tight, fibrous tissue in the base of the breast. This leads to a distinct set of features, which can vary in severity. Tuberous breasts are characterized by a narrow breast base with an underdeveloped lower breast and a high breast fold.. The areola are often prominent or large and it's not uncommon common to have significant breast asymmetry. Correction typically requires a combination of breast implants with a lift and or fat grafting. Be sure to consult with a. plastic surgeon certified by the American Board of Plastic Surgery with experience in correction of tuberous breasts. Good luck. I hope this helps..

Hello and thank you for your question. Photos taken prior to your breast augmentation would be very helpful in determining the cause of your asymmetry. Often significant asymmetry exists preoperatively, which can make it more difficult to achieve symmetry with breast implants. It does appear you have a combination of issues contributing to your asymmetry. I would agree that you do have some "bottoming out" on the right side, which can be corrected with removal of your implant and repair of the capsule. Mesh support may be indicated, particularly if you want a larger implant. The implant on the left is "high riding". Correction requires removal of the implant, release of the capsule and possible additional release of your chest muscle to allow the implant to sit in a lower position. If you had a constricted breast before the surgery, additional procedures may be necessary, including lowering of your inframammary fold on that side. If you had a wide distance between your breasts before surgery, achieving more cleavage can be difficult with implants alone. I find that this can be effectively done with fat grafting. Good luck. I hope this helps.

Hello and thank you for your question. Gynecomastia can be treated with liposuction, direct excision or a combination of the two procedures. It really depends on your physical findings. If most of the soft tissue fullness in your chest area is due to fatty tissue, then liposuction alone may suffice. Direct excision alone would be appropriate if the fullness is caused by excessive glandular breast tissue. Most cases of gynecomastia are secondary to a combination of excess glandular tissue and fatty tissue, and therefore a combination of direct excision and liposuction often gives the best results. In my practice, I typically use VASER liposuction. For best results, you should consult with a plastic surgeon certified by the American Board of Plastic Surgery.