Steri Strips are off, and the scars look so good so far! I feel like the swelling is going down a bit, I'm hoping to see the lipo swelling come down more this week. I am able to move around much more, and I went down a size in my waist garment.
Breast lifts can be challenging procedures because the results evolve over time. I always counsel patients that a mastopexy (breast lift) will reshape the breast and reposition the nipple to a more central, youthful location. However, the procedure relies on skin and breast tissue that previously failed to support the breast, so some degree of settling and stretching is expected as the tissue adjusts to its new shape. Most of this settling occurs in the first 3 months, with more subtle changes continuing up to 6–12 months. One of the most common concerns during this process is a loss of upper pole fullness. Experienced surgeons often anticipate these changes by tightening the lower pole and placing the nipple slightly lower than the final desired position, knowing that the breast will change over time—but individual healing and tissue quality can make results somewhat unpredictable. The good news is that in plastic surgery, very few situations are truly hopeless. There are several excellent options to improve your result: 1. Breast Implants: Adding an implant can restore upper pole fullness and overall volume.2. Fat Grafting: Liposuction with fat transfer to the upper breast can provide a natural boost in volume, although results are less predictable and more subtle (typically improving volume by about half to one cup size).3. Mastopexy Revision with Internal Support: A revision breast lift can be performed, often with the addition of an internal mesh or scaffold ("internal bra") to help maintain shape and support long term. Discuss these options with your board-certified plastic surgeon to determine what approach aligns best with your anatomy, goals, and lifestyle.
Implants often sit high on the chest after surgery due to several factors, including swelling, skin and tissue tightness, and muscle compression. This is a normal part of the healing process. As postoperative swelling subsides, there is more room for the implant to descend. Over time, the skin and breast tissue gradually stretch, allowing the implant to settle into a more natural position. If the implant is placed under the muscle, muscle relaxation and decreased spasms during healing also help the implant drop. Additional factors like scar formation and surgical technique can influence this process. The most significant settling typically occurs within the first 0-3 months after surgery, with more subtle changes happening between 3-6 months. The final implant position is usually reached between 6-12 months. While some additional descent can occur after this period, it becomes much more difficult. Aggressive massage and the use of a bandeau are most effective during the initial 3 months, but may still offer some benefit afterward. It’s important to maintain regular follow-up visits with your surgeon, as both preoperative planning and postoperative care are just as important as the surgery to achieving optimal results. Your board-certified plastic surgeon should assess the reason behind a high-riding implant - such as capsular contracture or implant malposition - and guide you through appropriate treatment options to help meet your aesthetic goals.
You’re in a very difficult situation, and I’m sorry you had to experience this. It’s hard to determine exactly what happened without seeing your preoperative anatomy or the intraoperative details - surgery is very complex and I never want to say your surgeon did anything wrong. I often counsel my patients before surgery that if their breasts are naturally widely spaced, the implants may also need to be placed wider apart as well. Otherwise, the implants may not sit properly under the breast tissue, and the nipples can end up appearing too lateral or even off-center. The good news is that in plastic surgery, there are almost always options - though they may require further surgery. However, your options will heavily depend on your physical examination. I perform many breast augmentation revisions, and in your case, potential solutions might include:1. Exchanging your implants for higher volume (larger) or lower profile implant (flatter profile), which would provide more width to better fill the space between your breasts. It all depends on your personal goals.2. Converting to a dual-plane (partially under-the-muscle) placement, which can help shape the lower pole and round out the breast contour more naturally.3. Using mesh or an "internal bra", which can help control implant positioning and support more medial placement, depending on your anatomy.4. Considering a breast lift over the implants. Ultimately, the best next step is to consult a board-certified plastic surgeon who can perform a thorough physical exam, understand your goals, and create a tailored surgical plan unique for your situation. Wishing you the best on your journey forward.
Yes, a Mentor Classic breast implant may be slightly more likely to ripple than a Mentor Xtra smooth implant. Breast implants vary by volume (cc's), base width (the width of the implant that sits on your chest), projection (profile, how far it projects forward), and cohesiveness (how firm the gel is). Mentor Xtra implants are more cohesive - meaning the silicone gel is firmer and holds its shape better. This increased cohesivity helps the implant distribute tension more evenly and reduces the risk of internal folds or wrinkles (which cause visible rippling). Rippling is typically only a concern in very thin patients, those with minimal natural breast tissue, or patients who have had rippling issues with previous implants. That said, Mentor Classic implants can still produce excellent results, especially when placed under the muscle (submuscular) or partially under the muscle (dual-plane). Always discuss your goals and anatomy with your board-certified plastic surgeon, who can recommend the best implant options for your needs.
Keloids can be challenging, as they are largely influenced by your individual and unique healing response. That said, the abdomen is actually one of the areas least likely to develop keloids, especially when compared to higher-risk zones like the chest, shoulders, upper back, and ears. As plastic surgeons, there are several techniques we can use during your tummy tuck to reduce the risk of keloid formation:1. Meticulous tissue handling to minimize trauma2. Intraoperative steroid injections3. Minimizing tension on the wound (e.g., using "progressive tension sutures")4. Layered, precise skin closure — I often use removable sutures to avoid prolonged inflammation from dissolvable ones. Postoperatively, there are additional tools we can use to support optimal healing:1. Silicone-based scar treatments2. Consistent sun protection3. Compression garments4. Early steroid injections or laser therapy if needed If a keloid does develop, treatments like scar revision, corticosteroid injections, or laser therapy can significantly improve the appearance and symptoms. The key is good communication with your board-certified plastic surgeon, who should tailor the surgical and postoperative plan to your risk profile. It’s great that you’re thinking ahead - this kind of discussion is exactly what leads to better outcomes.
