Phillip Dauwe, MD

Rippling occurs more commonly in thin patients. If you have less soft tissue covering the implant, then it is more likely that you will see the rippling in the shell of the implant. Going larger is not the right answer to fix this. This will only stretch your soft tissues leading to worse rippling. If you exchange your implants for "form stable" implants, which comes in the Allergan Soft Touch or Cohesive or Sientra 106 gel, this will help.

Your results look great for 2 weeks. It is not natural to have "perfectly circular" areolas, and very difficult to achieve that surgically, especially with the amount of lift and size implant that was used. Give it time and allow your tissues to adjust to the implant. Time fixes a lot!!

Hi there, When a breast lift is performed the skin from the areola is sometimes left at the lower part of the breast when the nipple is moved up. This is a simple revision, but if you want all the pigment out, you will likely need to have a surgical revision. I would consider this more of a "second stage" to the operation rather than a "revision". Your results are really great, and this is a pretty simple fix. Generally, I recommend 6 months before doing surgery again. 

I always recommend that my patients stop smoking altogether, but my patients must be completely nicotine free for 4 weeks before and after surgery. I do not make exceptions for the type of surgery being performed. Every surgery requires wound healing, and it is scientifically proven that nicotine impairs wound healing. In my opinion, you are just asking for problems. 

Implants "drop" into position over 3 months following surgery. Everyone progresses at different rates. What is actually occurring in your breast, is the implant is expanding the lower pole of your breast. Breast bands can help tremendously. It would be helpful to see some photos of your implants. Ultimately, I recommend that you speak with your surgeon about your options at this point. 

There is no one implant that will consistently outlast another, as there are too many variables leading to revision surgery. The most common reason for implant revision is malposition or droopiness of the breast. In these cases, the implant has not been compromised at all. The factors that do increase longevity of your implants are choosing the implant appropriately in terms of the size and match to your anatomy. Generally, larger implants are revised more often than smaller implants. 

This can occur for several reasons. The cutaneous nerves could be stretched from either the implant or the donut lift. You could also have an implant malposition, which can place more stretch on the nerves going to your skin and nipple. There are some medications you can take to help with nerve pain, but I would address these concerns with your surgeon. Ultimately, it can take 12-24 months for nerve pain to completely resolve. 

Breast augmentation costs vary depending on the geographic area you are in. RealSelf does a really nice job of analyzing average cost on each area and supplying that information for consumers. Generally, prices only vary +/- $1000, so I would focus more on choosing the right surgeon rather than making the decision about price. 

I would choose your surgeon based on his/her level of experience and training rather than number of awards or special feature in magazines. These awards are often not given on merit. However, your general level of comfort with the surgeon during the consult means a lot. Go with your gut! Don't be swayed by ads and awards that can be bought. 

Redness of the skin following surgery can be normal, but you discuss this with your surgeon. If you have any tenderness, fever, or chills this may be a sign of infection. The fact that it is on both sides indicates that it is likely just an inflammatory response to the surgery, but you should certainly get it checked out by your plastic surgeon.