Dr. Ashley Tregaskiss is a board-certified plastic surgeon in Vancouver, British Columbia. The founder of Pacific Plastic Surgery, Dr. Tregaskiss specializes in breast enhancement, tummy tucks, body lift surgery (including back lifts, arm lifts, and thigh lifts), and complete mommy makeovers. He is also highly skilled in face and neck lifts, eyelid lifts, and brow and forehead lifts. “It is a privilege to be a plastic, reconstructive, and aesthetic surgeon,” says Dr. Tregaskiss. “It is one of the most challenging, diverse, and at times humbling medical careers. As a plastic surgeon, I have developed an eye for detail and a desire to always attain the very best results for my patients.” After receiving his Bachelor of Medicine, Bachelor of Surgery (MBBS) degree in Surgery and Pathology at University College London, Dr. Tregaskiss earned his Master of Science degree from the University of Louisville. Internships at London, Edinburgh and Plymouth hospitals in the United Kingdom followed, and a plastic surgery residency with the NHS in Bristol, England. He was also awarded three fellowships: one in microsurgery at St. Vincent’s Hospital in Sydney, Australia; another in breast reconstruction at Vancouver General Hospital in Canada; and a craniofacial fellowship, also at Vancouver General Hospital. Dr. Tregaskiss is board-certified by the Royal College of Physicians and Surgeons of Canada - Plastic Surgery. He is also a member of the Canadian Society of Plastic Surgeons and a Fellow of the Royal College of Surgeons of England.
A: This appears from the front view photo at least be a very mild case of symmastia (2 breasts meeting in the midline)
Agree with the other surgeons comments here. Unfortunately there is not a non-sx treatment that will help this. Options include a) trying to suture the affected skin back down to the chest wall b) changing augmentation to a sub-muscular implant placement with a modestly smaller implant (more likely to work).
IMO get a second opinion.
A: Breast asymmetry can have multiple components including differences in volume, breast footprint, ptosis (droopiness), nipple position and more rarely significant skeletal (chest wall) asymmetry. It can being frank, be a very challenging problem in some cases.
But here goes. From your photos the obvious asymmetries that I see are in breast volume(projection) and nipple position, although as other authors have noted there could also be chest wall asymmetry present too. The first two issues are readily improved upon, the third if present can be harder to correct.
Without a in-person assessment it can be hard to accurately determine the relative importance of these factors and come up with a plan to improve things for you. Hence the reason for the disparate views of my fellow surgeons. Get a second or even a third opinion before undertaking any further Sx.
A: Yes, all of your stated goals are attainable with an augmentation + lift.
A lift alone will not giving you any lasting upper breast fullness, nor increase the size as you desire, even if it is a modest increase.
A: The short answer to your question is maybe. You look to me to be a 'borderline' candidate for aug versus aug/lift. The 10 cm measurement is a guide only and is not a hard and fast rule as far as i am concerned.
Judging from your pictures I have had similar patients some of whom have opted for implants only and some of whom have opted for a lift plus implants.
The answer is tailored to the individual patient/circumstances. Some patients are very averse to having additional scars on their breast and some patients are very particular about the shape they are trying to achieve (thus requiring a lift as well)
In this setting I find 3D simulations such as Vectra very helpful as they can give simulate the results of both approaches. Interestingly, I have been frequently incorrect in my assumptions about which patients opt for augmentation versus aug/lift based upon their initial requests.
My advice would be to seek out a provider who can perform such simulations and confirm what it is you prefer/dislike before proceeding
A: Hello,
Judging from your photo, if you look closely the light reflection on each pupil it is at the same level on both sides (or very close to it). I therefore think the primary problem is the enophthalmos (eyeball sitting back inside the orbit on that side) rather than the hypoglobus.
Without looking at your CT it's hard to say why this is happening but typically with the syndrome there is some collapse of the orbital floor. If so, this can potentially be reconstructed with an implant (preferably custom in such a case) to correct the deformity. If as you say however the bony orbit looks 'normal' then it could be due to soft tissue atrophy (wasting) within the orbit, which would be difficult if not impossible to correct.
If you have not already I would recommend consulting with a surgeon who has extensive cranio-maxillo-facial experience to discuss this problem further.
Thanks