14 Weeks Post Op. Not Satisfied with Results. Implants Seems Too Wide. When Can I Change my Implants? (photo)

Question

(transaxillary silicon gel 250/275cc moderate profile). I am very petite 5’1” 103lbs, 26.5” ribcage. I am not 100% satisfied with the results. I feel that the implants are too wide for my body, there is too much upper pole fullness It also seems like I have a bit of ‘side boob’ on my left breast. At this point I feel like I should have gone with 275/250cc high profile or something similar, with a smaller circumference than the 250 mod profile. When can I change the implants?

Jed H. Horowitz, MD, FACS · Answer

Depending on the reason for #revision, it's typically  best to wait approximately 6 to 12 months to undergo the next breast procedure.  Matters such as sagging or drooping  and size change will not improve with time. As with all cosmetic surgery, results will be rewarding if expectations are realistic. With any surgical procedure, there are some risks which your doctor will discuss with you during your consultation. It's best to consult with a board-certified plastic surgeons who have specialized in breast surgery and cosmetic surgery are suitable to perform your breast augmentation. You will then greatly improve your chances of getting the result you desire, and, without the need for a revision surgery. Aside from checking board-certification, it is suggested that you look at before and after photos of the surgeons actual patients, and read patient reviews. Gathering all of this information will help you make a well-informed decision. Please be advised that each patient is unique and previous results are not a guarantee for individual outcomes.

Jaime Perez, MD · Answer

If you are not completely satisfied with your breast implants a revision surgery may be performed. Fourteen weeks is an acceptable amount of time for recovery and you should be able to proceed with the revision. You may want to opt for a lower profile implant. If you wish to bring the breasts closer together it is possible to use dissecting techniques to bring the pockets closer together, but the ability to do this depends on your anatomy. Another option to move them together would be fat grafting.

	 

	Jaime Perez, MD
	Breast Implant Specialist
	Plastic Surgery Center of Tampa

Jourdan Gottlieb, MD · Answer

I can see the things that are unsatisfying to you, and feel they are unlikely to improve, so the revision you seek can be done any time. 

	I would prefer that you choose a smaller implant and that a high profile implant be used.

	Both pockets would do well to be lowered a bit, and that would be difficult to do with an axilary incision. A direct breast fold incision would be best. Through that incision, the outer portion of the pocket could be closed off with sutures if necessary. 

	Thanks for the question and your photos. Best wishes.

Florence Mussat, MD · Answer

Dear Patient,

	you are right, your breast implants are too big and too high for your petite body frame.

	at 14 weeks, you can undergo a revision: you would need  bilateral inferior periareolar incisions for better access, with lowering of the implants pockets, and maybe exchange to high profile smaller implants ( around 200  cc +/- )

	your current pocket dissection is placed too high, which may be seen in transaxillary approaches.

	you may wish to discuss all this with your Plastic Surgeon.

	good luck

	Florence Mussat, MD

Robert L. Kraft, MD, FACS · Answer

I would not have used the transaxillary approach as it can produce the kind of result you are unhappy with.  The sizing differential would not be as critical, perhaps, with more dissection of the breast pocket.

Darryl J. Blinski, MD · Answer

To me I would have used HP implants and not trans axillary approach. You can have exchange at any time now after 3 months of healing. You might want the left medial infra fold lowered a bit. Just my observation only of the posted photos.

Carl W. "Rick" Lentz III, MD (retired) · Answer

The best results in my opinion for breast augmentation is a periareolar incision and and sub mammary textured silicone hi-profile gel implant. This requires that you have adequate upper pole breast tissue to cover the ripples that are natural in all breast implants. If there is not enough upper pole breast tissue then a dual plane (under the breast on the lower pole and under the muscle in the upper pole) though a periareolar incision is best in my hands.
	In your case I believe that your implants are a bit too high and for you a little too big. Your idea to exchange them for smaller high-profile implants makes a lot of sense. It would be very difficult to revise them through the transaxillary approach. I would recommend a periareolar incision, a sub mammary or dual plane, high-profile 250 or 275 cc textured silicone gel implants. At this point it would be best to wait for six months to allow the tissue to settle down. You could have the present implants removed and then wait for the six months or leave them in and wait for the six months. This would give you the best chance to avoid any problems.

14 Weeks Post Op. Not Satisfied with Results. Implants Seems Too Wide. When Can I Change my Implants? (photo)

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