4 months post-op implant not dropping. Do I need a revision? (Photo)

Thank you for your question. Some patients can still have high implant placement four months after surgery, particularly if the muscle hasn't completely relaxed. Also, lack of volume on the upper portion of the breast can be affected by the size and form of the implant, your natural breast tissue and skin elasticity, the proper pocket creation during surgery, and the scar tissue surrounding the implant, which can create distortion and impact volume distribution. To evaluate the result, provide your surgeon with high-quality before and after photos. Although it's annoying, giving it a little more time—as your surgeon advises—allows for adjustments. Tell your surgeon about your worries, they'll provide you with the right advice.

Unfortunately, you have not provided before photographs. However, it appears your breasts were quite low on the chest wall to begin with. You would have been better off with a breast lift and smaller implants. At this time, I would recommend you wait until 6 months before surgery before doing any revision. At 6 months, I would recommend explant with Bellesoma Method. The implants are removed, your breast tissue is reshaped, elevated higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained if not injured during your previous surgery. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

I agree with waiting the full six months. You don’t want to operate too early and give the implant every chance to drop in its own

Thank you for your question. First, waiting six months from the time of the original surgery is 'standard' so I don't see anything unreasonable about that. However, I don't thing's will change significantly, although all tissues will get softer. The size and shape of the right breast appear acceptable. The left breast is more complicated. Although many would say that early capsular contracture is to blame, another thing that must be considered is the disproportional relationship of the pectoral muscle and the breast tissue/parenchyma. When the latter is corrected, the implant can be in a better position. A lot depends on the experience and knowledge of your surgeon. Seeking another opinion after his/her recommendation at six months is a good thing.

You still may drop over the next two months. I would suggest wearing a bra band and doing ultrasound treatments to encourage it to drop.

Based on your posted photo and no preoperative posted photo, needed. I would recommend in person or virtual consultation. Were you a symmetric preoperatively? Because it appears you had different type breast. Now the larger breast appears more normal, though you might have a slight droop. The smaller breast appears not to have had a lower pole breast dissection for the implant to fall into the lower pocket. You were correct you need a revision and revision can be done now expect revision to in fee from $10-$15,000. Best virtual consult with.

To make a quality assessment regarding the outcome of any plastic surgery procedure we need to see quality before and after pictures.
If you don’t have before and after pictures, then ask your surgeon to forward the pictures they took.
Breast augmentation surgery outcomes are based on three variables.
The first is the patient candidacy for the procedure.
Not everybody seeking breast augmentation is an ideal candidate.
Variables that determine candidacy include breast, droopiness, breast asymmetry, breast position on the chest wall, and breast divergence.
The second variable is a choice of implants in regards to size shape, and type.
Using implants that are significantly larger than the natural diameter of the breast preoperatively increases. The chance of undesirable blood comes, complications, and the need for revision surgery.
The third variable is the surgeons ability to place the implant in the correct anatomic location.
Without seeing before pictures, we can’t really assess the outcome since we don’t have a good understanding of your individual candidacy for the procedure in the first place.
Provider selection is in the end, probably the most important variable followed by implant choice.
There isn’t all that much patience can do regarding their own candidacy.
That said, understanding your own candidacy can go along ways in delivering increased postoperative satisfaction.
Understanding the impact that your own personal candidates he has on the potential outcome of the procedure can greatly improve patience understanding of what is possible and not possible.
Patients who are excellent candidates for cosmetic surgery, have the potential of having excellent outcomes in the hands of the right provider.
They can also have poor outcomes in the hands of the wrong provider.
Individuals who are not great candidates for cosmetic surgery do not have the potential of having great outcomes regardless of who does the procedure.
It does look like you’re left. Implant needs to be lowered slightly.
Without seeing proper before and after pictures it’s not really appropriate to make any definitive statements regarding the plastic surgery outcome.
Best,
Mats Hagstrom, MD