Smaller Breast After Augmentation Revision

I just had my right breast fixed 2 weeks ago because it never dropped. So now, my doctor made a new pocket and tacked it up! I am wearing a band to get it to drop, but now I'm so worried that my breast lost all its fullness and it looks a lot smaller than my left breast (a year old). You can see a huge difference between them. I am so scared.

Is this normal, or will I now need a bigger implant put in to even them out. I feel that it shouldn't have been tacked up, just the pocket pulled down. It changed my whole breast; What can be done at this point?

Doctor Answers 18

Communicate with your surgeon

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Please contact your surgeon's office and express your fears. Being scared about your early result is not uncommon, but good communication is the key to sorting through the situation. Many patients are fearful of appearing confrontational or may presume that their surgeon will ignore their concerns. We work very hard in our practice to keep communication open and encourage patients to contact us with their questions. Be persistent in your effort and you should get the information you require. If not--post back here for further suggestions.

Bottom line: 2 weeks is too early to anticipate your results, and your surgeon is the best person to address your concerns. Hope this helps.

Breast Augmentation Revision Often Causes The Breast to Look Smaller

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Thank you for your question. Be sure to meet with your Plastic Surgeon and discuss your concerns.

When revising a Breast Implant pocket to make the implant drop, the pocket holding the implant is made larger. Thus the same size implant has more room or space to move around in and the breast will look smaller.

As you heal, normal wound healing most likely will cause tightening of the pocket around the implant and the breast will look fuller.

I would wait 6 months before considering revision again in my patients. Keep in contact with your surgeon and discuss your concerns.

Revision breast augmentation will correct asymmetry.

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I know this is not what you want to hear, But I am afraid you will need another operation. I don't know why your breast implants are not the same, but it looks like the right pocket needs to be lowered, and a larger implant put in.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Tack up, pull down?

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I will assume that by "tacked it up", you are referring to the breast itself. That would explain the "boxy" appearance of your breast. This "boxiness" is a typical result of a classic breast lift procedure. If this is the case, then it could cause a tightening and slight decrease in the size of your breast. The skin should relax somewhat over time and as the implant descends it may round out the base of your breast again. At 2 weeks it is way too soon to critically assess your result. Wait it out and follow up closely with your surgeon. Good luck!

Too early to worry

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Sometimes it is difficult to revise only one side, because of this very problem.  It is however, too early for you to worry.

Breasts Appearing Smaller After Unilateral Pocket Revision

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                  It’s not unusual for breasts to appear smaller following unilateral pocket revision. This is primarily the result of pocket expansion, which causes the implant volume to be more evenly distributed and results in less projection of the breast.

                  The immediate post-operative period is characterized by dynamic changes which effect the appearance of the breast for up to six months following surgery. For this reason, we generally don’t recommend revisional surgery for at least six months. It’s important to realize that the left breast is further along in the healing process than the right breast. This will obviously account for some of the differences that you see.

                  It’s important that you continue the use of a superior breast compression device. It’s also important to continue massage of the breast.

                  This type of problem can result in significant anxiety. It’s therefore important to discuss this issue in detail with your surgeon. If you’re not satisfied with your surgeon’s response, it’s not unreasonable to get a second opinion. 

Different Size and Shape After Revision May Improve

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The differences between your breasts may even out with time.

Tissues change in the months after surgery, including resolution of swelling and settling of tissues.

You owe it to yourself to discuss your concerns openly and directly with your surgeon, and follow his/her suggested time frame.

If you are still dissatisfied, get a second opinion, but give yourself 3-6 months before making any decision to have more surgery.

Paul C. Zwiebel, MD
Denver Plastic Surgeon
4.7 out of 5 stars 46 reviews

Smaller Breast After Augmentation Revision

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Hi DIVA77, We don't have before photos here so it's hard to compare what you have now to what you are describing.  I don't see a huge difference in volume between your two breasts. If a larger pocket was created, the implant volume now has more room to distribute. Regardless, at this early healing stage, it's too soon to make any assumptions. Your surgeon is the only person who can address any of these very specific concerns, they know your history. Make sure you are seen for your scheduled follow up appointments and they monitor you closely. Good luck to you.

William Aiello, MD
Orange County Plastic Surgeon
4.9 out of 5 stars 65 reviews

Seeing final results takes time.

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Just like after your initial surgery, it takes time for the breasts to reach their final placement and appearance after a revision surgery. It is understandable that you’re nervous about waiting, especially when you ended up needing revision surgery after the initial surgery. However, there is a reason that plastic surgeons recommend waiting at least six months before considering revision surgery, and that’s because your body is still settling into your final contours. Call your surgeon if you have concerns, but also remember that you might have to just try to be patient before you see your final results.

David N. Sayah, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 10 reviews

Breast asymmetry after revisional surgery

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When a breast pocket is "tacked," there is some relaxation that is to be expected over the course of healing.  As you are only 2 weeks status post surgery, it is something to watch over the course of 2-3 months as the implant relaxes and "falls."  Sometimes the waiting is the hardest part.  Relax and keep your scheduled appointments with your plastic surgeon so you can have him/her make comment through your healing process- and yes, you are still healing.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.