Do I Need a BA Revision? Puckering Areolas and Goggly Eyed Not Centered Nipple/areola?!

I am 1 1/2yr healed since BA :) I got 300cc, Mentor silicone, high profile, under muscle, periarioler, breast implants. The ONLY thing that bothers me with these puppies is that one implant(on MY right, with the mole above it) looks googly eyed and not centered areola/nipple. I am an out of town patient, so I can't go see my PS whenever, but he told me this is normal with puckering of under muscle placement, but any way to fix w/o overs? Is MY right breast worth correcting? Please help and thank you!

Doctor Answers 13

Post augment, is revision necessary?

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I think your nipples and areolae look O.K.and I don't think revision would produce any significant improvement.

Your right nipple is sitting a little wide on your right implant but it looks like your right nipple was wide in your pre op photos.

Placing your right implant to centre it on your nipple would increase the gap between your breasts and give you a wider cleavage. 

Changing the plane of your implants and putting them in front of your pecs would be a bad idea because there would be very little soft tissue to disguise your implants.

I think your result looks good and I wouldn't advise revision.

Melbourne Plastic Surgeon

Breast Augmentation with Animation Deformity

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Congratulations on your results.  Judging from your before and after breast augmentation photos, I think you have a very nice result.  Looking at the preop photos, there is some slight asymmetry where the right nipple and areola are a bit more lateral or more to the outside of that breast.  You notice this more after the surgery as it is normal to assess your postoperative breasts even more so than before.  The animation deformity is part of having implants behind the muscle.  It is one of the drawbacks but since there are so many more benefits, in general, most plastic surgeons place implants behind the muscle now.  Therefore, I would not recommend changing your implants to in front of the muscle, that would not be good.  Hope that helps. 

Farbod Esmailian, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 88 reviews

Breast augmentation issues

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Your results do look nice as compared to your pre-ops.  Changing the pocket location may not be a good idea since you did not have a lot os soft tissue coverage to begin with.  

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Breast augmentation second opinion

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I would not recommend over the muscle placement of breast implants in someone as slender as you.  The results of this long term will look very unnatural.  The lateral position of your nipple likely is related to where it was positioned pre-op.  If you are okay with a scar around your nipple, it might be able to be moved towards the middle a bit with a small office procedure.  Good luck.

Do I Need a BA Revision? Puckering Areolae and Google Eyed Not Centered Nipple/areola?

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      Your result is good based upon preoperative photos.  The placement of the implants in a subglandular plane would not be recommended due to lack of breast tissue and more likely implant visibility and rippling.   The animation deformity is not particularly impressive either, but fat grafting or placement of dermal matrices are the two options available.  Kenneth Hughes, MD Los Angeles, CA

Sub muscular breast implants will be distorted when the pectoralis muscle is engaged.

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Sub muscular implants will be distorted when the pectoralis muscle is engaged. The provided photograph is an excellent example.

Breast implant revision

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It seems to me that you have a very reasonable result following your breast augmentation. Your right nipple is naturally more lateral than the one on the left, and this is still reflected in your postoperative outcome as expected.  Your puckering when flexing your muscle can happen following implant surgery, particularly in very thin and fit individuals.  The advantages of having the implant in this position, however, far outweigh the disadvantages and this is why your breasts look well under most circumstances, when you are not flexing your muscles.  It does not appear that you need a revision at all.


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While you might decrease the animation deformity by converting to a subglandular pocket, I don't think it's worth the possible tradeoffs including a somewhat higher risk of capsular contracture and more likely visible rippling, especially given your lack of coverage. You might also see the upper edge of the implant resulting a more obviously augmented, less natural upper slope. If you can accept this normal outcome with submuscular augmentation I think you might be better off leaving this nice result and staying with your current pocket.

Breast augmentation puckering

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I believe you have a great result.Changing your implants on top of muscle not a good idea.Nipple reposition doen't always work and can live you with undesirable scars.

Dr.Rosendo Martinez,FACS

Puerto Rico

Rosendo Martinez, MD
Puerto Rico Plastic Surgeon

Good Result

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Thank you for photographs.  Based on your photos I would recommend leaving well enough alone.

Dr. ES

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.