Breast revision - asymmetrical, cording, tugging at nipple, implant flipped. Will going larger and a lift help? (Photos)

Question

Sientra hsc+ gel (gummy bears), ultra high profile 510cc both sides. having a revision next month.They are not symmetrical. My right breast is a little larger and drops down more than the left. The left didn’t settle as low as the right. I developed cording (axillary web syndrome) in my left armpit that felt like it was attached to my nipple, felt a tug at my nipple when raising arm. I had the fat pads lipoed during the procedure as rec. by my surgeon. I had only ever experienced this 1other time when I had a large abscess lanced under that same armpit 4 yrs ago. Could cording have possibly interfered with implant dropping fully? I was able to relieve cording through stretching/massage within a month/2. My surgeon didn’t have an answer. The difference in drop/size aren’t a big difference but enough I can see it when not wearing a bra in some outfits and it makes me self conscious. The 2nd reason is right breast implant FLIPPED inside of me a few months ago. I was very lightly massaging my breast like my surgeon instructed me to do daily. I was able to flip back. So far the plan is to go slightly larger. Maybe 600cc left and 550-575 right? And a lift on the right. To fix the asymmetry and fill the right pocket more and she will suture the pocket to make it smaller. Does this sound like a good plan? I am concerned about further nerve damage. Will going in the same incisions, top my nipples, cause further lack of sensitivity issues? Or is under breast a better option for this?

Daniel Barrett, MD · Answer

Dear SpoiledOilfieldWife,

breast revision surgery is the most difficult plastic surgery procedure performed. Botched breast surgery alters normal tissue planes and laxity, the ability of breasts to heal properly, and leaves scar tissue that dramatically affects the level of difficulty of the corrective surgery.
Many patients come in to correct poor outcomes from their initial surgeries. The most common problems are due to implant malposition, bottoming out of the implant, poor scarring, and incorrect implant size.
While the type of revision required will depend on the result of the previous surgery and the desired result of the patient, some revisions involve extensive pocket repair that may or may not need specialized external bras.
If you are considering breast surgery revision, you should speak with a board certified plastic surgeon and have yourself properly assessed. Only after a thorough examination you will get more information and recommendations. Also, you have to make sure that your surgeon understands your breast augmentation goals.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

I would not go larger and would go with smooth round implants which can flip around all they want. Round implants also have a longer lifespan and fewer risks. On your lower breast, the implant is dropping a little more than it should outside the breast. Going larger may make this worse. Bigger is not always better.  I would not use the armpit incision.

Darryl J. Blinski, MD · Answer

Based on your series posted photos, I would do a full breast lift with a smaller implant on the lower and larger breast. I would also do a release of this axillary scar component with some fat grafting. Fee $8000-$10,000. Best of virtual consult with.

Mats Hagstrom, MD (license on probation) · Answer

To make a quality assessment, we need quality information.
At a minimum that means having a complete set of proper before and after pictures.
It should ideally also include an examination and access to your operative report.
To get a proper second opinion consultation, I suggest you schedule those as in person consultations with other plastic surgeons in your community.
 Come prepared to bringing with you a complete set of proper before and after pictures and a copy of your operative report.
You can request these from your current provider. They are part of your medical record which you have a right to.
Anytime, excessively large implants are used the chance of having undesirable side effects, complications and need for revision surgery will go up.
The bigger the implant the more likely ought to have problems and need further revision surgery.
 This can lead to a slippery slope with multiple repeat operations, making things more complex and difficult each time.
If you’re going to choose the same provider to do the revision surgery, then make sure here she has experience doing this kind of revision.
Ask them to open up their portfolio and show you their entire collection of before and after pictures of previous revision cases like yours, they have done.
 When things don’t turn out well from the primary procedure, the chance of a high-quality outcome goes down.
My best suggestion is to find the most experience provider.
I generally always recommend patients have multiple in person consultations before selecting a provider.
The more complex the situation is the more important provider Selection becomes.
Good luck,
Mats Hagstrom MD

Breast revision - asymmetrical, cording, tugging at nipple, implant flipped. Will going larger and a lift help? (Photos)

Answers (4)

Answer: Breast augmentation

Answer: Breast augmentation

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Everything you need to know about Breast Implant Revision

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Breast revision - asymmetrical, cording, tugging at nipple, implant flipped. Will going larger and a lift help? (Photos)

Answers (4)

Answer: Breast augmentation

Answer: Breast augmentation

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Recommended reading

Everything you need to know about Breast Implant Revision

Our mission is to create a world where every investment in modern beauty is Worth It.