Implant malposition? I have no upper fullness and am very sad. Options? (photo)

Question

30 year old mom of 1. Had a mommy makeover and I am underwhelmed with my breasts. In fact they make me quite sad. I went in believing I had bottomed out which I still feel is a possibility. I feel like they still “hang” my left breast is much firmer and when I lay on my side it is uncomfortable on that side. I see a huge asymmetry that I didn’t notice before. In size as well as shape. My doctor is thrilled with the results and doesn’t see my concerns at all.

Gary M. Horndeski, MD · Answer

The technique I recommend is explantation and lift using The Bellesoma Method. The implants are removed, your breast tissue is reshaped creating upper pole fullness, 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 or small implants can be placed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Robert L. Steely, MD, FACS · Answer

Hello!

sorry for your disappointment- we don't undergo cosmetic surgery to be underwhelmed wit the  results!

looking at your photo- i do agree your breasts are too low- the distance from your nipple to your fold seems too long for your breast envelope, cheat wall height,  and implant size.  that being said- there can be other factors such as skin elasticity that can contribute to this issue.

I have good news and bad news.  The good news is that can certainly be fixed- and frankly now that you have an internal capsule to work with due to having an implant you results would likely be even better than they could have been anyway.  The bad news is that it does take another surgery.

Make sure you wait AT LEAST 6 months before embarking on another procedure- you need time for the capsule to mature to be able to use it as an "internal bra" to help hold your implants.

i hope this helps.

Daniel Barrett, MD · Answer

Dear Paigewieting,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Paul E. Chasan, MD, FACS · Answer

Thank you for your question.  Although your result is not a poor aesthetic result, I understand your concerns and have developed a surgery over the last 20 years to correct this issue.  There are many women who have fairly large breasts and would like to have a much higher, more round appearing breast.  Most surgeons do not know how to perform a Reductive Augmentation. it appears that you never had the correct procedure for your desired outcome, i.e. removing the inferior pole breast tissue. You are an excellent candidate for a procedure I developed termed "Reductive Augmentation" in which we perform implant exchange to an ultra high-profile silicone implant, lateral and inferior capsulorrhaphy-internal bra, and revision mastopexy with removal of inferior pole breast tissue. I published in 2017 you can view it on my website under publications. Best wishes to you.

Ronald J. Edelson, MD · Answer

It’s not a bad result at all. It is possible that the lower portion of the breast has stretched out and a revision could tighten that skin. I would need to take specific  measurements to be sure what needs to be done. But it is a good result

Wess Cohen, MD · Answer

Thank you for your question. The links from your nipple to inframammary fold appears too long and there is a large amount of breast tissue and implant that are sitting below your nipple which is causing it the lack of upper pole fullness. The correction for this is to shorten this distance as a mastopexy. This needs to involve re-suspending the breast tissue as well as possibly raising the IMF. A surgical mask may be useful in helping achieve this goal. Furthermore, your left breast is a different shape and firmer than your right breast and also has pain which could be indicative of capsular contracture. Good luck

Connie Hiers, MD, FACS · Answer

With your anatomy, your breasts naturally sit somewhat low on your chest and your bases cannot be raised. Your nipples are in good position, but one breast does sit slightly lower than the other.  Going larger may give a little more upper breast fullness, but more likely to sag again with time.  I would suggest keeping what you have for now.  Some women cannot have high sitting breasts and you are in that category.

Darryl J. Blinski, MD · Answer

Only 1 posted photo, no before photos posed?? Maybe your preoperative breasts were much worse? But yes you need full lift revision to obtain better symmetry and higher placement of N/A complexes. fee $10,000. Best to virtual consult with...

Richard P. Rand, MD, FACS (retired) · Answer

I can't say anything about the firmness you feel and whether it represents some scar tissue around the implant. However, from the width of your vertical scar and how long it looks, I imagine you had a lollipop lift. If you put a tape measure with 0 right in the fold under the breast and measure how long it is up to the bottom of the areola, unless it is less than 6-7 cm, the limb is too long and making you look baggy and matronly. If you were to revise that, you would need an incision in the crease (anchor lift or T scar) to tighten up the lower pole. If you look at all the lift photos on my website, they all have the T scar.