Should I get a revision? (Photo)

Dear jotbanks,
you can wait until you are fully healed to see the final results. In case you are not satisfied with the results, you can get a revision surgery. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Your breasts have bottomed out, your nipples are pointing upward and you have no upper pole fullness. Your inframammary fold was released and that is why your breasts have bottomed out. You will need smaller implants, the pockets dissected towards the top to allow placement of the implants and the inferior and lateral pockets sutured to eliminate the inferior displacement.

Best Wishes,

Gary Horndeski, M.D.

Your main problem is that your implants are too heavy for your tissue and are bottoming out. If you decide to have surgery, you need to go smaller, tighten the inferior pocket, and might need mesh for support.

I see three issues with your augmentation.
The first is that you have breast divergence. This would be visible on your preoperative pictures, and it cannot be changed with breast augmentation. This is something that you will always have and needs to be excepted.
In regards to the size difference your breast, while they are slightly asymmetrical in size are fairly even and certainly by average women’s breast would be considered normal. No woman has two breasts that are identical ever.
If the size alone bothers you enough to have a second procedure that would be up to you. Your surgeon could’ve done a slightly better job at implant selection. What age provider has their own way of choosing implants and sometimes how things look during surgery it’s a little different than how things turn out down the road. I think most plastic surgeons would say this is an acceptable outcome.
The third issue is perhaps the biggest problem and that is that your implants have already begin to bottom out.
This is potentially much more of an issue than any of the other problems. Implants bottom out when the pocket created the place the implant is put to low. In order to avoid this enough pectoralis muscle needs to remain intact to support the implant against gravity from sliding down.
What is the process of bottoming out as the gun contraction of the pectoralis muscle and gravity will both contribute to the conditioning worsening.
Treating bottomed out implants is better done before the condition gets worse.
The more the implants bottom of the more difficult, the correction becomes
There are basically two techniques plastic surgeons use to correct bottomed out implants
The first and most traditional way is to use internal sutures to close the pocket and support the implant, pushing it in a higher position.
A more modern approach is to also include either mesh or cadaver dermal products, like Alloderm, to support the weight of the implant and strengthen the lower pocket, holding up the implant.
Ideally, the weight of the implant should be held up by the lower fibers of the pectoralis muscle, and sufficient muscles should be left intact to not allow the implant to slide down.
Once this tissue has been transected, and the implant is not supported by the pectoralis muscle, and the skin will eventually continue to stretch lowering the implant.
If you look at your breast straight on the most of the volume should not sit below the nipple. The implant should be placed centrally on the breast without sitting so low.
Revision surgery to treat bottomed out implants is complex and requires someone who has a fish in Skilling experience with a proven track record of doing this procedure successfully long-term.
Each time someone has revision surgery, things get more complex, and the chance of long-term at successful outcome decreases.
Generally speaking surgeons who perform augmentations attend to bottom out, probably aren’t the surgeons to use for correcting the problem.
I have no idea if your surgeon has the skills and experience to correct this condition.
My best suggestion to you is to have multiple inperson consultations with plastic surgeons who have very strong breast, augmentation practices, and who take care of a lot of secondary breast implants issues.
Should you happen to live in Southern California check out the practice of Tom Pustie, MD. There are plenty of plastic surgeons who can handle this condition. Well, but finding the right provider usually takes a bit of work.
The following is a general summary and recommendations for provider selection.
To find the best provider, I suggest patient schedule multiple in person, consultations with experienced plastic surgeons in their community. During each consultation, ask each provider to open up their portfolio and show you their entire collection of before, and after pictures of previous patients who have similar body characteristics to your own or whatever procedure you are interested in. an experienced plastic surgeon should have no difficulty showing you the before and after pictures of at least 50 previous patients. An experienced provider should in fact have hundreds or preferably thousands of before and after pictures to choose from for commonly performed procedures. Being shown a handful of preselected images, representing the best results, other providers career for patients who don’t look like you is insufficient to get a clear understanding of what average results look like or what your results are likely to be in the hands of each provider.
There is no correct number of consultations needed to find the best provider. The more consultations you scheduled the more likely you are to find the best provider for your needs. Take careful notes during each consultation, especially regarding the quantity and quality of before and after pictures. It’s not a bad idea to bring pictures of your own body to use this reference when reviewing before and after pictures. The biggest mistake patients make is scheduling only one consultation without properly vetting or comparing providers before scheduling surgery.
Best,
Mats Hagstrom, MD