Over dissected pocket, deep ripples, bottoming out, implants switched, honest mistake w/ unsuccessful remedy or botched? (photo)

Pre-op I was told 425L 400R week 2 post op R was larger and I heard a pop near axila, deep ripples on R side when I lean forward. Was told just swelling and just a stitch. 1mo found out implants were switched because R breast "fell to the side" during surgery. 2mo breasts were uneven in size and right was much lower, they also are very far apart. Dr. Offered to correct right pocket only and gets very aggravated if I ask any questions. I'm terrified to go back into surgery and come out even worse

Doctor Answers 5

Need more information.

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I am sorry to hear you are having difficulties. You should ask your surgeon more questions if you are not happy with your results, or if you don't have confidence seek another opinion. Over dissection of the pocket looks to be an issue on the right, and this can happen. It sounds like he may have added sutures but it's easy to have one break with vigorous movement and allow the implant to drift laterally. With very large implants it can be difficult to correct this without a reinforcement using a biologic dermis or mesh. Again, seek consultation with your doctor or another.

Santa Barbara Plastic Surgeon
4.8 out of 5 stars 17 reviews


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There are multiple issues with your case which should be handled more effectively in an in office consultation. 

Ron Hazani, MD, FACS
Beverly Hills General Surgeon
4.9 out of 5 stars 316 reviews

Right breast malpostion

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You are demonstrating right breast malposition, which is caused by over dissection of the lateral breast pocket if not present on your preop. What you need is a revision of your right breast to close off the lateral pocket. This will bring your implant to the center and improve your cleavage and middle fullness. A consultation would be helpful to determine what revision you would need.

Arian Mowlavi, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 106 reviews


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Thank you for the photos and question and if you now have lost faith in your surgeon I would go on consults with experts in your area

Dr Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 65 reviews

Unsatisfactory Result After Breast Augmentation

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I am sorry about your situation. Your photos depict the right implant sitting slightly lower and more lateral than the left, which appears to be in good position. There is no way to determine if the pocket was made too wide or not based on your current appearance, because this can theoretically happen regardless. All we know is what you said you discovered, that your right implant was already too lateral in the operating room. As for rippling, I would expect you to have that on both sides given your lean body, small breasts, and choice of implants that are anatomically too big for your breast dimensions.

Repair should not be attempted until at least 3 months, the minimum time it takes for the capsule to mature.  There are many options available to try to fix the malposition as well as the rippling, including sewing the capsule down on the side, creating a new subpectoral pocket, using an acellular dermal matrix (ADM) like Strattice for support and 'tissue thickening', changing to form stable implants (gummy bear implants), or changing to smaller implants.  All of these options can be used in various combinations with each other depending on what you and your surgeon determine to be right for you.  

Your surgeon should be experienced in and have a great reputation for revision surgery; certification with the ABPS and membership with the ASAPS are minimum but important criteria.  If  your doctor is this well qualified, then it might be worth sitting down with him and telling him his behavior scares you and what you need from him is support. Although your issues are seemingly minor, it is not unreasonable to want an improvement. If you can't make a connection, move on.

Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 100 reviews

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.