Would any doctors be happy with this result? Breast augmentation (Photos)

Hi! I had a breast augmentation on 16th July this year. At first I was delighted and I was happy with the shape. I have followed instructions properly, after care, washing, sports bra wearing etc. I feel that they have sagged WAY faster than anyone should expect. I expected this after a few years not weeks. My nipple is a lot larger than the other one aswell. I've attached some pictures just after surgery, and some from today. I feel £6400 is a lot to pay for my results.

Doctor Answers 16

Realistic Expectations?

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Hi Shazzyb1990, You look great! I am saddened and surprised that you are this unhappy and wonder what your expectation was with this surgery? I hope that your surgeon set a realistic expectation for your outcome. It appears from your photos you had a full mastopexy, not just a breast augmentation. Two of the key issues with this procedure that greatly affect your outcome are: gravity and skin quality. Your natural breasts before surgery were already stretched and sagging, that's probably your key reason for seeking out surgery in the first place! However, this procedure doesn't change the quality of your skin. Once your skin is stretched, that's it! The quality of that skin is poor. It can't hold weight and keep it's shape. A mastopexy will lift and cut away some of the the stretched tissue, but the skin that remains is still this poorer quality. Add to that the weight of an implant (the larger the implant, the more weight) and gravity will cause the breast to sag again. That being said, you don't look to be sagging at all...yet! I do agree that your areolas would benefit from a quick revision, reducing their size and tightening the skin a bit. Otherwise, your outcome looks great! That being said, it is important to share your feelings with your surgeon. Contact them and open the lines of communication. P/S If your cost is in USD $, you paid a very fair price for your procedure! If you're in Birmingham ENGLAND and not Alabama, I'm not sure! Best of luck to you!

Orange County Plastic Surgeon
4.9 out of 5 stars 65 reviews

Augmentation Mastopexy combination.

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This is the operation that requires the most patient education because it is variable in its outcome. It is prone to implants settling unevenly, recurrent laxity and even scar widening from the force of the  implants on the lift.

Size also makes a difference. Large implants go south, lift or not and your implants look big.

Some adjustments and scar revisions can be easily accomplished, but wait a year until the tissues have fully relaxed.  If your goal is to make those large implants stay north you may not be satisfied. Smaller implants, smaller breasts take on less droop.

Hope this makes sense.

Adam Tattelbaum, MD
Washington DC Plastic Surgeon
5.0 out of 5 stars 115 reviews

Depends On What You Expected and Understood

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As a surgeon, to my aesthetic eye, it looks a little big to me overall.  You did not mention what size implants were used.  Your pre-operative pictures look like you had a fair amount of your own breast tissue and probably a Grade 2 breast sag (ptosis) to begin with.  It would have depended on your exam pre-operatively, but sometimes it is better to have an aggressive breast lift first and then do the augmentation months later.  I recommend this quite often.

However, having said that you had them together and the result you have is basically what would have been expected.  It actually looks like a good result with good symmetry.  It is a complex operation to plan and it looks like your surgeon did good pre-operative planning judging from your marking pictures. Yes, your areolas have stretched out some, but that is to be expected when doing and augment and a lift at the same time.

Continue to have open and positive communication with your surgeon.

Gordon Telepun, MD

Decatur, AL

Results after breast augmentation with a lift

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Sorry to hear that you are unhappy with your results. I would always share these concerns with your surgeon as some things can usually be addressed in their office. The stretching or widening of your areola is a common one.  Revising this and placing a permanent suture can be tried. As far as the lift, this too can be tightened although with large, heavy implants in place it is always going to be hard to fight gravity with already damaged skin tissue.  Usually you will need to wait at least six months before attempting any revisions. Good luck!

Jennifer Geoghegan, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 13 reviews

Breasts mini lift

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Dear Shazzy,

    Thanks for submitting your before and after pictures. From observing your pictures, I must tell you, Shazzy, that you have gotten a very nice result except for the areolas that got stretched excessively, even though they are above the crease, which is the desired location. Correcting the areola is quite simple - mini lift (donut, Benneli ) with permanent sutures. That procedure will reduce the size of the areola to a more attractive size and tighten the skin.

    You have to realize that gravity and skin elasticity are beyond the control of the surgeon and you have to have realistic expectation. Before surgery you were saggy, just by the shear force of nature. Adding large implants to your genetics, will , obviously hasten the descent of the breasts. 

   Your surgeon did a good job , except for the areolas as I said before and that can be corrected easily. The price that you payed for such a complex procedure is quite average.

                     All the best,

                                      Dr Widder

Augmentation mastopexy

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Augmentation mastopexy is a complex procedure and should not be regarded as permanent and has a high revsion rate - if your skin was damaged with lots of stretch marks prior to surgery then your breast with sag more quickly if large implants are used and one areola can stretch more than the other - you may require a small revision and slight further skin tightening to maintain your result - wait 6 months then discuss with your surgeon

Circumareolar mastopexy augmentation

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It can be a very tricky operation.  Depending on the size of the implant, thinness of your soft tissues and degree of lift (or skin excision) attempted all influence the outcomes.  It is common for the areolas to enlarge due to the competing forces of the mastopexy and implant.  A Gortex blocking suture can control the areola widening to some degree.  It is also common to see tissue sag particularly in patients with thin skin and large implants.  

You have an acceptable result.  Your overall breast aesthetics are good.  If you are unhappy with the size of the areolas and/or implant position, you can always revisit with your surgeon at the year mark to discuss a possible revision mastopexy. 

Andrew Gear, MD
Charlotte Plastic Surgeon
5.0 out of 5 stars 29 reviews

Breast augmentation/lift

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I'm sorry to hear you have concerns regarding your recent surgery.  Breast augmentation with a lift is a complex surgery with a number of variables.  Your breast shape is dependent on the implant used and the nature of your breast tissue.  Large implants can cause a more apparent sag or droop due to the weight on your native breast tissue.  Additionally, women with native breast tissue laxity or droop can have the tendency to stretch or loosen post-surgery.  As far as the nipple areola complex, a permanent suture should be used to decrease stretch or widening.  I would discuss your concerns with your surgeon.  Revisions can be done but I would suggest waiting six months from the time of surgery.

Best of luck,

Dr. Mooty

R. Clark Mooty, MD
Lubbock Plastic Surgeon
5.0 out of 5 stars 28 reviews

Results from lift 3 months post op

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it is very hard to predict how tissue will heal. When patients start with very large nipple areolar complexes (NAC) as you did they tend to want to stretch back out some from where it was when the procedure was performed. That's why most when dealing with the size NAC you had preop would have placed a permanent suture for the area around the nipple to try to minimize the tissue from stretching back out. I would suggest reviewing this with your surgeon. Best of luck.

William J. Hedden, MD
Birmingham Plastic Surgeon
4.8 out of 5 stars 334 reviews

Breast lift and implant

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Thank you for your question. Your nipple stretched after surgery. Also your breasts sagged more. It depending on factors like size of the implant, quality of the tissues etc. Please talk to your PS and express your concerns and revision can be done after 6 months of procedure.

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.