5 Weeks Post-op Breast Augmentation - Breasts Look Different (Bottomed Out, Asymmetrical)

The problem is indeed that your left implant has dropped to low.  This is a progressive deformity resulting from the combination of two factors :  submuscular(or dual plane) placement and violation of the tight attachments at your native inframammary fold.  Placing breast implants under the muscle creates a few aesthetic problems. If you look at your picture, your breasts are too far apart at midline to have a natural appearance.  any time your arm moves this appearance will widen and worsen.  This is the reult of releasing the inferior portion of the pectoralis major muscle.  The more superior origins will not allow the implant to sit in a natural place and the continual forces of the muscle constantly push the implant down and out.  When this is combined with excessive undermining of the inframammary fold, the deformity that you are seeing results and continues to progress.  This is a very common finding with submuscular placement.  To understand these forces better, stand in front of a mirror topless, put your hands on your hips and push down onto your hip bones firmly.  You will see both breasts move down and out.  these forces over time always cause lowering, lateral displacement, thinning of the breast tissue and stretching of the skin.  This is the reason that I use a unique technique in my practice called 'cold-subfascial augmentation.' This technique leaves the muscle alone and out of the equation but should not be confused with 'above the muscle' which I would also not recommend.  The cold-subfascial augmentation harnesses the strong structural power of the pectoral fascia to create a truly natural breast shape and act as a living structurally sound brassiere inside the breast protecting the breast from the pressure of the implant and forces of gravity.


I have seen many patients with identical problems to the one you present and in my opinion there is only one good solution- changing placement to a new cold-subfascial plane.  All of the native inferior support of your breast is now violated and conventional techniques like capsulorrhaphy and neosubpectoral placement rely on structurally unsound scar that will surely stretch and recur.  There are several mesh and biological products people use to restore support but these in my opinion do not offer lasting support or add new risks or unnatural feeling/appearance.  In my experience, revising breasts such as yours with a subfascial plane can create a more beautiful and lasting augmentation then your original before the problems started.  I hope this helps! 

All the best,

Rian Maercks M.D.

It appears that you have significant post-operative
asymmetry following your breast augmentation.
This asymmetry is hard to evaluate without pre-operative pictures and a
physical examination, but was probably present prior to your surgical
procedure. Your post-operative pictures
suggest significant asymmetry of your nipple areola complexes and infra-mammary
folds which was probably present prior to surgery.

Breast
asymmetry represents one of the more challenging situations encountered by
plastic surgeons. This is especially
true when asymmetry involves the nipple areola complexes. Under these circumstances, it’s virtually
impossible to have symmetry without re-positioning one of the nipple areola
complexes. Unfortunately, this requires
a breast lift procedure with its associated scarring.

In
this situation, breast augmentation performed without correction of nipple
areola malposition has inevitable consequences.
When the implants are centered beneath the nipple areolas, the
infra-mammary folds are asymmetric. When
the infra-mammary folds are symmetric, one of the nipple areolas will be off
center.

In
your case, it appears that your left infra-mammary fold was lowered to create
symmetry between the two folds.
Unfortunately, your left nipple areola now sits high relative to the
breast mound.

Although
some adjustments can be made to improve symmetry, these should not be
undertaken for at least 3 to 6 months.
It’s important to thoroughly discuss your surgical options with your
surgeon. It’s also important to be realistic and realize that some compromises
may be necessary. In some situations,
perfect symmetry isn’t always possible.

Victoria~

This is actually a rather challenging case.  Given the fact that you had asymmetry before your surgery, chances were high that you would have asymmetry after your surgery if adjunctive procedures were not performed. These include a possible mini-lift (on one or both sides) to adjust nipple position, use of differently size implants ( to address a difference in size, and adjustment of fold position. 

My recommendation is that you speak with the Plastic Surgeon who actually performed your surgery.  A good surgeon will most likely want to make sure that you have great results since a majority of our referrals come from happy patients!