Breast Augmentation Revision Recommended? (photo)

I had a breast augmentation in May 2012 (it's now March 2013). Prior to this, I had a lumpectomy (10 years ago) in the right breast. I had 325cc, high profile, round, under the muscle in both. The pictures show my 'progress' the day before the operation, the day after the operation and 6 and 9 months following the operation. I am unhappy with the results (asymmetry). What has happened? Did my anatomy dictate this would happen (as my surgeon suggests)? Or is this a result of malpositioning?

Doctor Answers 9

Breast Augmentation Revision Recommended? (photo)

Thanks for this very interesting question and posting excellent photos! Your issues are symmetry after a lumpectomy. I must state your result is very good but you desire a tweaking. I might suggest fat grafts to the inferior and medial pole of the right breast to try to gain symmetry before consider a more aggressive surgery. Also a unilateral use of the BRAVA might help. 


Miami Plastic Surgeon
4.6 out of 5 stars 171 reviews

Breast asymmetry and result

You started off asymmetric with the right breast having a higher fold than the left. It is difficult to correct shape differences in breasts without lift procedures. Volumes can be approximated by the implants.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 26 reviews

Should I have a breast revision?

Thanks for an excellent question.  I have read my colleagues answers.  I will start with a general comment, I do not think you are being unreasonable to want more out of your result.  That being said I do think some of your existing asymmetry, prior lumpectomy, and anatomy played a role in your result and your surgeon is thus right.  Now to your question: revision reccomended?  If you were my patient I would want you to be happy and I believe that your asymmetry could be improved, your conversation with your surgeon should be centered on what could be done and the risks involved and not what already we know has happened.  Good luck.

Vishnu Rumalla, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 190 reviews

Revision

I would agree with Dr. Griffin. The result of the breast augmentation depends on the starting breast shape. Your had a lot of asymmetry and breast implants job is to enlarge the breast and not to make them 100% symmetrical. I would suggest fat grafting over the implant for symmetry.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.7 out of 5 stars 120 reviews

Breast Asymmetry

From your pictures, I think you have a combination of things going on.  One is your inherent asymmetry that was present on your preoperative picture although the angle of the picture makes it difficult to truly assess.  The other is the asymmetry in the implants. Having said that, I don't think that adjusting the implant alone will make you exactly symmetrical due to the difference in the shape of your breast and the position of your nipples.  It certainly can make them a little closer symmetry-wise.

Don W. Griffin, MD
Nashville Plastic Surgeon
4.8 out of 5 stars 71 reviews

Malpositioning of implant

It is difficult to answer your question for anyone without knowing more about you. The pre operative picture is at an angle and doesn't really show your shoulder position. The lumpectomy might have affected the way you healed, but if you were radiated, as is typical after all lumpectomies, that would cause this. Mal (bad) positioning of your implant does not mean that your surgeon did a bad job. You might have looked perfect on the table, but upon awakening, the scar or radiation might have made the implant act differently. it looks like your implant has settled a lot. Your surgeon might have some answers to help you yet. Best of luck

David Janssen, MD, FACS
Oshkosh Plastic Surgeon
4.9 out of 5 stars 16 reviews

Breast revision

The right implant is higher than the left, which has caused the assymetry.  This is obvious from the first postoperative day.  As time and gravity take their effect, the left implant has descended moreso than the right.  This certainly could be caused by previous scar tissue tethering, or preventing a symmetric "drop" of the right sided implant.  Was your lumpectomy on the bottom of the right breast? 

Michael Orseck, MD
Greenville Plastic Surgeon
4.9 out of 5 stars 122 reviews

Reasons Many Seek Breast Revision Surgery with a Board Certified Plastic Surgeon

The most common reason women seek breast implant #revisions are to change their implant #size, and, capsular contracture . Capsular Contracture occurs in about 5-10% of breast #aumentation patients. However, only a small number of these patients experience pain or visual issues that actually require correction.  Additional matters of concern which many seek a revision are malposition of the implant, changes in shape and size following pregnancy, weight change and also #deflation or #rupture of an #implant. Please be advised that each patient is unique and previous results are not a guarantee for individual outcomes. As with all cosmetic surgery, results will be rewarding if expectations are realistic. With any surgical procedure, there are some risks which your doctor will discuss with you during your consultation. Your procedures should always be performed by a #PlasticSurgeon who is board-certified and has a great deal of experience specializing in cosmetic #surgery. You will then greatly improve your chances of getting the result you desire, and, without the need for a revision surgery. It is suggested that you look at before and after photos of the surgeons actual patients, and read patient reviews. Gathering all of this information will help you make a well-informed decision. Please be advised that each patient is unique and previous results are not a guarantee for individual outcomes. As with all cosmetic surgery, results will be rewarding if expectations are realistic.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 106 reviews

Breast asymmetry after augmentation

Thanks for your question.  Your right breast was slightly smaller and had a slightly higher inframammary fold compared to the left one prior to surgery.  An experienced breast surgeon should be able to compensate for this by using a slightly larger implant on the right and position it slightly lower to make the result more symmetrical.  The asymmetry was apparent right after surgery.  It's doubtful the breast would be more symmetrical with time.  I would recommend correcting the asymmetry with a breast augmentation revision.  Currently the right breast implant looks too high and the left breast implant looks too low.  I would raise the left inframammary fold and lower the right inframammary fold.  You implants are too far apart with poor cleavage.  I would release the medial origins of the pectoralis muscle to create better cleavage definition.  Perhaps on the revision you may chose a slightly wider implant to achieve better cleavage. 

Benjamin Chu, MD, FACS
Honolulu Plastic Surgeon
4.8 out of 5 stars 91 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.