Breast Implant Revision - How To Correct My Problems? (photo)

I had augmentation surgery one year ago, was a small size A prior to the surgery, a big B after. The breasts are not even close to uniform in shape or what appears to be size. My doctor stated this is due to my original anatomy and rib cage. I am requesting a revision and want to understand how this occurred in the first place and what will be corrected so I am comfortable using the same doctor. How could the doc not know during original surgery the breasts were so off? What do I ask?

Doctor Answers 8

Breast Implant Revision - How To Correct My Problems?

Although you may have had some asymmetries before your surgery which I cannot evaluate without a pre-op photo, you appear to have "bottoming out" of your left implant.  This can be repaired by suturing the capsule at the bottom of your pocket closed, or by creating a "new-subpectoral" pocket  up in the proper position and closing off the old pocket.  Using Strattice would be much more expensive, and would be needed in patients with very thin and stretched tissues, but I think that an attempt at closing off your old pocket by one of the two techniques mentioned above would be worth trying first and should solve the problem. 

Seattle Plastic Surgeon
4.9 out of 5 stars 86 reviews

Revisional Surgery For Breast Implant Malposition

Your pictures demonstrate a lower position or bottoming out of the left breast implant. This is a known risk of breast augmentation surgery and differences in implant position are one of the most common reasons for revisional surgery. Why this happened can be debated but the good news is that it can be dramatically improved by implant repositioning and capsule tightening from below. The most important question you want to ask is to how to keep this from happening again.

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon
4.7 out of 5 stars 71 reviews

Bottoming out after breast implant surgery

Your pictures demonstrate bottoming out on the left breast.  It can result if there was overdissection in the lower pole and disruption of the inframammary fold.  It can be corrected with internal suturing or the placement of accellular dermins (alloderm or strattice) to help support the implant and keep this from happening again.

Matthew Schulman, MD
New York Plastic Surgeon
4.9 out of 5 stars 324 reviews

Breast implant malposition

Your breast implant can be fixed by a repair of the pocket to raise the implant on the low or 'bottomed out' side. This can happen naturally for a few, however it is likely the pocket was uneven and lower on one side. The low point of projection makes the nipple appear higher and my guess is that things will even out as the capsule is repaired.

Best of luck,

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.1 out of 5 stars 41 reviews

Breast asymmetry

It certialy looks liek you botomed out on the left . It is always helpful also to see your pre-op photos. as well. This can probably be corrected with internal suturing techniques.

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

Revision breast augmentation works.


1)   You have "bottomed out " on the left.  I don't know why it happened.   Raising the left implant pocket  will improve shape and bring your nipples into alignment.  Also you have a dent on the inside of the left breast that needs to be smoothed out.

2)   You need to have a lot of confidence in your surgeon.  If you are not sure, get another opinion.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
4.8 out of 5 stars 9 reviews

Options for correcting breast asymmetry after implants

I am sure you understand that without examining you personally, no one can give you definitive advice, and seeing pre-op pictures would be helpful. With that in mind, the pictures do appear to show that the left implant has bottomed out would benefit from a revision. The procedure is called a capsulorrhaphy and involves suturing up the bottom part of the scar capsule. If the tissues are too thin to support the repair then a Strattice graft might be considered.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 50 reviews

Breast Implant Asymmetry?.

Thank you for the question and picture.

It appears that the left breast implants is inferiorly  displaced (bottomed out). Bottoming out involves inferior migration of the implants. This causes the nipple areola complex to appear too high on the breasts. Also, the distance from the areola to the inframammary fold is too great. This is corrected by “raising” the inframammary fold using internal sutures. This is done after careful measurements are made from the areola to the “new” inframammary fold.

In order for you to feel comfortable with your surgeon's  ability to correct this problem you may want to ask to see before and after pictures of similar patients and their results.

Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,465 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.