Considering Breast Implant Revision/Tubular Deformity? (photo)

8yrs ago I had a BS to correct tubular deformity. I had 270cc saline placed over the muscle w/ no lift. At first my nipples still "puckered out" over the implant but after breastfeeding it improved. The left is still more restricted. I have little tissue, thin skin, deep stretch marks, different size areolas, ripples are visible even through clothing & feel like a plastic bag, implants are too round & too far apart. Can they look more natural? Can I go bigger? What would the best option be?

Doctor Answers 6

Breast Augmentation Revision

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    Silicone implants under the muscle with tightening of the pocket with capsule alteration may help all of these aspects.  An exam will be necessary.  Find a plastic surgeon with ELITE credentials who performs hundreds of breast augmentations and breast augmentation revisions each year.  Kenneth Hughes, MD Los Angeles, CA

Implant exchange

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You probably can go larger and I would probably recommend the silicone over the saline implants. You may also have a capsule.  Best to be seen in person.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Breast implant revision

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It appears from your photos (especially lying down) that you have some capsular contracture.  I do not see evidence of tubular deformities.  I would suggest replacement of saline implants with silicone gel (slightly larger) under the muscle and reduce the size of your areola.  You should have a more natural result.

Lawrence Enisman, MD, FACS
Albany Plastic Surgeon

Revision options after augmentation and tubular breast

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There are several variables and issues that need to be considered in situations like yours. You may have capsular contracture, there is probably insufficient coverage and implant support because of thin tissues, and the implants may not be a good match to the base diameter of the breasts. New implants under the muscle will help coverage of the upper breast but not the bottom or sides. Implants with a wider base diameter may help but this can be tricky with tubular breast. Another thing is Strattice grafts to make a living internal bra for coverage and support. This could be especially helpful if you have capsular contracture. In any case, the best solution is probably not as simple as you would like and I would make sure the proposed solution addresses all of the issues or it can become even more complicated.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 59 reviews

Separated and contracture breast implants

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Dear cn2013 for my point of view you have many points that we should address first is the gap between your breast I think is due to the capsular contracture developed in your breast , I just don't see the tubular breast maybe it was corrected with the first surgery and the baby , your areolas are uneven , inthink the best option would be to remove those implants , fix your areolas  place new implants with silicon 5th generations texture implants under the muscle and give you a cleavage closer ti the midlle 

Eduardo Gongora, MD
Mexico Plastic Surgeon
4.7 out of 5 stars 62 reviews

Considering Breast Implant Revision/Tubular Deformity?

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There are too many issues for which photos alone are not satisfactory, so an in-person consultation will be much more useful in terms of giving you the right recommendations.   That said.......

I think you would be well served by switching to silicone gel implants, placed under the muscle, with an areolar reduction on the right side. I do think that you can use larger implants if that is your preference. You may get a little more central fill, but less that you and your surgeon would like.

When you are ready for an in person consultation, RealSelf has listings of surgeons in your area. You should consider cross referencing the listings from the The American Society of Plastic Surgeons (plasticsurgery dot org). A listing in the ASPS website assures you that your surgeon is not only board certified,  but also is a member in good standing of the major plastic surgery organization in the U. S. Thank you for your question, best wishes.

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

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.