Breast Implant Revision

Dec 09 I had a breast augmentation - 325cc, silicone round implants placed through the armpit, under the muscle. - No trouble till Dec 10 - nipple on left breast started to point downwards and implant sat much higher, no pain or hardness. - Implant revised in April 11. No signs of contracture. Implant just needed to be placed lower. Very happy with position and nipple alignment, however I seem to have lost the fulness in this breast. I am just wondering how long or if this fulness will return

Doctor Answers 9

Breast Implant Revision

It's difficult to suggest online and without any photos. However, aAdditional elective cosmetic #surgery is a personal choice. Your concern may be related to your beast implant's profile. The #profile is determined by the amount of projection versus roundness that the you desire, as well as the size of the implant and size of your chest. As much as it's important to know what size bra you currently wear, the strap size is important to know as well. It affects the diameter of the cup and subsequently the diameter of the #breast implant that you choose.

#Subpectoral or #submuscular implants refer to placement under the muscle which still remains the most common placement in the United States. #Submammary or #subglandular implants are the placement under the breast tissue in front of the muscle. This tends to more common in Europe and South America. General guidelines suggest that women with larger drooping (ptosis) breasts that do not want a breast lift often have the implant placed above the muscle, although another option, #DualPlane, has become more popular. In the Dual Plane method, the implant is placed under the pectoralis muscle but the breast tissue is also release, in part, from the muscle. Those patients with minimal breast tissue should usually have the implant placed beneath the pectoralis muscle for more soft tissue padding.

Another option to consider is a Breast Lift.  #BreastAugmentation without a #BreastLift is usually a mistake looked back on by many patients. Most breasts will look larger and more droopy. They will sag more and sooner because of the excess weight altering the longevity of the results. The shape will usually not be satisfactory and sometimes results with “Snoopy” breast or double bubble. A #mastopexy or breast lift operation is designed to improve the shape and position of the breasts without reducing their size. It is the most suitable for #breasts which sag or droop (ptosis) as a result of development, aging, pregnancy, breast-feeding and weight loss.

I suggest beginning with an in-person #evaluation with your original surgeon, or, with a board certified plastic surgeon. It is best select a plastic surgeon who is #board-certified and has a great deal of experience with breast #augmentation and the incision type, #implant placement, and implant type. Plastic surgeons who have specialized in breast surgery and cosmetic surgery are suitable to perform your breast augmentation.

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.

Orange County Plastic Surgeon
4.9 out of 5 stars 110 reviews

Breast Implant Revision?

Thank you for the question.

Unfortunately,  it is not possible to give you good advice without direct examination or without viewing pictures. However, you may have  “lost fullness” of the breast because it is sitting lower on the chest wall after revisionary surgery.

In any case, it would be in your best interest to follow-up with your plastic surgeon to discuss questions and concerns.

Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,501 reviews

Breast implant revision

If the same implant was used but just repositioned lower, then you did not lose volume, you just don't have as much upper pole fullness as when the implant was too high.  That fullness will not return on its own (that is, unless you get a capsular contracture and the implant gets squeezed upward again).  You would need an implant replacement to get a larger implant with more fullness in the upper pole.

Robert M. Grenley, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 87 reviews

Breast Implant Revision

From your excellent description but no posted photos I guess the lowering of the inferior pocket caused you to lose the upper pole fill. No, it will not correct itself. Seek discussions with your chosen surgeon concerning this issue. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 174 reviews

Nipple pointing down following breast augmentation

It sounds like you may have a capsular contracture that is causing deformity of your breast.  A small percentage of patients develop that condition months or years following surgery.  In these cases, the internal scar tissue surrounding the implant will start to squeeze the implant.  This pushes the implant upward, causing more fullness, and results in the nipple pointing downward.  Capsular contracture is treated with a surgical procedure called a capsulotomy or capsulectomy, depending on your situation.

David Stoker, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 55 reviews

Breast implant revision

As has been said, there would not likely be an expectation of the fullness returning after lowering an implant.  You might need another implant to regain fullness.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

The implant size has not changed but shifted to lower part of the breast

The size of the implant on the left side has not changed with pocket revision. The volume shifted and that makes your breast look smaller. The only choice would be going with bigger implants.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.7 out of 5 stars 125 reviews

Fullness Not Going to Return

Since the implant was lowered on your chest, the volume has also been placed lower. The only way to have better nipple position and alignment, and upper pole fullness would be to go with larger implants. You are too early for that exchange. You will need to re-evaluate at about 6 months post-op.

Good Luck!

Brian Klink, MD
Vacaville Plastic Surgeon
5.0 out of 5 stars 94 reviews

Breast Implant Revision Surgery

Dear Sarah_louise in Australia:

Breast implant revision surgery to lower an implant that is too high tends to settle quickly. If you are two months out, it is not likely to change much, and is not likely to become more full. Implants do tend to look larger when they are too high.

Joseph Mele, MD
Walnut Creek Plastic Surgeon
4.5 out of 5 stars 17 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.