Breast Implant / Uplift Gone Wrong

i had a breast uplift/implant 6 weeks ago.on my left breast the whole of the areola has come away from my nipple.its leaving a big hole all the way around the nipple.were you can see the tissue inside my breast.and my right breast the implant has bottomed out.i am really unhappy at the way my breast look .my surgeon said that the bottoming out should fix itself.he adviced me on getting a 320 implant which makes me a dd. which i did now he is saying that i need a 380.what size will a 380 make me?

Doctor Answers 6

Wound Care First - All Other Breast Questions Later

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The open area on your left breast will need meticulous and continuous treatment for a couple of months.  It appears your plastic surgeon has you treating your wound with Silver Sulfadiazine.  This is one of many wound care treatments which will heal your periareolar dehiscence (separation). 

BTW, I never heard of bottoming out fixing itself.  Bottoming out means that your breast implant is too low, your implant pocket too large, and your nipple pointing upwards (star gazing).  The suggestion of switching from a 320 to a 380 implant indicates your surgeon is attempting to cure bottoming out by using an implant with a larger base diameter. 

Since you have asked this question on Real Self, it indicates you may be concerned about the treatment you received from your plastic surgeon, and based on some of the comments you have reported to us on what he or she said, I would recommend seeking a second opinion from a Board Certified plastic surgeon in Liverpool. 

Breast lift and implant gone wrong

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In all likelihood, you will remain a DD cup with the 380 implants. It may take 3-6 weeks to heal prior to considering a revision

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Wound issues for lift and implant

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It looks like some of the skin around the nipple areola closure has died. Now you have to let this heal before doing anything else. Hopefully your implant willnot become exposed.  Follow closely with your surgeon.

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

Breast implant/uplift complications

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Yikes!  You need some really good would care which should start with debridment (removal) of all that dead stuff in the wound and followed with some frequent dressing changes.  Forget about the bottoming out and the bigger implants for now.  They are secondary.  If this would does not get proper treatment (and even if it does), your implant is at risk for exposure and/or infection and it would need to be removed.  First things first.

Lisa Lynn Sowder, M.D.

Lisa Lynn Sowder, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 77 reviews

Wait for the wounds to heal completely before doing any more surgery

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Dear Samantha,

Unfortunately, you have wound healing problems that likely stem from insufficient blood supply to the areolar region. This is a known risk with breast augmentation and mastopexy, and the risk is worsened if you a smoker. At this point, the priority is to allow the areas to heal on their own if possible. It looks like you have some ointment on the wound; the wound should be kept clean and dressed on a daily basis as well. Assuming that the implant does not become exposed, there is no hurry to have any type of surgery right now. It may take weeks for the wounds to heal, and months for the scars to soften. Only after the wound is healed and scars softer, would I entertain doing a revision procedure. In the meantime, your plastic surgeon should continue to follow you closely until the wounds are healed. Do not be concerned about what implant size you should have, things will change with time, so there is no way to predict what should be done in the future.

Best regards.

Lawrence Tong, MD
Toronto Plastic Surgeon

Complications from breast lift and augmentation surgery

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You have a significant region of necrosis (dead tissue) associated with your areola. This is a complication of breast lift surgery. The risk of areolar necrosis is higher when combined with a breast augmentation procedure. Hopefully you were informed of this possible complication prior to surgery. The good news is that these regions of necrosis tend to heal with careful wound care. You may have some extra scarring around your areola because of this unfortunate event. 

Stay in close contact with your plastic surgeon- this complication requires careful wound care and lots of attention to achieve an acceptable outcome.

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.