I am 22 days Breast implants post op with 410cc unders. My right breast is settling great. It's lovely and rounded and is getting more and more naturally looking everyday. My left breast is not. It is ver strange looking. It's more square and is not rounded at the bottom. The scar is slightly up on my left breast so I assume there is still swelling. You can see in the picture how odd it looks. I am so worried that the implant has somehow slipped into the left of my body. Is this possible? I really am so unhappy and worried.
Left Breast Implant Possibly Slipped Through?
Doctor Answers 5
I am afraid you will need a revision.
I know this is not what you want to hear, but I have a lot of experience, and I think the left breast is going to need to be touched up. The left fold is lower than the right, and the lower inside corner of your left breast is sharply cut off. Perhaps the pectoral muscle needs to be released here.
We try to prevent this in our Manhattan practice in the following way. Before the end of surgery, we place our breast augmentation patients in a sitting position (you are still asleep, of course). Then we can check for sure that the shape and the size and the symmetry of the breasts are all great. If the breasts are not great, we keep working. This takes the guess work out.
Don't do anything for 6 months.
It is unlikely that this problem will correct itself
You do show significant asymmetry. It seems that the left implant pocket was under dissected iferior-medially and over dissected inferiorly. All my augmentation patients are placed in a sitting position after placement of the implants to check for symmetry of placement, shape, level, superior fullness and lateral fullness. Besides myself, I have my nurse, scrub tech and anesthetist look to make sure the position is correct. I use smooth walled implants. Textured implants will not move and massage will not help them either to drop into position. You will need a surgical revision on the left side. I would wait 4-6 months before having this done. Good luck.
Revision surgery may be needed
There is a fair amount of asymmetry present from your surgery 22 days ago. The right breast implant appears slightly lower than the right. There is also a sharp cut off on the inferior medial segment on the left. It is possible that either the implant pocket dissection was not symmetric or that the implant as moved slightly. It is possible that some degree of massage may help the implant expand out in this area. At three weeks post op the capsule around the implant is already formed and with a textured implant you are unlikely to get much movement. The texturing acts almost like a velcro and the implant will generally stay were it is placed. Over the next few months, if the implant does not change in position a revision surgery will be needed in order for you to achieve symmetry.
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Shaped implants can indeed shift
The Allergan 410 implant is a textured cohesive gel implant with an anatomic breast shape which holds its shape no matter what; it has no 'flow'. Here in the US we use this implant in breast reconstruction because the shaped implant will impart some personality to the reconstruction which has been lost in the mastectomy procedure.
In breast augmentation I always use a round implant to enhance the natural breast shape and prefer a liquid gel or saline because of the more natural 'flow' of the material and the resulting softer breast. The breast has its own natural shape and placing a breast shaped implant can introduce problems. We hope the implant will be flexible and soft after augmentation, and be indistinguishable from the natural breast tissue in the best of worlds. I know that surgeons in the UK and in Canada use the 410 implant in augmentation and they have reasons, though I fail to understand why.
Concerning your picture, it may be that the 410 implant has rotated or shifted, or just as likely that the placement of the implant has not been symmetric and evenly shaped right to left. With a textured 410 implant this asymmetry in the breast fold is not likely to improve and your surgeon should have a look.
Best of luck,
Left breast may require a revision
I agree you have some mild asymmetry. It may be that the muscle was not released enough medially, producing the flattened appearance, but too much centrally, causing the bottom of the implant to be too low on your chest.
Having said that, you are early in your course, so things may improve with time. If you remain unhappy, you may require a revision of the pocket.
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