11 months post op - should I expect my implants to continue to drop or should I consider a a revision? (photos)

Since it’s almost a year with no changes, you may want to consider a revision.

Opening the lower pocket from inside should allow the implants to drop, fill the bottom more than the top and result in better breast shape, nipple position.

An exam and consultation with a plastic surgeon is recommended to discuss your options and expectations.

Thansk for your question! If you feel as though your implants are too high, the only answer is revision. In order to figure out what went wrong, it would be helpful to see before photos also. Good luck!

Dear adri_0917,
there will probably be no changes in your breasts shape and size. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Best is to consult your surgeon and ask the question because he would know the technique used. If your implants are submuscular, it is unlikely that they will drop since the muscle will hold them up.

You did not post your before photos, so I cannot state if your implants are just sitting high or if your nipples are sitting a little low. go back to your surgeon and discuss your concerns and look at your before photos.

At eleven months post op you are seeing your final result. Continuing to wear the surgical bra and band will not likely lead to any noticeable changes. A surgical revision would be needed to reposition the implants. See a board certified plastic surgeon to learn more.

Breast augmentation outcomes are usually based on three variables. The first is patient candidacy. The second is implant selection and the third is the surgeons ability to put the implants in the correct anatomic location.
Whenever outcomes are less than ideal, we can usually attribute the outcome to one or more of these three variables.
To assess the outcome of any plastic surgery procedure we generally need to see a complete set of proper before and after pictures.
If you don’t have before, and after pictures, then ask your surgeon to forward the pictures they took.
Generally speaking, I do not recommend people travel long distances for elective surgical procedures.
I generally recommend people stay local for surgical procedures and have multiple in person consultations with a number of providers before selecting surgeons.
People do not seem to appreciate the importance of having in person consultations before selecting providers, the number of people who have real concerns after surgery, the number of patients will end up needing revisions or that complications Actually happen.
From your pictures, you look like a fairly good candidate for breast augmentation surgery.
Your breast sits slightly wide on your chest wall, but not too bad.
Your nipple position is excellent and you don’t have much breast divergence.
Your natural breast diameter is substantially smaller than the size of your implants.
This is the number one reason why you’re unhappy with the outcome.
The implants are bigger than your breast and they have to go somewhere.
If your surgeon opened your IMF (infra mammary fold)then your implants are likely to bottom out overtime.
without opening the IMF, the implant has no place to go other than the upper half of your breast.
Had you chosen more modest size implants than this would not be an issue.
The implants are not riding high. They are bigger than your breast diameter.
Working with excessively large implants will always increase the chance of undesirable side effects, complications and the need for revision surgery.
Lowering the IMF is going to set you up for more problems.
My best guess is that your implants will settle into place with time and your best option is to do nothing.
Had you opted for slightly smaller implants you would be seeing a much more natural outcome at this point.
As I mentioned earlier whenever there are problems related to breast augmentation surgery we can almost always Break this down into a problem of patient candidacy, implant selection, or the technical aspect of putting the implant in the correct position.
I think your doctor did an excellent job with your augmentation.
I personally would not lower the implants much more because of the risk of long-term complications, especially implants bottoming out.
If we had access to your before pictures, we could understand your candidacy for the procedure much much better.
In particular, we would understand what your natural breast diameter was, and what size implants your breast could tolerate without looking distorted.
Almost everybody has breasts that sit differently on the chest wall.
Most people at the left breast is about half an inch higher on the chest wall than the right side.
This seems to be the case for as well.
Recognize that this is normal and that is the position that your implants should be sitting.
It may be possible to open up the pockets slightly, but doing this comes with certain risk.
It is especially problematic if you open the pocket inferiorly because once the IMF has been violated gravity, and the contractual pressure of the pectoralis muscle can push the implant downward, creating a “bottomed out” implant.
The fault is not in how the procedure was done or your postoperative management.
The issue is directly related to your candidacy for the procedure and the selection of implants. Again, the implant diameter is substantially larger than the natural diameter of your breast.
Had you chosen bigger implants then the problem would be worse.
Had you (or your doctor) chosen smaller implants than your outcome would look more natural.
Best,
Mats Hagstrom MD