Odd-shaped Breasts After Augmentation

Question

I just had breast implants 6 weeks ago and I'm starting to feel a little discouraged. Since augmentation my breasts have an odd shape. They're kind of like egg-shaped and a little bit flat-looking. My nipples are still not centered, and they are low. My plastic surgeon said that as soon as my implants drop, the nipples should center. I haven't noticed a change with the positioning of my nipples, not even slightly. I am not happy with the way they look. Is this normal for 6 weeks, and am I still in the early stages?

Otto Joseph Placik, MD · Answer

I would respectfully disagree with my colleague below.  There is always room for professional differences of opinion and experience. Your surgeon may use a technique that differs from others in which he/she does observe dropping over time.
There are several factors that play into the final appearance. In a breast that has been previously big and subsequently decreased in volume (after nursing or weight loss), I would agree that the capsule may have developed at 6 weeks and continue to hold the implant up. In other words, the skin or the breast is not the limiting factor. In this case additional surgery to lower the implant or lift the nipple may be required but I would defer this for 6-9 months after surgery.
However, in a previously small breasted individual, the skin may be the limiting factor (not the capsule) and a larger implant may force the skin to stretch/expand and loosen over time. This can take 6-9 months and I have observed implants drop over this time period. There are patients of mine that if I had operated at 3 months, it would been too early and unnecessary.
Placing the implants under the muscle can also hold them up. Use of implant displacement exercises and upper pole compressive bands can help to bring implants down over time.
Discuss your concerns with your surgeon and keep us posted.

Richard J. Bruneteau, MD · Answer

It’s difficult to evaluate your
situation without pictures or a physical examination.Your history suggests superior displacement
of your breast implants.This may occur
for a variety of reasons.It’s important to realize that the
period of time immediately following breast augmentation surgery is
characterized by rapid change.At this
time, swelling, muscle spasm and the healing process itself all contribute to
changes in the appearance of women’s breasts.In some cases, muscle spasm and
swelling can displace the breast implants in a superior direction when implants
are placed beneath the muscle.In other
cases, superior implant displacement may be due to inadequate dissection of the
inferior breast pocket.With
time, assuming adequate pocket dissection, these implants might return to a
more normal position.Sometimes, the use
of a bandeau superiorly and massage may facilitate the process.It
may take 3 to 6 months for these implants to drop into a normal position.If no progress has occurred by then,
revisional surgery may be necessary.This would involve recreating the lower portions of the breast pocket.It’s
important to have good communication with your plastic surgeon.Make sure he is aware of your concerns.He is familiar with the specifics of your
surgery and will be able to give you appropriate direction.

David Shafer, MD, FACS · Answer

If you post pictures, we may be able to give you more specific advice.  However, you are fairly early after surgery.  Hopefully, your surgeon gave you exercise to do and/or a bra strap to help with the implants, since it sounds like they are high.  You will see a differences as the swelling resolves, the tissue settle and the implants drop.  Good luck.

Brian S. Glatt, MD, FACS · Answer

If it were within the immediate postoperative time point, then I believe your surgeon would still have a good point, but unfortunately by 6 weeks the internal capsule, which forms around your implants to keep them where they are, has fully formed.  I believe that the chances of your implants "dropping" at this point and your overall breast appearance changing significantly is pretty low.  I find that in my practice that by 6 weeks, what you have is what you have.  I wonder what kind of implants you have that thye are "egg shaped".   Sometimes, the use of high profile implants may create this appearance.  Also - your nipples may have been off center prior to surgery, but if that was the case, then this shoul dhave been discussed with you before hand.  Although you ARE still in the early stages of healing on a large scale, I believe it is unlikey that  your shape will change significantly - maybe a little bit, but not significantly. 
If you were to need a revision, it is way too early to perform this - you should wait at at least 3 months, but you can certainly hve the discussion with your surgeon about this as a possibility and see what he or she says.  You should be happy with the appearance of your breasts after this surgery and I would hope that your surgeon would entertain a discussion with you about what he or she could do to help you achieve the results you desire.
Best of luck!

Remus Repta, MD · Answer

Hello,

	Depending on what you started with it may take longer for your breast augmentation to mature.  I would encourage you to take photos or have your plastic surgeon take photos as time passes and you can look at them together to judge if things continue to change or if the process has stopped.  At that time you can discuss possible revision surgery with your plastic surgeon if that is what is needed.

	All the best,

	Dr Repta

Odd-shaped Breasts After Augmentation

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Odd-shaped Breasts After Augmentation

Answers (9)

Answer: Unhappy

Answer: Unhappy

Answer: Unhappy with breast shape after breast augmentation

Answer: Unhappy with breast shape after breast augmentation

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Everything you need to know about Breast Augmentation

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