What are my options for a breast reconstruction revision? (photos)

Question

Hi! I'm looking for feedback. My right breast had a mastopexy and my left has a Natrelle silicon 495 cohesive implant on Dec 20th. I'm healing fine but I'm thinking the implant is not a good match (suggestions?) or so we simply fat grafting?

Casey Anderson, MD, FACS · Answer

The most important thing here is to give time for things to settle. Realistically, 3-6 months are needed for settling prior to determining what should be done for further correction.

Donald R. Revis Jr, MD · Answer

Good morning,
I would wait another 2-3 months to be able to determine the exact size difference, but overall I completely agree with you- you need a larger implant and fat grafting is not going to make up the difference.

Gary M. Horndeski, MD · Answer

Since you are only about 1 month out I recommend you waiting for approximately 6 months before undergoing any revision. It appears that the implant is larger than necessary for symmetry. You may want a smaller implant and it would also decrease some of the upper pole fullness. In terms of your other breast, you may benefit from a repeat lift. You may also undergo a nipple-areola reconstruction.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Zoran Potparic, MD · Answer

You have too big implant after reconstruction. Smaller implant and fat grafting of the upper pole and on top of implant may give you more symmetry. You have to be very patient with fat grafting because it may take 2 or more stages. Good luck.

Ram Kalus, MD, FACS · Answer

An examination in person would be required to properly evaluate you, however from your photos it would appear you would benefit from a different implant for your reconstruction with less upper pole convexity. I do not believe fat grafting should be considered until optimal plant selection has been considered.

Please consult with an experienced board certified plastic surgeon if you have lost confidence in your current plastic surgeon. Best of luck to you.

Please consult with an experienced board certified plastic surgeon if you have lost confidence in your current plastic surgeon. Best of luck to you.

Daniel Barrett, MD · Answer

Dear Glowsprite,
breast revision surgery is the most difficult plastic surgery procedure performed. Botched breast surgery alters normal tissue planes and laxity, the ability of breasts to heal properly, and leaves scar tissue that dramatically affects the level of difficulty of the corrective surgery.Many patients come in to correct poor outcomes from their initial surgeries. The most common problems are due to implant malposition, bottoming out of the implant, poor scarring, and incorrect implant size.While the type of revision required will depend on the result of the previous surgery and the desired result of the patient, some revisions involve extensive pocket repair that may or may not need specialized external bras.If you are considering breast surgery revision, you should speak with a board certified plastic surgeon and have yourself properly assessed. Only after a thorough examination you will get more information and recommendations. Also, you have to make sure that your surgeon understands your breast augmentation goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

The reconstruction breast has a high profile implant that does not really fit your frame. I would suggest lowering that profile.

Aleksandr Shteynberg, MD · Answer

Hello Glowsprite. 
The breast on the mastopexy side appears somewhat lower, smaller, with less projection, and insufficient upper pole volume. This is not unusual to have a degree of mismatch when one breast contains natural tissue and the other - an implant. Probably the best option would be to place an implant on the mastopexy side: it will increase volume and projection, improve the upper pole. It is possible that the reconstructed breast may need a less projection implant to allow maximum symmetry. Another option is to place a smaller, less projecting implant on the reconstructed side. 
Best. 
A. Shteynberg, M.D. F.A.C.S.Diplomate, American Board of Plastic SurgeryNew York, NY.

Camille Cash, MD · Answer

You will want to wait until you are 9-12 months post op before considering further revision.  This will allow time for you to heal and for the tissues to settle.  This will take much of the "guess work" out of determining what implant size would better suit you and if a further lifting procedure is indicated.

Douglas Taranow, DO, FACOS · Answer

I would wait for at least 8-12 months before considering a revision procedure.  You may require an implant placed on the right side as well as a revision lift to raise the height of your nipple/areolar complex.  
Things change over time, so once again, give it several more months before considering anything.
Best wishes.
Dr. Taranow

What are my options for a breast reconstruction revision? (photos)

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