What Breast Revision Do I Need? (Photos)

TUBA 11-4-10 My doctor said CC at 5/6 month post. Now it seems softer but wont move upward like the other one but hurts on the bottom. no bra hurts. I have to wear at least a tight sports bra but wearing normal bra or push up bra hurts even more. It looks funny with or without a shirt.. Can I please get an opinion. Is it even CC or something else? My Dr says a capsulectomy and reopen the top pocket. Is that all or he is omitting some part of it? What is a cost I can expect?

Doctor Answers 14

Implant asymmetry

I think that an exam is key to figure out what would benefit you. It doesn look like the right implant is a bit high and the left is a bit low.

New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Breast aumentation revision following TUBA

Hi. It does appear that you have 2 problems. The right implant capsule is too high and the left too low. To correct this problem, you would probably benefit from a capsulotomy on the right to lower the pocket and allow the implant to sit in the center of the breast and not the upper pole. On the left side, you will need a capsulorrhaphy to reduce the size of the capsule and place the implant in a higher location within the center of the breast. Unfortunately, TUBA is not an option at this time as one needs to be directly over the breast to accurately correct this problem.Just make sure you see a surgeon who is certified by the American Board of Plastic Surgery. Good luck!

Richard Chaffoo, MD, FACS
San Diego Plastic Surgeon
4.8 out of 5 stars 23 reviews

Breast asymmetry after TUBA

The left implant looks as though it is too low or bottoming out.  Implant malposition (the implants not exactly where you want them to be) is a problem with the TUBA approach.  From your belly button, the implant must be placed through the breast fold which can cause it to drop - that's what your left breast looks like.  I would recommend repairing this fold, which will leave a scar at your breast crease but will greatly improve your overall results.  Good luck!

Bivik Shah, MD
Columbus Plastic Surgeon
4.4 out of 5 stars 26 reviews

Breast revision

Your left breast implant looks too low, down and out. You need a tightening of the implant space  (capsulorraphy). If it doesn't move easily up and towards the inner area you will need a capsulotomy to open up the space. You will have better success through an inframammary approach (beneath the breast - in the crease). I sort of think your right implant is a bit too high, and this could be lowered, but that is just personal preference.

Ronald Schuster, MD
Baltimore Plastic Surgeon
4.9 out of 5 stars 78 reviews

What Breast Revision Do I Need? (Photos) Answer:

From your description I can’t tell which breast is painful to you but to me your left breast (the lower one) looks more normal. The nipple is centered pretty well in the middle of the breast and you are not artificially high on that side. My suggestion would be to leave the left side alone (harder to raise an implant anyways) and open the capsule up on the right at the bottom, not the top. I know it’s too late but, this is a problem with TUBA & its difficulty in accurate creation of the pocket.

John J. Corey, MD
Phoenix Plastic Surgeon
4.6 out of 5 stars 45 reviews

Breast augmentation revision

Thank you for the question and picture.

Based on your picture and description you may benefit from right sided capsulotomy/capsulectomy and left sided capsulorraphy (internal sutures to repair inferior and lateral breast implant displacement), unless you are pleased with left breast implant position.

Please make sure your surgeon is a board certified plastic surgeon.

I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,499 reviews

Revision for both breasts best option


There is likely a pocket issue with both breasts with the pocket being under released at the bottom on the right and the pocket over released at the bottom and side on the left.  It would be ideal to address both issues as opposed to making the right breast over dissected to match the left breast.  A right breast capsulotomy/capsulectomy will be needed via an open approach and a left breast capsullorhaphy (repair) will be needed via an open approach as well.

All the best,

Dr Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 165 reviews

What Breast Revision Do I Need? (Photos)

This demonstrates the risks of the TUBA operation, almost a "blind" operation. You need "open revision" exposure to correct the many issues you have. See Dr Steven Cohen in San Diego. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 174 reviews

You will need revision through breast crease incision

TUBA is attractive to patients since there is no scar on the breast but lack the control of the breast pocket and implant position during the surgery. You will need bilateral revision. Your right implant is too high and left implant bottomed out.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.7 out of 5 stars 124 reviews

TUBA & Post-OP Implant Problems...

I agree with my colleague and others who steer away from TUBA because of the limited access and control it offers when something goes wrong.

Not knowing without examining you, there is a possibility of capsular contracture on your right causing slight elevation of that implant. The more obvious problem is the "bottoming-out" you're experiencing on your left. This, in itself, will require correction using an approach other than your original TUBA.

Contemplating a capsulectomy for your right breast, a capsulorrhaphy for your left breast and, perhaps, new implants, you may be exposed to a cost equal to or even greater than your original cost. I would urge you to seek a second opinion from another board certified plastic surgeon.

Good luck!

Charles Gruenwald, MD (retired)
Baton Rouge Plastic Surgeon
5.0 out of 5 stars 11 reviews

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.