Do My Breasts Post-BA Look Uneven, Deformed and Too High?

Hello Pettitegirl5,

Your re-posting yielded more responses this time.  Please review mine again:


Both of your implants are sitting too high, especially the right implant, to be considered normal. It is very difficult to make truly accurate assessments with only photographs and not conduct an actual examination, but it looks like there may be an element of capsular contracture to the right implant, and neither look like they are sitting against your natural inframammary fold, something we would expect after an augmentation.
 

Regardless of why your implants are too high, I will give you assurance that vigorous massage, vitamin E, compressive bands, or pharmaceuticals like Singulair or Accolate will not be effective. It is possible that given enough time they may drop some, but not to the extent that I think you would find pleasing.
 

Most likely you will need to have a revision surgery that will improve the position of your implants and address any other concomitant issues you may or may not be having (capsular contracture). Revision surgery is more complicated and requires extensive experience on the part of the surgeon. I would recommend that you consult highly regarded breast surgery specialists and get second opinions. These doctors are certified by the American Board of Plastic Surgery and are usually also members of the American Society for Aesthetic Plastic Surgery.
 

Best of luck.
 

Thank you for your question and for sharing your photos. At five months, it there is a chance that the implants may not settle much more.  Keep a close follow-up with your surgeon.  If they continue in their current position, you may consider releasing the lower pocket of the breast to create more internal laxity of the lower pocket of the breast.

Some patients with tighter skin find that their implants take longer to drop and fluff. It looks like this may be true fro you. Ask your surgeon about what you can do to help the process, such as massage or wearing a bandeau around the top of your breasts. If however you find that this doesn't work, you'll probably need revision surgery to adjust the pocket. It might not be positioned properly.

Your breasts appear to not have dropped and fluffed. Since you mentioned that you have firm, tight skin, you may need a little while longer for this process to complete. Sometimes it can take 6 months or longer. You can help the process with massage, however please talk to your surgeon for their advice. They can give you the exact instructions on how to perform the massage. If this doesn't help or other suggested nonsurgical treatment, you may require revision surgery to reposition the implants, placing them lower and perhaps choosing an implant that would achieve more natural looking results. Best of luck!

         It’s always
difficult making recommendations without performing a physical exam or seeing
pre-operative pictures. Despite this, your post-operative pictures clearly
suggest several problems that are probably related to the initial breast pocket
formation. It appears that your breast implants are medially displaced and too
high and as a result, the nipple areola complexes are malpositioned.

         This problem will
not correct without surgical intervention and will most likely require a pocket
revision. When transaxillary breast augmentation is performed, it can be
difficult to separate the muscles along the inferior border of the breast
pocket. This under dissection can create the type of problem that you are
experiencing.

         Correction involves
expansion of the pocket laterally and inferiorly. This is most easily
accomplished through an inframmary approach.

         It’s important that
you discuss these issues with your plastic surgeon. In some cases, a second
opinion may be appropriate. 

Your breast implants appear to high and should have dropped into place by 5 months.  I would see your plastic surgeon to reevaluate for revision surgery to place the implants in a more anatomical position and improve your appearance.

Your photos show high implants, square shaped breasts and symmastia. I suspect the implant base diameter is too large for your "very petite" frame and the pocket and the muscle was not adequately freed up on the inner lower quadrants of the breast. The smooth round moderate profile style 1600 325cc has a base diameter of 12.6 to 13cm. I suspect your frame will not aesthetically hold a base diameter of more than 11cm.

You can wait a year or 10 years but I do not think this will change much. You will need additional surgery with placement of different implants, release of the muscle in the lower inner quadrants and adjustment of the implant pockets in order to fix this. You need to get copies of your operative report and before/after photos if you decide to go with another surgeon. 5 or 6 months is sufficient time for a revision surgery.

I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Based on your photos it appears your breast implants are too high and should have "dropped" by five months. You could have capsular contracture which is preventing your implants from settling. I would discuss this with your plastic surgeon to see if you need a revision to lower the implants or to downsize the implants. If you have capsular contracture (hard scar tissue) you may need this scar tissue removed as well.

Best wishes,

Dr.Bruno

It looks as though you have high riding implants or "malposition". At five months after breast augmentation, the position of the implants could improve, but not dramatically. This is a common ocurrence when having a breast augmentation done through the axilla, although it is avoidable. You may require a revision either through the axilla, but more than likely, through an incision in the inferior breast fold.

Your breast implants are too high and at this point I would not expect them to change much.  There are often subtle changes in the position of breast implants over time but by 3 months I would expect them to have settled more.  I would discuss with your surgeon about breast implant revision surgery.  In this case I would make an incision in the lower breast crease and further release the lower pole tissue in order to allow the implant to fully drop.  The goal is always to get the implant to settle behind the nipple so that the nipple is on the most projecting part of the breast.  That can be accomplished for you but will unfortunately require an additional procedure.  Good luck.