Unhappy with Results After BA? (photo)

I am three months post op from my BA. I got 286cc under the muscle silicone implants. I am unhappy with the results, I feel they are still very flat on the top and are still tubular in shape. I spoke with my surgeo and he gave me 2 options. A. I can go through surgery again and replace my 286 implants with 350, but my surgeon doesn't think that would be good for my body frame. B. to get fat injections in the top of my breasts to fill them out. I don't know what to do if anything. Would love advice!

Doctor Answers 13

Unhappy with Results After BA

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You do have some of the features of tubular breasts,Some of features that define a tubular breast are:

•Wide and puffy areolae
•widely spaced breasts
•high breast fold
•constricted lower pole (deficient tissue in lower half of the breast
•minimal breast tissue
•high breast fold
•narrow base of the breast\

From the pre-op photos, I see the first two features, with low set areolae, also a common feature. 

I find myself looking at a nice result by-in-large, but one that could be improved by a breast lift which could elevate and slightly centralize the nipples and areolae. 

The entire breast is lower than on some women, and that is not really improvable but also not something that looks unattractive. 

If you consider this, be sure to look at photos of the lift scars when evaluating the pros and cons.

Thanks, best wishes.

Seattle Plastic Surgeon

Results of augmentation in mildly tuberous breast.

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You have a very nice result from your augmentation.  Augmentaiton cannot be expected to dramatically change the shape of the breast or the areolas.  A breast lift can change shape and areola size and you may want to consider it.  BUT - if I were you, I would learn to love your result.  It is very, very good and the enemy of good is better, even in plastic surgery. 

Your breast augmentation results look good you may benefit from breast lift

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Thank you for your question and photographs.  Honestly considering your preoperative breast appearance the result of your breast augmentation look very good.  Be certain that what is bothering you is not the fact that your nipple position is low.  If you feel the nipples are low a breast lift might make the breasts look more appealing to you.  Larger breast implants most likely will sag further down into the breast and will not give you the fullness above the areola.

Unhappy after BA

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I  think  your  doctor   since   the  beggining   should     be  aware   of tubular  breast ,    i do not think  changing    the   size    implant   irself      will   solve  the  situation   350   is  a  good  size   for    you under muscle  the   problem   is    that   to change  this  tubular  shape   it  needs  to be  treated   with internal    radiation of  whole   mamary gland  tissue  including  periareolar  surgery  to reduce     the    size  of  areola   and   with  combinatio  of radiation   and periareaolar  incision      treat    the herniation that  your  nipple    presents,  after  this    you can   decide       if   you want  to  go    to   bigger   size implant . because     ounce  radiation   is  done    then  implant   will   show    and   get   a   rounded   shape ,  this tubular   shape   you  are  presenting  is not  because  of   the  size   of  your   implant   is   because    the tubular  shape   was  not treated 

Cynthia Disla, MD
Dominican Republic Plastic Surgeon

Revision after breast augmentation

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Based on your preoperative photos, your breast augmentation went exactly as planned.  The implants are in a normal position based on your breast.  If you are unhappy with the shape of your breast and the position of your nipples, I think a breast lift would give you a good result.  This would allow some improvement in the tubular nature of your breasts as well as decrease the size of the areola and lift the nipple.

Mild tubular breast and ptosis

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I do not think that getting larger implants or fat grafting will help much. What you don't like about your breasts is not a lack of volume, it is the shape. The best way to change the shape of the breast is with a mastopexy or breast lift. You appear to have a mild form of tubular breast with dilated areolae. I would suggest having a vertical breast lift with areolar reduction. A periareolar lift is another option, but I do not like the scarring associated with the typical "donut" mastopexy. 

Unhappy after breast augmentation

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Your result is a reflection of what you were before breast augmenation, and as the nipple was low on the breast it has remained so after your augmentation. Without moving the nipple higher anything done to increas fill on top will cause the nipple to sink lower. More volume alone is OK if the scar is not right for you, but do expect the skin envelope to remain the same.

Implants just magnify the breasts you have

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The problem here isn't with the work done by your doctor but with the fact that implants just magnify your preop shape and anatomy. Unless you can adapt and learn to like your new look, you will need another surgery with its recovery and costs.  From what I can see the main thing you need is a lift. I would advise against far grafts.  New implants can give more fullness but without a lift they will actually make you potentially look worse.

Revision breast augmentation

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I think that you probable need a circumareola  reduction to improve the shape and appearance of the breasts.  That is my guess based solely on your photos.

How Can I Improve The Appearance Of My Breasts- I Am Unhappy With The Post Operative Results

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If you were my patient, I would do a circumareolar reduction of your nipple areolar complex.  This would give you a smaller nipple size, eliminate the puffiness of your nipples, flatten your breasts to decrease the tubular shape, and make your breasts rounder, all simultaneously.  I would also increase the size of your implants to give you more fullness in the upper quadrant using a moderate or moderate plus profile which will give a greater base diameter.  Finally, and as an aside, I would suction out your axillary breast tissue to give a more attractive overall appearance to your breasts. 

All that being said, your desires and possibly my suggestions should be discussed with your plastic surgeon. 

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.