Breast Revision, Saline to Silicone do I ned a lift? Is it necessary ? What size is best for me? (photos)
Doctor Answers 8
Implant revision from saline to silicone with a lift and nipple areola reduction
- When implants have been in for many years and you are no longer pleased with the shape- changing them is a reasonable thing to do. I have never had a patient regret going from saline to silicone implants. Current gel implants are softer, show less ripples in thin patients, and have a very high patient satisfaction rate
- In your photos, I think going for great symmetry of the shape and reducing the nipple diameter to make them equal is a great approach. I would caution AGAINST high profile for you. The HP implants will exert strain on your nipple incision resulting in spreading and less-than-ideal outcome.
- A small lift may be needed based on your side view pictures- but a plastic surgeon can decide in person. It is not easy to tell with photos alone
- Please see a plastic surgeon who does a large number of replacement, revision and reconstruction cases a year. The chance of an outcome that require revision surgery within a few years is relatively high with replacement surgery. So go with the best and busiest.
- Best wishes for nice outcome.
Best breast implants for revisionary breast surgery?
Generally speaking, the best online advice I can give to ladies who are considering revisionary breast augmentation surgery (regarding breast implant size/profile selection) is:
1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work.
2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals. In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or "D or DD cup” etc means different things to different people and therefore prove unhelpful. Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate.
3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery ( after the use of temporary intraoperative sizers). Viewing the patient's chest wall in the upright and supine positions, with temporary sizes in place, help select the best breast implant size/profile for the specific patient. I hope this, and the attached link (dedicated to revisionary breast augmentation surgery concerns), helps. Best wishes.
New implants and a lift?
Hi and thank you for your question. From the pictures you provided it looks like your skin envelope is already fairly tight. You might not have sufficient skin to increase your implants from 400 to 600 cc's. I think you would benefit from some modifications to your breast shape, lifting your nipples a bit higher and reducing the size of your areolas. I think it's more important to focus on the changes that will make your breasts prettier than to focus on the size. I think you would likely get a nice result with a donut mastopexy and implants in the 400-500 cc range. If you haven't found a plastic surgeon you are confident in yet then you should keep looking. Good luck to you.
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It's not uncommon for several docs to give you very different options. We all have a particular preference on how we do things, and what techniques we depend upon for a successful outcome. As always, best to be healthy, no smoking, and make sure any health concerns you have are managed by your primary care md. Best to you.
Augmented Breast Revision - Do I need a Lift?
A lot of what is wrong with this breast may be the result of using large implants which are exceed the underlying chest frame (falling sideways) and stretching everything in front of them resulting in huge Areolas and then by sagging. It makes no sense to try and fix the problem by overlooking the major cause for it. I therefore think you should look at high profile and ultra high profile gel implants and pick one that fits your chest. I would then make the overlying breasts fit the implants. This would require tightening the present capsule( to keep the implants from falling sideways and keep them pointing forward), the breasts may need to be lifted and the Areolas need to be reduced to a more attractive 4cm diameter.
Approaching your breasts in such a planned logical way is the only way to get the best breast.
Dt. Peter A. Aldea
Bigger implants will give you some lift. It may not lift them as much as you want. The size implant is your choice. You would choose larger than 420 if you wanted to be bigger. If you want your nipples reduced, you will get a scar around the nipple. You would need an additional vertical scar to lift the breast.
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.