Should I have a revision to correct asymmetry after already having correction surgeries?

Question

I had BA in 2017, after a late seroma in 2020, i have had a few surgeries (implant exchange, then had to fix CC in one breast, then the other breast dropped too low). The breast that had CC did not drop as much as anticipated after surgery to correct it and the breast that bottomed out is dropping low again. I can see that i am a complicated case at this point. Is it worth seeking another doctor for revision options? Id just love to have better symmetry and comfort. My implants are not large, only 250 moderate plus. I appreciate any advice!

Yily De Los Santos, MD · Answer

After multiple surgeries, especially with a history of seroma, capsular contracture, and bottoming out, it’s very common for a case to become more complex. Each procedure changes the tissue quality and how the implants behave over time.

From what you describe, it sounds like each breast is responding differently: one tends to stay higher because of scar tissue, while the other continues to drop lower again. That can make perfect symmetry more difficult to achieve, but it does not mean improvement isn’t possible.

Seeking another opinion from a surgeon with extensive experience in complex breast revisions could be very worthwhile at this stage. These cases sometimes require more advanced internal support techniques, pocket adjustments, or even changes in implant positioning to create better long-term stability.

The most important thing is having realistic expectations. In revision surgery, the goal is usually improved symmetry, comfort, and stability — not necessarily absolute perfection.

Fernando Ovalle Jr., MD · Answer

Hello and thank you for your question!

I'm sorry to hear you are going through this - multiple breast revisions are tough for surgeons but tougher on the patient!

I do think it is totally reasonable to seek multiple opinions from surgeons who specialize in breast revision surgery. What you are describing is unfortunately a difficult cycle we sometimes see after multiple operations where the tissues become increasingly less predictable over time.

Your history of seromas, capsular contracture, recurrent implant malposition and bottoming out suggests that your soft tissue support and capsule dynamics have been significantly altered by scar tissue which will always be weaker than native "virgin" tissues.

The good news is that there are still revision options available. Depending on your anatomy and current implant position, these may include site change/pocket reconstruction, internal suturing/capsulorrhaphy, mesh or scaffold support (i.e. "internal bra"), and/or combining revision with a lift for improved symmetry and support.

The next best step would be in-person consultation with several breast revision specialists. My personal recommendation would be to not price shop and be willing to travel. Good luck on your journey!

Daniel Barrett, MD · Answer

Dear alexis9530,

it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Mats Hagstrom, MD (license on probation) · Answer

If your surgeon is the one who created the augmentation with an implant that bottomed out, then you should pick another surgeon.
Without showing proper before, and after pictures, we can’t begin to make an assessment.
Your chance of having a quality outcome is fairly low with the number of complications and previous operations.
Your best option is to find the most experienced and talented breast surgeon you can.
 Finding the right provider is probably going to require having multiple in person consultations.
For second opinion consultations, you need to come prepared bringing with you all previous before and after pictures of all your previous operations spread.
You should also bring medical records, especially previous operative reports.
 From what you describe, the chance of having a quality outcome is considerably lower than those who have not had these complications.
Much of this could’ve been provided by choosing providers carefully in the first place.
I should be a bit careful what I say but that’s what it sounds like to me.
Best,
Mats Hagstrom MD

Should I have a revision to correct asymmetry after already having correction surgeries?

Answers (4)

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