If my implants are already in but I haven't had nipple reconstruction yet, is it too late to make any changes?

My plastic surgeon hasn't included me on any decisions and I'm very unhappy with my look. My breasts are far apart with a large flat spot between them. My teen daughter even asked why I look the way I do. My doctor didn't ask what type of implant I wanted or anything throughout the process.

Doctor Answers 2

Changes

Dear Patricah,

I'm sorry you are unhappy!  Going through mastectomies is difficult enough without being disappointed, so hopefully you will be on the same page with your plastic surgeon soon.  It isn't too late to make changes at all.  Most of my breast reconstruction patients, even the ones who go direct to implant, undergo a second "touch-up" surgery for exactly this reason.  Some are unhappy with size or shape, and frequently there are other small changes that need to be attended to as well.  In addition, surgery is frequently necessary again after radiation is complete to counter any tightening and elevation that has occurred as a result of the radiation process.  The thing to remember is that it's never too late to make a change, as long as you are willing to go through the surgery required to make that change.  Usually the revision surgeries are much less painful and shorter than the mastectomies.  Best of luck to you!

Dr. Jespersen


Arlington Plastic Surgeon
5.0 out of 5 stars 4 reviews

Breast implants too far apart

It is definitely possible to correct your breast reconstruction. In breast reconstruction, implants are placed underneath the pectoralis muscle. The action of the pectoralis muscle squeezing the implants underneath them can sometimes push implants to the sides. This can be corrected either by cutting the pectoralis muscle near the middle of your chest and revising each breast pocket so that your implants can move closer together or by removing the implants altogether and switching to natural tissue breast reconstruction. Ideally, this is a decision that you make together with your plastic surgeon as you go over all the possibilities for solving your problem. Of  note, I would wait on your nipple reconstruction and correct the breast shape and positioning first. It would be a shame to place the nipple in the wrong spot, and then correct the breast shape and position afterward. I always like to think of the nipple reconstruction as the final touch after the breasts are absolutely perfect!!

Constance Chen, MD, MPH, FACS
New York Plastic Surgeon

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