Has one of my breasts bottomed out? Do I need a revision? (Photo)

Question

I feel like one of my breast tissue (shown) has almost separated from the implant if that make sense. From the side you can see where my natural breast tissue ends and the implant keeps going. Is this normal or do I need a revision? Is it just my natural breast anatomy

Daniel Butz, MD · Answer

You have a double bubble. This can be an issue if you had a short lower fold and the surgeon had to lower the fold to improve the shape. Typically the old fold or crease is internally scored to allow it to open up and round out. 
Bottoming out can cause this too if the implant falls below the intended crease. 
A revision might be necessary. Talk to your doctor. Maybe they scored a bunch and it needs more time. Hard to say not seeing how severe the crease was before surgery. 
You would likely need a modification of that crease - releasing the muscle some more and vertical scoring. 
For smaller defects fat transfer is an option as well.

Gary M. Horndeski, MD · Answer

Unfortunately, you have not provided before photographs. However, it is possible that the concavity represents your original inframammary fold and the new implant has created a new inframammary fold. I would need before photographs to compare the asymmetry to give you a more accurate answer.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Connie Hiers, MD, FACS · Answer

Yes, you have a double bubble where your implant has dropped some below your breast tissue.  Tissue may need to be scored inferiorly to spread out your breast base even more.  Please go back to your surgeon and discuss your concerns.

Camille Cash, MD · Answer

I'm sorry you are having issues with your breast augmentation.  The look that is shown in your submitted photos is not normal or expected and will need to be corrected with revisional surgery.  Visit with your surgeon for an evaluation and to learn more about correction.

Mats Hagstrom, MD (license on probation) · Answer

In order to make an assessment regarding the outcome of any plastic surgery procedure, we need to see a complete set of proper before and after pictures.
If you don’t have before and after pictures and ask your surgeon to forward the pictures they took.
It looks to me like you had Constricted breasts, consistent with A mild to moderate tubular breast deformity. The construction is still present, and the natural diameter of your breast was much smaller than the diameter of your implant.
The constrictive tissue that gave you tubular breast is still present and this is why you have the shape you do.(if my assessment is accurate)
Scoring the inside of the breast releasing some of these tissue bands that cause the construction is The textbook answer.
I’m only making assumptions based on what I see and an accurate quality assessment requires better information.
consider reposting with before and after pictures if you want a better assessment.
Generally speaking breast augmentation outcomes are based on three variables.
The first is patient candidacy which includes variables like breast shape, breast position on the chest wall, breast divergence, etc., etc.
The second variable is implant selection in regards to shape size and type.
The third variable is the surgeons ability to put the implant in the correct atomic location.
Whenever there are issues with the outcome, we can always trace them back to one or more of these three variable spread
In your case I believe the issue is related to your candidacy for the procedure.
Best,
Mats Hagstrom MD

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