Breast Augmentation revision (Photo)

Had breast lift and augmentation 4/29/16,right breast deformed now and cuz of so much pain I am scheduled for revision 6/29/16.dont know the cause of it.had 2 other consultations,one said capsular formation the other said ripped muscle,now planning to ask PS to go over muscle?any suggestions

Doctor Answers 7

Lift and Augmentation Revision?

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There really is not enough information provided to give you any specific answers. You appear to have implant malposition on the right side and there can be many reasons for this. It would be unusual to have capsular contracture this early after your surgery. In fact, it might even be a little early to consider a revision because you are not yet fully healed and this may improve with time. Your surgeon should have the most insight into what is going on.

One thing that is clear is that this yet another example of complexity and difficulty in achieving consistently high quality results when an augmentation and breast lift are performed at the same time. Studies have shown that the revision rate for this combined procedure are 30% or greater. Hopefully your surgeon discussed this issue with you prior to your surgery.

Breast augmentation revision

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Sorry about your troubles. From you photo, unless it is flipped, it looks like your right breast is significantly smaller than the right. It also seems like it has not dropped into the breast pocket the way the left breast has. It is rare for a capsular contracture to be severe enough to cause pain in just 8 weeks, but it certainly seems like the more likely diagnosis compared to a ripped muscle. If you had a "ripped muscle" I would think that the implant would be more likely to drop down into the pocket, filling out your breast as opposed to sitting up high in your chest. 
Ideally you know the reason for why the breast implant is so displaced. Putting it on top of the muscle may make you more prone to capsular contracture. 

Lily Lee, MD
Pasadena Plastic Surgeon
5.0 out of 5 stars 29 reviews

What is causing your size discrepancy?

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Contractures rarely happen that quickly and ripped muscles don't explain that either.  Before having anymore procedures so quickly, the correct diagnosis must be made.  Photos suggest fluid on the larger side or leaking on your smaller side if saline was used.  Make sure you understand clearly what is happening and consider your options carefully before jumping back in for more surgery.  Most surgeons would wait 6 months before going back unless a problem such as bleeding or massive seroma.  If this can wait, you should wait longer before going back for more surgery.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

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Thank you for the question and clearly from the photos one implant seems higher then the other causing a difference in size and shape.  With time this may correct on its own but an examination and review of your operative note and preop photos is really needed.

Dr. Corbin 

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 65 reviews

Breast Revision

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Thank you for the photo but this is not enough information to give you definitive advise on how to move forward.
There are many possibilities which could have led to this appearance of the breasts.

It is clear the right breast implant is sitting higher than the left and has not descended into the lower pole of the breast creating a significant difference in the appearance. However, there is also a significant difference in the volume of the breasts which may require maneuvers other than implant manipulation alone.

Going above the muscle is not a solution I would recommend in this situation with the information you have provided. The rate of encapsulation of breast implants above the muscle is higher than below and this would also create more problems for future procedures.

Capsular contracture within the first 8 weeks is very unusual and I am not sure why you were told the muscle was "ripped".

I would suggest seeking another consultation with a board certified plastic surgeon with extensive experience in breast surgery and breast revision surgery.

Good luck and I hope this was helpful

Robert W. Kessler, MD, FACS
Corona Del Mar Plastic Surgeon
5.0 out of 5 stars 130 reviews

Breast revision

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It is rather difficult to comment on your situation with one picture but there's a possibility that you may have capsule formation and may need a capsulectomy to relieve your problem. It also seems that possibly the inframammary fold may be breached but it's hard to tell. It would be a lot easier if I could examine you in person. 

Capsular year with possible seroma

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The picture may be deceiving however it seems like the left breast shows a double bubble deformity with possible fluid collection. There may be a seroma formation. An ultrasound prior to surgery may be useful. Recommend possible open capsulectomy with drainage 

Stuart A. Linder, MD, FACS
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 43 reviews

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.