HELP I have Poland Syndrome - advice on best & last implant revision & replacement option? (Photos)

Question

130 lbs 36 yo F with Poland Syndrome. No nipple or breast tissue development in left breast. Normal growth/ development of right breast. 2000 augment to address flat chest (L saline implant only). Revision/replacement 2006. Have 480cc Mentors Smooth Round High Profile in left breast and 275cc Moderate Plus Profile in right. Little weight fluctuation (between 125-135) and no kids or plan to. Looking for advice to achieve size symmetry and areola height while having some natural tissue in R side

Ned Snyder, IV, MD · Answer

Hello, you have a nice outcome for only having had a couple of procedures many years ago. Your next surgery to match symmetry should be a lift of your right breast. At that time you should consider exchanging the implant on the left as well. To improve the symmetry of you areola colors, you could also tattoo your left areola to match the right.

Daniel Barrett, MD · Answer

Dear QDubbs,
breast revision surgery is the most difficult plastic surgery procedure performed. Botched breast surgery alters normal tissue planes and laxity, the ability of breasts to heal properly, and leaves scar tissue that dramatically affects the level of difficulty of the corrective surgery.Many patients come in to correct poor outcomes from their initial surgeries. The most common problems are due to implant malposition, bottoming out of the implant, poor scarring, and incorrect implant size.While the type of revision required will depend on the result of the previous surgery and the desired result of the patient, some revisions involve extensive pocket repair that may or may not need specialized external bras.If you are considering breast surgery revision, you should speak with a board certified plastic surgeon and have yourself properly assessed. Only after a thorough examination you will get more information and recommendations. Also, you have to make sure that your surgeon understands your breast augmentation goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

The reconstruction areola cannot be lowered, but your lower one could be lifted some. The inferior pocket could be shortened on the reconstructed side somewhat to try to help symmetry of the areolae.  An examination is needed to determine what can and cannot be done. More could be done if you go down in size.

Bruce K. Smith, MD · Answer

Congratulations, as the breast shape is quite nice and the asymmetry in breast volume is very slight. The  problem that I see now is that the reconstructed nipple-areola complex is too high and the vertical distance from the areola to the inframammary fold is much greater on the left than on the right. The left nipple can be lowered by excising skin in the inframammary fold area but the nipple position is so high, the nipple can only be lowered 1- 1.5 cm. and it needs to be lowered more. It will probably require two operations with an interval of 6 to 12 months to allow the upper pole skin to stretch before the nipple can be repositioned to match the right side. Some darker tatooing of the left nipple and areola would also improve your reconstructive result.

HELP I have Poland Syndrome - advice on best & last implant revision & replacement option? (Photos)

Answers (4)

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