I Can Feel my Implants at the Sides of my Breast and the Skin is a Bit Loose? (photo)

Hi, I had a breast reduction about 7mths ago and have noticed that the edge of my implants are slightly visible, especially my right and the breast seems to kind of fall off the implant/there is too much skin remaining. The effect is that my right breast looks a little square and has two bumps. I spoke with my PS and he said we could do a revision and replace the implant with a narrower topped one but there was no guarantee that the issue would be fixed. Is it possible to get people's thoughts?

Doctor Answers 11

Augment Mastopexy results

Hi Jadeks

It is unclear from your question whether you had implants already and just a recent lift/reduction over the top, or both procedures performed at the same time .Without pre-op photos to compare to, it seems like you have a pretty good result.

However, in respect to your concerns:-

1. Extra skin? - your side and oblique views show your nipple positioned well over your implant/breast mound. The amount of 'extra' skin is very small if any. Having overly tight skin also places stress on your healing vertical scar and will make that scar more visible even once it finishes healing. 

2. Squareness of your right breast - this is something that can be minimised with a full thickness wedge of skin/fat/breast along your existing vertical scar. It would be only a small amount needed if any. Although it would be reasonable to perform this adjustment now, waiting till 1 year post op will give your plastic surgeon more certainty over your final result.

3. Palpability of the implant. Your side and oblique views show a dimple between your chest wall and implant, and your front on view shows your implant spilling over the side of your chest (but this could be a optical illusion from the camera). IMHO your implants are too wide for your chest. However, that is unlikely to be the cause of the palpability - it is the soft tissue (skin and fat) coverage that is too thin. Thickening this with either a dermal matrix or fat grafting is the most reasonable solution. Changing to a narrower implant will make the overlying skin more loose over the top and need tailoring so it fits snugly.

All surgery and revision surgery is imperfect. I would not make a guarantee either.

Good Luck

Dr Gavin Sandercoe

Sydney Plastic Surgeon
5.0 out of 5 stars 8 reviews

I Can Feel my Implants at the Sides of my Breast and the Skin is a Bit Loose?

Of the two issues you note, I would agree that, should you wish it, a revision to excise some tissue from the lower pole of the breasts would improve the outcome. As to the implant position, I am not sure that the margin for improvement is low enough that any slight problem that might occur wouldn't overwhelm the improvement. An in person exam might lead to a different conclusion, though.

All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.6 out of 5 stars 45 reviews

Implants that extend beyond the natural lateral border of the breast can demonstrate visible contour irregularities.

One problem with large implants, particularly saline, is that they are covered only by skin in a small amount of subcutaneous fat laterally when they go beyond the natural anatomic border of the breasts. Revision is certainly possible but as your surgeon pointed out not a guarantee that this will necessarily remedy the problem.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.7 out of 5 stars 35 reviews

I Can Feel my Implants at the Sides of my Breast and the Skin is a Bit Loose?

No before photos posted! But appears as a very acceptable result. Thus, I might leave well enough alone. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

I Can Feel my Implants at the Sides of my Breast and the Skin is a Bit Loose?

      Implant palpability and visibility can be improved with a dermal matrix or fat grafting, and the breast lift can be revised to remove additional skin and tighten the skin envelope.  It is important to realize that skin quality will limit the final result to some extent and all results relax over time.  Find a plastic surgeon with ELITE credentials who performs hundreds of breast lifts and breast lift revisions each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.  Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

Breast lift with implants?

It sounds like you had a lift with a wise pattern closure and what you are complaining about is the palpability of the implant, which I do not think you can correct.  Best to be seen in person to get a better idea of what is possible.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

Best Breast Revisionary Operation for Me?

Thank you for the question and pictures. Revisionary breast surgery is certainly possible and exactly what procedure would be best for you will depend on your specific concerns and findings on physical examination. For example, if “loose skin” is of major concern, then additional skin excision ( revision mastopexy) may be helpful. On the other hand, if the breast implant shifts to the sides ( especially when you lie down), then internal suture “repair” (capsulorraphy)  may be indicated. Of course, these operations are not mutually exclusive.

Generally speaking, patients who are considering breast revisionary surgery need to weigh the degree of concern they have with their  dissatisfaction with their breasts against the downsides of having additional surgery ( including potential risks/complications, recovery time, expenses etc.).  Ultimately, for patients who are generally doing well, these types of decisions become a very personal decision.

 When the time is right, see consultation with board-certified plastic surgeons who can demonstrate significant experience helping patients in your situation.  During the consultation process you will be able to learn more about the pros/cons associated with additional breast surgery.

 You may also find attached link helpful to you as you learn more about options.

Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,486 reviews

7 months post BAM/Mastopexy with residual excess lower pole skin

I agree with you in that the breast tissue is hanging off both implants.  You did not mention if implants were saline or silicone.  There is a higher risk of palpating or visualizing the edges of saline implants, especially since you have thin skin which has been stretched.  I highly recommend silicone breast implants in your case.  Also, I recommend the implant be placed under the muscle.  Your implants look wide for your body.  Exchanging to a narrower implant with more projection may help.  I agree, a revisional mastopexy to excise the excess glandular tissue (also called double bubble) from the lower pole and lift the breasts, would be recommended.  

Best wishes...

Dr. Mizuguchi

Nana N. Mizuguchi, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 49 reviews

Loose skin

hi, loose skin in breast reduction is an issue.   you´ll need probably a revisión to remove the skin, and yes, changing the size of the implant.  implants that are wide in diameter can be touch at the sides as if there were edges. 

Juan Pablo Cervantes, MD
Mexico Plastic Surgeon
4.7 out of 5 stars 86 reviews

Revision a breast lift

The most outstanding feature of your breast that can be corrected is the inferior pole.  I would think that a revision of the vertical incision below the areola would tighten the inferior pole of the breast, improve your upper pole fullness and narrow the base of the breast.  It is hard to tell if anything needs to be done with your implants.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 19 reviews

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