I had 350cc & i wanted to have them replaced with the gummies as well as go slightly larger & have the upper pole fullness. I had them replaced with high profile gummies, 385 cc w/a periaerolar lift. 2 mos after surgery i have ZERO upper pole fullness and it almost looks like my breats are sagging. if i wear a low cut shirt it barely looks like i have any cleavage. does this seem normal? I thought the high profiles would give me the upper pole fullness - i had more with the moderate saline.
Answer: Upper pole fullness The size difference isn't much from your old implants to the new. Most likely the old implants, as well as age and time have stretched your tissues, and therefore either a significantly larger size is needed or a more substantial powerful lift that the periareolar approach doesn't quite provide. A full lift, pocket revision, and a more substantial size increase (approx 100cc or more) can give you a fuller look.
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Answer: Upper pole fullness The size difference isn't much from your old implants to the new. Most likely the old implants, as well as age and time have stretched your tissues, and therefore either a significantly larger size is needed or a more substantial powerful lift that the periareolar approach doesn't quite provide. A full lift, pocket revision, and a more substantial size increase (approx 100cc or more) can give you a fuller look.
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November 20, 2017
Answer: Best breast operation to achieve my goals? I am sorry to hear about your concerns after revisionary breast surgery. It is hard to give you precise advice but it sounds like the use of larger volume implants, adjustment of breast implant capsules (capsulorraphy) and/or revisionary breast lifting may be indicated to address your concerns and achieve your desired outcome. Best to communicate your concern/goals directly with your plastic surgeon, in front of a full length mirror and with the help of goal photographs. Best wishes.
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November 20, 2017
Answer: Best breast operation to achieve my goals? I am sorry to hear about your concerns after revisionary breast surgery. It is hard to give you precise advice but it sounds like the use of larger volume implants, adjustment of breast implant capsules (capsulorraphy) and/or revisionary breast lifting may be indicated to address your concerns and achieve your desired outcome. Best to communicate your concern/goals directly with your plastic surgeon, in front of a full length mirror and with the help of goal photographs. Best wishes.
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November 19, 2017
Answer: Upper pole fullness Dear akelley111,upper pole fullness is achieved with appropriate implant selection but more importantly, submuscular placement, and precise pocket dissection. The submuscular placement allows the muscle to cover the top part of the implant which allows the upper pole to appear more full. Keeping away from the lateral chest during pocket dissection allows the implant to remain higher and prevents it from falling off to the side. Implant profile is a very important consideration. Many patients wrongly assume that the higher the profile the better. The truth is, the more profile (or projection/height) and implant has, the narrower its base has to become. This has several problematic consequences. The first is that the patient loses width and therefor cleavage of the breast. The second is the breast becomes more narrow and pendulous, often falling lateral and onto the side of the chest, and third, high profile implants have a higher risk of bottoming out because they exert more pressure on the inframammary fold than moderate profile implants. High profile implants do have a role in symmastia repair (when I need to narrow the basewidth) but otherwise I try to avoid them.Daniel Barrett, MD, MHA, MS
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November 19, 2017
Answer: Upper pole fullness Dear akelley111,upper pole fullness is achieved with appropriate implant selection but more importantly, submuscular placement, and precise pocket dissection. The submuscular placement allows the muscle to cover the top part of the implant which allows the upper pole to appear more full. Keeping away from the lateral chest during pocket dissection allows the implant to remain higher and prevents it from falling off to the side. Implant profile is a very important consideration. Many patients wrongly assume that the higher the profile the better. The truth is, the more profile (or projection/height) and implant has, the narrower its base has to become. This has several problematic consequences. The first is that the patient loses width and therefor cleavage of the breast. The second is the breast becomes more narrow and pendulous, often falling lateral and onto the side of the chest, and third, high profile implants have a higher risk of bottoming out because they exert more pressure on the inframammary fold than moderate profile implants. High profile implants do have a role in symmastia repair (when I need to narrow the basewidth) but otherwise I try to avoid them.Daniel Barrett, MD, MHA, MS
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Answer: When you don't change anything (35 cc's in a gel from saline upgrade is not much at all), you will not see much benefit. You should discuss your concerns with your surgeon and find out where the 'miscommunication' occurred and what your surgeon is responsible for and find out what options you have. This can range from fat grafting, larger implants, or a more aggressive mastopexy. But now one would have expected you to have much improvement with only a 35 cc difference going from saline to gel.
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Answer: When you don't change anything (35 cc's in a gel from saline upgrade is not much at all), you will not see much benefit. You should discuss your concerns with your surgeon and find out where the 'miscommunication' occurred and what your surgeon is responsible for and find out what options you have. This can range from fat grafting, larger implants, or a more aggressive mastopexy. But now one would have expected you to have much improvement with only a 35 cc difference going from saline to gel.
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November 19, 2017
Answer: No Upper Pole Fullness I am sorry to hear that. It is hard to comment accurately for you without pictures. When you say gummy's do you mean shaped gummy implants or smooth round gummy implants? It makes a huge difference for upper pole volume. Sorry I can't tell you more. You need to chat with your surgeon. If you post photos let me know and I would be happy to take a look.
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November 19, 2017
Answer: No Upper Pole Fullness I am sorry to hear that. It is hard to comment accurately for you without pictures. When you say gummy's do you mean shaped gummy implants or smooth round gummy implants? It makes a huge difference for upper pole volume. Sorry I can't tell you more. You need to chat with your surgeon. If you post photos let me know and I would be happy to take a look.
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