40, 125lbs, 200/250cc, how do I go forward after a donut lift with high profile small implants? (Photos)

Question

(right breast settled far out)? I'm 40 y/o- 125 pounds. Broad shoulders/wide chest (was previously 36A). Wanted moderate profile 275-300 cc but my surgeon- "boob doctor" pressured me last minute (minutes before surgery) to get high profile-telling me moderate wouldn't look good-not explaining why. I wanted the width & natural look of moderate. These small, 200/250 high profile implants look terrible far apart. Based on photos, should I have surgery to bring them closer or will moderate 275/300 be better

Gary M. Horndeski, MD · Answer

As you can see, your breasts are still widely separated. I recommend a lower profile implant, perhaps slightly larger as well with more medial dissection and lateral plication to move the implants more towards the midline. I recommend you wait 6 months from the last surgery before doing any revision. Another alternative to consider is fat transfers done medially to give the fullness as well.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Daniel Barrett, MD · Answer

Dear Bluebuthopeful,
dropping of implants is part of the healing process and this occurs after the tissues surrounding the implants slowly relax, allowing the implants to settle into their final position. It can take about four to six months for the implant to drop down to their final position.I understand that you are worried about your implants are not dropping as expected. However, you are still in the early phase of the recovery period. Please do allow some time for the healing process to occur. If after six months, you are not satisfied with the appearance of your breast, you can visit your plastic surgeon and discuss your concerns.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Gerald Minniti, MD, FACS · Answer

Your pockets need to be repaired, and you need a wider implant. It's a mystery why he did a donut lift; you did not have excess or loose skin.

Connie Hiers, MD, FACS · Answer

Your lateral pockets can be tightened so that the implants do not fall so much to the sides. However, you do have a natural gap between your breasts which you will keep. The bases of your breasts cannot be moved. I think the moderate plus profile would do well for you.

Darryl J. Blinski, MD · Answer

Based on your nicely poster photos, your anatomy and breast shape, size and location on chest wall was a guaranteed for wide set results no matter what profile implant use. Best to place implants in the dual plane location, not under muscle and increase size and use of moderate profile plus the 250 to 325 cc ranges. Best of virtual consult with. The range from $6000-$10,000. Again, best of virtual concert with.

Mats Hagstrom, MD (license on probation) · Answer

your breast sit wide on your chest wall.
When that’s the case, this characteristic tends to be amplified with the projection of implants.
If the surgeon puts the implants close to the midline, the implants won’t be lined up correctly on each breast.
If the surgeon put the implant correctly lined up on each breast, then the implant will sit for apart.
It’s sort of like you can’t have your cake and eat it too.
High profile and low profile implants have their advantages and disadvantages.
Low profile implants are wider and there’s not a lot of space from the side of your breast until you’re on the side of your chest wall.
For this reason, low profile implants are less ideal.
Hi profile implants give more projection and projection makes the breast position more obvious.
Patients who are not ideal candidates for breast augmentation surgery generally put the variables that keep them from being ideal candidates on display.
This is true for women who have breast divergence and women who have breast that’s it far apart on the chest wall.
In your case, you were not an ideal candidate for augmentation and your surgeon could’ve probably put the implants slightly more towards the midline.
Personally, I’m not a fan of the donut breast lift, a.k.a. Benelli mastopexy. It has a tendency to cause the areola to stretch creating wide scars and leave the breast looking flat. 
To make an accurate assessment, we need 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.
We need to see your breast from different angles.
In the end, I think your outcome is a combination of your breast sitting wide on your chest wall, and to some degree how the procedure was performed.
Best,
Mats Hagstrom MD

40, 125lbs, 200/250cc, how do I go forward after a donut lift with high profile small implants? (Photos)

Answers (6)

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