Appears as a very unusual technique in breast lift with the 'boxy' appearance outcome. Only revision can help. Return to Dr Ortega for revision or seek other PSs..
Thank you for you question and photos. ALL implants will descend or lower some with time. As your lower pole skin stretches, to accommodate the implant, the upper portion of chest will appear less full. Yes, you can add an internal "bra" and that will help. But that will not eliminate the extra lower pole tissue that you already have. I would recommend repositioning the implant and adding internal support or a neosubpectoral pocket and then tailoring your soft tissue around that..analogous to tailoring fabric on a dressform. I would caution that a vertical "lift" will not be adequate to achieve the look you want. Also, be sure you a see a board certified plastic surgeon who does a lot of breast and/or revision surgery.
it most be repeated the anterior technique i only would change the implant i would rather choose a less volume with higher projection and anatamical shape that would improve better the results to stay satisfied
I most commonly address this problem, which can usually be avoided by maintaining inferior pectoralis muscle attachments, with internal sutures and possible the additional use of Seri-Scaffold to support the implants and keep them higher on the chest.
Without preoperative photographs it's impossible to explain why the present situation exists. I can't see anything except surgical revision to correct the problem.
You presented a very common scenario that I see - A lift with implants that has sagged in a short time. The way I approach these cases - either primary (first time) or revisions is to do what we call a plus/minus lift where tissue is removed from the bottom portion of the breast (the part that sags) and replace the tissue with an implant. The breast can be made smaller, bigger or remain the same. The other part is to use some material internally to hold the implants up. The breast tissue and skin is by definition saggy - it cant hold up the implant. We use either Strattice, Seri or Galflex mesh as an internal bra in addition. results seem to be very long lasting. I have some patients almost 6 years out with Strattice with excellent results
Thank you for asking about
your breast lift and breast augmentation.
- Sadly, when the breasts sag, it means the skin has stretched so it may stretch again.
- There are things that can be done -
- A re-do of the lift,
- A re-do of the lift with ADM or other internal support material.
- A smaller implant.
- All of the above!
- Which of these are best for you (and your pocket book), is something to discuss with your surgeon.
- But that high, round perky look right after a breast lift is from swelling - and it is not likely to last.
Always see a Board Certified Plastic Surgeon
Hope you found this answer helpful. Best wishes.
Yes you have different options such as going with a smaller implant and redo the lift, redoing the lift with a biologic material to hold the implants in a better position versus staying the way you are now and doing fat grafting to the upper part of your breasts to give you more cleavage when you are in a bra. But it would be best to see a board certified PS who can examine you and go over all your options.
When you need a breast lift it means that your breasts do not have good elasticity. It is rarely possible to maintain long term upper pole fullness from an implant in these cases and it is important to tell patients as such up front. The worst thing you can do is to go bigger and bigger trying to achieve an unachievable goal, only to see the tissues fail to hold up the ever larger/heavier implants. You are doing all you can with the bras...keep it up.
I always tell my patients that whatever skin is there will remain there but through a breast lift we will remove some excess and we also have to leave enough behind to accomodate an implant.Once the swelling goes down there will be some settling that occurs.