Under muscle, gummy bear, 295cc, not happy with space & 1 larger, thoughts & advice? (Photos)

Question

Under muscle, gummy bear, 295. I’m not happy with space and one breast is clearly larger than the other. photos are before, 3 mos, 6 mos. I always Lacked volume in right breast, and had me left breast reduced With augmentation 14 years ago to fix (no implants). I believe my doctor just put them in and sewed me up. Nothing special to account for my anatomy, etc. I’m looking for thoughts and advice…thx in advance!

Ronald J. Edelson, MD · Answer

Considering the situation you started with I think your result is reasonable.  You could have a lift done but it would involve scars and might not be worth it

Paul E. Chasan, MD, FACS · Answer

Thank you for your question.  I have been in practice for 30 years and revision breast surgery is a large portion of my practice.  You would benefit from performing an internal bra/capsulorrhaphy as well as a revision of your lift.  I have treated many patients with very similar anatomic features. You should be able to have an excellent result with an attractive cleavage.  Best wishes to you.

Connie Hiers, MD, FACS · Answer

The lower side needs the lower pocket reshaped and perhaps a lift to even out your areolae.  I would not suggest using high profile implants, but ones with a wider base. Naturally, your breasts sit somewhat far apart, and the bases cannot be moved.

Camille Cash, MD · Answer

From the photos it appears you had some asymmetry prior to surgery.  If the same sized implants were used and no corrections were made to address it then you will have the same issues after surgery, just enhanced.  Further correction to address your concerns unfortunately will require more surgery.  Due to your anatomy it is not likely you will be able to achieve breasts that are close together.

Mats Hagstrom, MD (license on probation) · Answer

It’s a little bit difficult to understand your post, especially about having a reduction and augmentation without implants at the same time.
The left breast typically sits higher on the trust wall on all people, both men and women.
And most people the IMF(infra mammary fold) is about half an inch higher on the left side.
This appears to be true for You as well in your before picture.
In your after picture, the IMF was lowered most likely to create some symmetry.
Plastic surgeons can’t move the breast on the chest wall.
Opening the IMF to have the implant sit lower that the breast naturally sits on the chest wall can lead to undesirable side effects like implants bottoming out.
Different plastic surgeons have different approaches to how to deal with this.
Personally, I believe the implant should sit centered on the breast, even if the breast are not even on the chest wall.
 Other plastic surgeons attempt to manipulate the breast position with maneuvers like opening the IMF.
If you have questions about the outcome of your procedure that I suggest you follow up with your provider who did the surgery.
It’s hard to understand what or why certain things were done during surgery without having been there.
 The outcome doesn’t look terrible.
Generally, speaking breast augmentation outcomes are based on three variables.
The first variable is the patient’s candidacy for the procedure in the first place.
The second variable is implant selection in regards to shape size and type.
The third variable is the surgeons ability to put the implant in the correct anatomic location. 
All women and men to some degree as well have breast asymmetry.Think of them as sisters not twins.
Best,
Mats Hagstrom MD

Under muscle, gummy bear, 295cc, not happy with space & 1 larger, thoughts & advice? (Photos)

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