Asymmetrical torpedoes one week post op breast lift with 250 cc implants. Will these issues correct themselves? (Photo)

My right breast was larger before the surgery but my ps was supposed to remove tissue to make them the same size and then add 250 cc implants to both sides as well as performing a lift. The outcome is actually very disturbing to me. The right is still considerably larger and still sagging. They both appear to be cone shaped and there is a lot of puckering around the areola. Are these issues that are going to correct themselves as the implant settles or is revision going to be necessary?

Doctor Answers 11

Too hard to tell

This is definitely a scary time in the healing process.  Different surgeons use different techniques- some that take a while to "settle" which is un-nerving to everyone involved- especially the patient.  The best surgeons that I trained with weren't willing to go through or subject their patients to this very stressful time (but that's just my experience and the philosophy that I adopted).  They wanted things beautiful on the table and if they needed to come back and do any revisions to tighten things up or move things a little, the patient was usually fine with it and never had to go through the "scary phase".  Just trust your surgeon's expertise and follow all instructions carefully- even if it includes don't look at them for a few months!

Final results take months to become evident!

Wow, you sound angry and accusatory so early after surgery. Didn't you understand that there would be swelling, and that scar softening, stretching, and maturation would occur over many months as gravity exerted its ever-present effects? For the technique chosen (modified lollipop lift plus implants), this is exactly the "usual" early post-op appearance. It will indeed change over time, and almost always for the better, since this technique pretty much always looks "funky" right after surgery.

I'm personally not a fan of any breast lift technique that tightens the breast skin brassiere in only one dimension, as the vertical scar is usually "too long," often crosses the inframammary crease (or is slanted off to one side as your appears, creating an inframammary scar that was supposedly to have been avoided), and the unnatural pinching of the tissues beneath the nipple/areola complexes gives a "snout" appearance (that you have quite accurately described as "cone shaped.") But this part of the vertical lift design is claimed to provide longer-lasting support and less long-term re-droop or recurrent sagging. Essentially, this is a certain degree of "over-correction" to take into account the effects of gravity and scar/tissue stretch with healing.

Puckering is another part of this design I do not like, but this too will improve over time. But some degree of puckering is present with any technique and simply due to the effects of the dissolving sutures below the surface of the skin. As the skin incisions heal and the sutures dissolve, this (largely) goes away.

Bottom line: your entire result is going to get a lot better as time goes by, but that time span is months, not weeks. Revision is a possibility with any surgeon and any technique, which is why I personally choose a technique that (IMHO) reduces the likelihood of re-operation in the first place rather than trying to over-ride the laws of biophysics and having to wait and see if the "avoid scar" technique is actually better than the precisely-designed full lift plus implants.

Everything is a choice and compromise, and both you and your surgeon made theirs. So be patient and put questions about revision away for at least 6 months. I hope you will be pleasantly surprised, but cannot honestly reassure you that you will be happy, even though I can truthfully state that things will definitely get better than they look right now. Hang in there and discuss your concerns with your surgeon without anger or accusation--this will not help you if you indeed want a revision down the road. Best wishes! Dr. Tholen

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 238 reviews

Takes time

I tell my patients - especially after aug/mastopexy not to look at their breasts or judge results in the early post op period. There is swelling,muscle spasm, healing ,etc that needs to resolve before judging the outcome. Most surgeon don't evaluate their results til at least 3 months postop but patients on Realself are frequently asking for second opinions two or three days postop when they take off their dressings and start second guessing their surgeon. You need to give this time. I want my aug mastopexies  to look like this immediately postop as I know they will " settle"  in 4-6 weeks

Glenn Lyle, MD
Raleigh-Durham Plastic Surgeon
5.0 out of 5 stars 10 reviews

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Post-Operative Asymmetry

It's not unusual for patients who undergo combination breast lift/breast augmentation to be concerned about the appearance of their breasts in the immediate post-operative period. It's virtually impossible to make aesthetic judgements regarding the size and shape of the breast when patients are only one week post-op.

During this period of time, swelling, muscle spasm, inflammation and the wound healing process itself. All contribute to changes in the appearance of the breasts. In most cases, it takes about 3 to 6 months before an assessment can be made about the aesthetic result.

At this point in time, your pictures suggest residual asymmetry, residual sag, cone shaped breasts and puckering around the nipple areolas. Many of these findings will improve with the passage of time. It's, therefore, important to wait at least six months before considering revisional surgery.

For these reasons, patients need to be patient and maintain good communication with their plastic surgeon. Their surgeon should be able to reassure them and alleviate their anxiety.

Results One Week after Breast Lift with Implants

Thank you for your question.

At one week, it is way too early to tell.  It can take 6 weeks to 3 months for implants to settle into the breast pocket.

To be sure, return to see your surgeon and keep all of your follow up appointments.

I hope this helps.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
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Asymmetric torpedoes and puckering after breast lift with implants

At 1 week, I think the shape looks fine, and things should settle nicely with time, as will the puckering.   The asymmetry may be due to swelling, with the larger breast having more work done, and more swelling, but you will just have to wait and see.  It will take 2-3 month to see how things turn out. Discuss your concerns with your plastic surgeon, but I see no cause for concern at this time.  If the asymmetry persists, a relatively minor revision could correct it.

Asymmetrical torpedoes one week post op breast lift with 250 cc implants. Will these issues correct themselves?

Much, much, much TOOO early to comment. Only 1 week post operative. Best to see you surgeon every few days for reassurance to how things are healing... 

Asymmetrical torpedoes one week post op breast lift with 250 cc implants. Will these issues correct themselves?

 It is MUCH to early to evaluate the outcome of the procedure performed.  Some of your concerns such as “puckering” are a temporary phenomenon. Although online consultants will not be able to provide you with meaningful reassurance, I can tell you that the appearance of your breasts will change (hopefully for the better and to your liking) over the course of the next several months. Your plastic surgeon, will always be your best resource when it comes to information, advice, predictions, and/or meaningful reassurance.  Best wishes for an outcome that you will be pleased with, in the longer term.

Asymmetrical torpedoes one week post op breast lift with 250 cc implants. Will these issues correct themselves?

The first thing to do is be patient.  No one is able to predict the final outcome at one week.  You need to wait minimum six months.  The nipple position does seem a bit low but may be that way only because of the significant fullness to each upper breast.  The right is larger and with that bruise on the right, you should see your doctor soon to just be sure there is not some bleeding issues going on at the same time.

Robert J. Spies, MD
Paradise Valley Plastic Surgeon
5.0 out of 5 stars 79 reviews

Asymmetrical torpedoes one week post op breast lift with 250 cc implants

One week is a little early to judge. Some of your concerns may be swelling and bruising. GIve it at least 3 months before you consider additional revision.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.