Breast implant revision? Bottoming out/asymmetry. (photo)

Question

Looking for general second opinions on how a surgeon would approach this situation. In 2019, 150CC silicone implant on left breast and lift on right (no implant) to fix asymmetry. Now areolas are too high and breasts are asymmetric, left seems to be bottoming out. How would one fix this? Could areola size be reduced as well? Can I go w bigger implants?

Matthew S. Kilgo, MD · Answer

Hello and thank you for your question.
While it is difficult to provide a specific recommendation without a  physical examination, based on your photographs, you do appear to have bottoming out on  both sides. The left breast is also slightly larger than the right, with a lower and more  poorly defined inframammary fold.
It can be very difficult to achieve optimal breast symmetry without placing implants on both sides. I would recommend a revision mastopexy on  the right with placement of an implant to provide more upper pole fullness. This would also help correct the position of the nipple areolar complex.
The left side would also benefit from a mastopexy with an implant exchange and pocket modification with a capsular repair. Given the implant malposition on the left, you may also benefit from placement of absorbable mesh to provide more long-term stability. You should consult with a surgeon certified by the American Board  of Plastic Surgery who has  extensive experience with breast surgery revisions. Good luck. I hope this helps.

Paul E. Chasan, MD, FACS · Answer

Thank you for your question.  I have been in practice for over 30 years, and breast revision surgery is a large portion of my practice.  I invented a surgery that is a particularly suited for your issues with significant breast asymmetry and published this in 2017.  It is called reductive augmentation.  I tried to remove more tissue from the larger breast so I can place the same size implants in both breasts and perform a lift and removal of inferior pole breast tissue.  You are an excellent candidate for this.  You should be able have an excellent result.  Best wishes to you.

Gary M. Horndeski, MD · Answer

I agree that both nipples are too high and pointing upward.  You would benefit from a circumareola approach that will reposition the nipple-areola complex.  You may also benefit from fat transfer to the upper poles to give more upper pole fullness.  You may also benefit from a curvilinear incision near the inframammary fold to take out excess skin, tighten you inferiorly and correct the bottoming out appearance of both breasts.

Best Wishes,

Gary Horndeski, M.D.

Farbod Esmailian, MD · Answer

Yes you could go with bigger implants.  Your areolas can be reduced by having a circumareolar mastopexy/NAC reduction.  The appearance of your breast will also be improved with a lift over all.  It would not be a traditional lift, but an inferior mastopexy.  
I feel that with the proper surgeon/surgery you could have a very nice outcome.

Hope that helps.

Darryl J. Blinski, MD · Answer

Based on the nicely posted photos, you do need revision surgery may be one stage or two stages. Best of virtual concert with. I would increase the volume of the implant on the lifted side with a minor lift on the non-lifted side and a smaller implant in the sitting position to adjust for sizing, I expect the Smaller previously lifted side would need a 350 to 400 cc implant while the non-lifted side that needs a small donut lift of the Ariola area would need a 150 C implant. Again best of virtual console with expect fees to range from $10,000-$20,000.

Breast implant revision? Bottoming out/asymmetry. (photo)

Answers (5)

Answer: Breast Revision Surgery

Answer: Breast Revision Surgery

Answer: Continued breast asymmetry,with unilateral lift implant options

Answer: Continued breast asymmetry,with unilateral lift implant options

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Breast implant revision? Bottoming out/asymmetry. (photo)

Answers (5)

Answer: Breast Revision Surgery

Answer: Breast Revision Surgery

Answer: Continued breast asymmetry,with unilateral lift implant options

Answer: Continued breast asymmetry,with unilateral lift implant options

Browse related questions

Recommended reading

Everything you need to know about Breast Reconstruction Revision

Our mission is to create a world where every investment in modern beauty is Worth It.