What Happened to my Lift with Implants? I Look Horrible... (photo)

I had a breast lift with implants... my breasts are now so uneven and look horrible. I have been told by the hospital that I need to go back after 6 months to have a revision on the right breast. I'm so scared to let them cut me open again as they have not told me why or how this has happened. I can't get time off work until November so I am stuck looking like this for the next 10 months :( Someone please help me with answers?

Doctor Answers 16

Breast lift and breast implants

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Your concerns are obvious from your posted photos which show disruption of the right crease and downward displacement of the right implant and symmastia. Not knowing what you looked like before surgery or exactly what was done during surgery it is impossible to say why or how this happened. You need to have a frank discussion with your surgeon so that you can go back to him/her for the revision surgery and not have to go from surgeon to surgeon as that could be costly. I do not know if your implants are above or below the muscle but if they are above moving them below as well the use of dermal matrix to reconstruct the right crease may help the situation.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Los Angeles Plastic Surgeon

What to do about bottoming out of a breast implant with asymmetry

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It is never good when the surgical plan and the early result do not meet up to your expectations.  Looking at your  photo, it appears as if you have developed some degree of bottoming out of your right implant, this sometimes develops when the crease under the breasts is high and tight and the implant needs to be lowered to centralize it over the implant.   The condition is referred to bottoming out.  You may need a revision in the future.    Sometimes we use a product called ADM or acellular dermal matrix to help set the crease.  While your surgeon is waiting for your soft tissue to heal it would be best to wear a nice support bra, possibly an underwire bra that may help to re-establish the inframammary crease.   

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

Augment mastopexy

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we have alll had operations that did not go as we would like them to. the likelihood of revision surgery after your operation is 30-35%.  do not be angry, it can be corrected. 6 months post op is a good time to do this at the earliest

Jonathan Saunders, MD
Newark Plastic Surgeon

Breast Lift Results

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It looks like your implant moved down, also known as "bottoming out". This would require a revision to correct.

Karol A. Gutowski, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 76 reviews

Bottoming out of Breast After Lift

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It appears that you have had bottoming out of your right breast. This can be corrected, but it will take a second procedure with either tightening of the breast capsule, or with the use of a product such as Alloderm or Strattice. These are dermal replacement products that can be used to reinforce the weakened area of the breast. See an experienced surgeon who is comfortable with this type or procedure as it is complicated, but can produce significant improvements. 

Best of luck!

Vincent P. Marin, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 52 reviews

Breast Implant Bottoming Out?

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I'm sorry  that you are experiencing the complication after breast augmentation/mastopexy surgery. It seems as if the implant on your right side is inferiorly displaced ( bottoming out).

Bottoming out involves inferior migration of the implants. This causes the nipple areola complex to appear too high on the breasts. Also, the distance from the areola to the inframammary fold is too great. This is corrected by “raising” the inframammary fold using internal sutures. This is done after careful measurements are made from the areola to the “new” inframammary fold.

I would suggest that you ask your plastic surgeon for demonstrable experience with this type of revision surgery.

Best wishes.

Bottomed out breast implant

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Your implant has bottomed out and will need revision using either sutures or an acellular dermal matrix to support the repair.  The ADM is substantially more expensive but has a higher percentage of success while the suture repair can break down again in maybe 10-20% of patients. 

As you can see from your other side, this is not necessarily something that is your surgeon's fault as they did a nice job on the good breast.  Occasionally, the crease below the breast is weaker on one side and has more trouble holding up the implant.  For sure don't try to go larger at the time of the repair as this will increase the chance of failure.  Wear a good fitting underwire bra 24/7 until you can get the surgery done. Good luck.

Bottoming out of implant after breast augmentation-mastopexy

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Based on your photo, it appears as if you have developed bottoming out of your right implant, which can happen after breast surgery. It means that you have had excessive stretching of your skin and the implant has 'bottomed out', or is positioned lower than we would like.  I would anticipate that revisional surgery will be required in order to reverse this. It may involve the use of a product called acellular dermal matrix (Strattice, Alloderm, Flex HD: all similiar products but manufactured by different companies). This sheet of collagen can be placed in the lower pole of the breast to help support the implant and correct this stretch deformity. Waiting 6 months post-operatively is a common recommendation so that all of the changes that my occur have had time to develop. In the meantime, wearing a supportive bra as much as possible can help prevent worsening of this situation.

Antonio Gayoso, MD
Saint Petersburg Plastic Surgeon
4.9 out of 5 stars 33 reviews

Implants/Lift Gone Wrong

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It appears that the crease has been lowered significantly.  You might have had different height of the creases before surgery.  A preop picture would be helpful.  The crease needs to be recreated either internally or externally.

Dr. ES

Breast revision

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It looks like you will need a revision of your lift.  If you have lost faith in yoru surgeon, then I suggest you see another doctor for a possible reviision. Good luck.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

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.