Peri-areolar breast lift with augmentation- Not Happy

I had a peri-areolar breast lift with augmentation (silicone, 250cc, submuscular placement) 6 weeks ago. As you can see from the pic, the results do not look great. I had a hematoma under the right nipple which is resolving yet I am still bruised and feel lumpy. Assuming that will resolve, my bigger concern is that I did not get the lift I expected, my breast are not round and my left areola is oddly shaped (4cm x 5cm). Will a revision help? How soon can I get one?

Doctor Answers 13

Periareolar breast lift

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Dear Perkster,

Periareolar lifts in conjunction with breast augmentaion are reserved for small breasts that have minimal sagging.  It is the most misapplied type of lift, usually due to patient demands pressuring  the doctor for a limited scar.

Assessing your situation, although it is still early and your implants will probably drop some,  I don't believe there will be an improvement to your appearance that will make you happy, unfortunately.  Your best option will probably be a revision lift that will include repositioning your nipple areolar complex into a higher position and removal of skin in the lower pole of the breast, creating a 'lollipop' incision.  Adjustment of your implants may also be necessary to achieve an optimum breast asthetic.  This should not be undertaken right away, and you should have a healing period of 3 to 6 months.

I wish you the best of luck.

Beverly Hills Plastic Surgeon
4.9 out of 5 stars 100 reviews

It is too early to determine the outcome

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You are six weeks out from lift and augmentation. I think you need to give it more time to settle. It takes several months to reach the final shape. In my experience, the breast will continue to change and improve over a period of 4-6 months. Your doctor will able to address your concerns. I advise you to follow up with him and take his advice.

Moneer Jaibaji, MD
San Diego Plastic Surgeon

Unhappy with circumareolar lift.

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Surgeons will make recommendations based on their experience and training using their measurements to guide them. Hoever, they may make options available to patients and allow the patients to decide. The key issue here is did the surgeon discuss teh options with you and were you open or did the surgeon say this was the only way to achieve a lift.. The goal of achieving a "perky" breast as implled by your name may not necessarily be a realistic goal.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Unhappy after breast lift and augmentation

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It looks like you may have benefitted from a "lollipop" breast lift which would have given you more of a lift with a vertical scar. Your implants look like they still need to settle out a bit into a lower position. I would give it 6 more weeks to see if there's any improvement. If not, you could then proceed with a revision adding the vertical component. That would lift the breasts up more and correct the areola asymmetry. Be aware that breast augmention with simulataneous lift has a very high rate if early revision.

Gary D. Breslow, MD, FACS
Paramus Plastic Surgeon
5.0 out of 5 stars 44 reviews

What does your surgeon say about this?

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I agree that mastopexy/augmentation is a demanding procedure. Results are often not as good as augmentation alone. I have not seen your pre operative pictures. There are many factors that enter into the decision on which procedure to perform and it is always a trade off between the amount amount of "lift" and the length and placement of the scaring. Personally I have gotten excelent rsults with periareolar mastopexy/augmentation but the patients must be carefully selected.

While it does appear that the areola is somewhat lower than I would have liked, I do not know what the pre operative plan may have been. Perhaps some bottoming out of the inplants can be expected. I would recomend a frank discussion with your surgeon reguarding your concerns. I would also recomend waiting at least several months before a revision.

Thomas R. Walek, MD
Providence Plastic Surgeon

Mastopexy Augmentation is a complex procedure

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From your post-op photo - my guess is that you needed a vertical breast lift to begin with. A peri-areolar breast lift does very little lifting. It really useful for areolar diameter reduction, but is not a great lifting technique. Many women are reluctant to submit to the additional breast scar with the vertical lift techniques, but breast shaping and nipple positioning is so much better. I'm sorry that you are unhappy with your result. The best thing to do is consider a revisionary breast lift using a vertical technique.

Early in recovery from breast lift

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You are early  in your recovery and need to keep close follow-up with your plastic surgeon and closely follow all of the instructions he/she give you. It appears that you had a peri-areolar breast lift which you and your surgeon decided upon. Many women do not want the vertical and sometimes horizontal scars that come with a more powerful vertical type lift. As I said, you are early in recovery and need to allow time to see how you will heal and what your final shape will be. It may be that you decide you are happy with the end results which is of course the goal. If you decide, in the end, that you want more of a lift, you will need to discuss your options with your plastic surgeon.

I hope this helps.

Dr Edwards

Periareolar breast lift with augmentation - results

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Thank you for your question. Revisions and further surgery for aesthetic procedures varies amongst surgeons and your preoperative discussion about expectations, results, and complications. Depending on your results and expectations, it would need to be a discussion that you have in terms of deformities and results.  At 6 weeks postoperative, it still is early to determine your final results.  It takes several months for the swelling to subside and the implants to settle.  

You should discuss your concerns with your surgeon and hopefully come to a conclusion. I would not be surprised if facility and anesthesia costs are your responsibility along with a possible surgical fee to correct, however, the last one may be waived pending your previous discussions and examination. Maintain follow-ups with your surgeon.  If revision is required, it may be considered at 3-6 months postop.  Hope that this helps and best wishes!

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 28 reviews

Final results post breast surgery

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At this point in time of recovery, it is far too soon for you to see the final results of your breast surgery. It is normal for you to be concerned with the shape of the breasts, as well as the incisions. Allow more time for your breast implants to settle. It is crucial that you follow the instructions of your plastic surgeon to ensure the best results possible. It would be in your best interest to massage the breasts to prevent encapsulation and promote softening of the implants. As the implants settle and soften, they will have a rounder shape and become more symmetrical and lifted. Consult your surgeon for further questions or concerns. It usually takes about 6-8 months before you see the final results of your surgery. Be patient. Good luck and take care.

Unhappy with periareolar breast lift + augmentation 6 weeks after surgery

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Since it is only 6 weeks, there may be some further inferior settling of the prosthesis. It does appear from your photos that your degree of ptosis “ droop” was too great to be addressed with a periareolar mastopexy alone. Since the prostheses are evenly placed, this can certainly be corrected with a secondary vertical mastopexy without touching the prostheses. It would elevate the nipple areola to the appropriate height, allow for correction of the asymmetric areola and tighten the drooping inferior portion of the breast. If things do not resolve over the next 6 - 12 weeks, which should give adequate time for the hematoma to dissipate, then you could certainly proceed with a 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.