Breasts Look Flat in Late Stage Process of Tissue Expanders? (photo)

    You have a large skin envelope, which usually works to your advantage in tissue expansion.  You may want to go larger with the size of the expander to get more projection and volume.  If there is a limitation in the capsule, the muscle, or dermal matrix (if used) these may need to be further released.  This last portion is impossible to tell from the pictures alone.  Kenneth Hughes, MD Los Angeles, CA

The pictures show what you are describing, but it is not possible to give specific advice online for this type of problem. Both the skin and the layer under the skin including the muscle are expanded with this approach, and the use of Alloderm has enabled better projection and rounding out of the lower portion of the breast. It may also be necessary to adjust the skin envelope with some version of a lift, which could be done at the time of exchange to implant.  In any case it appears that expansion to a higher volume may be needed to expand the middle portion of the breast to optimize shape.

It looks like you have a fair amount of loose skin in the inferior pole and this may need to be adjusted to get you the shape you want. Best to be seen in person for evaluation.

For some reason the expander is not allowing your skin to fill the expanded tissue expander.

Need to review the operative note and may be redo the expander and allow your skin to fill the expansion. You have a lot of skin to be used and get a good result.

aybe the used acellular matrix is tootight and not allowing the expansion. Revision is needed and a new proper expander and matching breast implant should be needeed