10 months post op from a breast reduction and lift with implants, what can be done to go from a DD to C cup? (photos)

Question

I am post opp 10months from a breast lift/reduction and implants 310R/325L. I am unhappy with my results as I feel like my breast are to large and heavy for my frame. I have always had fuller bust and was hoping to restore volume and lift sagging; however by breast are larger and sit lower on the chest than anticipated. I would like to have a revision to reduce my DD(some bras DDD) to a C cup. I am unsure if I should just explant my implants and fat graft or reduce implant cc.

Joel Patrick Maier, MD · Answer

I think you would definitely benefit from a revision lift/reduction. Depending on your expectations, you could proceed with or without implant removal. I would not hesitate to proceed as this will be very beneficial in improving proportion, shape and relieving chest and shoulder stress. Thank you.

Shaher W. Khan, MD · Answer

Hello, thank you for your question. It sounds like you are feeling uncomfortable with your current results, and it is important to address those concerns. In my professional opinion, stray away from fat grafting (I discuss why in the attached video that is detailed and specifically answers your question; please watch this video). Seek consultation from board-certified plastic surgeons to help you make an informed decision. It is crucial that you feel comfortable and confident in your choice.

Daniel Barrett, MD · Answer

Dear peace_rosas,
breast revision surgery is the most difficult plastic surgery procedure performed. Botched breast surgery alters normal tissue planes and laxity, the ability of breasts to heal properly, and leaves scar tissue that dramatically affects the level of difficulty of the corrective surgery.Many patients come in to correct poor outcomes from their initial surgeries. The most common problems are due to implant malposition, bottoming out of the implant, poor scarring, and incorrect implant size.While the type of revision required will depend on the result of the previous surgery and the desired result of the patient, some revisions involve extensive pocket repair that may or may not need specialized external bras.If you are considering breast surgery revision, you should speak with a board certified plastic surgeon and have yourself properly assessed. Only after a thorough examination you will get more information and recommendations. Also, you have to make sure that your surgeon understands your breast augmentation goals.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Gary M. Horndeski, MD · Answer

At this time, I recommend removing the implants as they are too large and your breasts are wider than your chest wall.  You will also need the scars revised.

Best Wishes,

Gary Horndeski, M.D.

Connie Hiers, MD, FACS · Answer

Although you did not state the size of implants you now have, you probably would do well with reducing more breast tissue from the lower part and going some smaller with implants. You might do well to completely remove the implants. Please discuss this with your surgeon.

Camille Cash, MD · Answer

Based on the photos and description of your goals you can consider decreasing your implant size as well as revising your lift to improve the shape.  Discuss your concerns with your surgeon so that the correct size and profile implant can be recommended for you.

Mats Hagstrom, MD (license on probation) · Answer

Your situation is pretty complex.
Simply, the idea of having an augmentation in conjunction with a breast reduction is fairly unusual.
There’s a lot to go over and you’re not being well served by opting for virtual consultations.
In fact, posting on this website should not be considered a consultation.
I advise in person consultations exclusively.
To getThere’s a lot to go over and you’re not being well served by opting for virtual consultations.
In fact, posting on this website should not be considered a consultation.
I advice in person consultations exclusively.
To get a proper second opinion consultation come prepared bring with you a complete set of proper before and after pictures and copies of your previous operative report.
 These are all part of your medical record and that is obtainable by requesting it from your current provider.
You may as well just ask for the entire medical record and make sure that includes all before and after pictures taken and the operative report.
If you want your breast to have projection, then you’ll need to keep implants.
Fat transfer is not at all appropriate in your case.
Fat transfer will only make your breast larger, which is the opposite of what you are attempting.
The only reason to have implants is to give your breast projection.
It would be helpful to understand what your discussion was during the consultation and who and why chose the size implants that you have.
There are limits to how much breast tissue can be removed during a breast reduction.
Doing a breast reduction with a breast augmentation and a breast lift is a high risk procedure.
If the surgeon tries to remove too much breast tissue, you could have disfiguring complications.
In your case, the problem, as I see, it is the size of your implants.
It may be possible to further reduce the size of your breast and decrease the size of your implants.
That is probably the way to go.
If you don’t care about breast projection, then have the implants removed and consider reducing the breast further.
If you want aesthetically good looking breast than the implants need to be kept in place.
Do not have the implants removed then change your mind and put in implants later.
It seems to me that there may have been a lack of proper communication regarding what you were hoping for with this procedure.
You should also recognize that the procedure is fairly complex and not all plastic surgeons would do this as a single operation.
Some plastic surgeons would do this as a stage procedure to minimize the chance of complications.
May be a good consolation is the fact that you healed well without having complications.
It shouldn’t be that difficult to get an improved outcome, making your breast smaller, whether it’s from changing the implant size, removing more breast tissue or a combination of both.
If you like your current provider, then continue working with him or her.
If you have lost faith in your current provider, then get second opinion consultations.
It doesn’t look like anything was done wrong, and perhaps the problem was simply miscommunication or misunderstanding of what you were hoping to achieve.
The chance of having revision surgery after the kind of procedure you had is in reality quite high.
I would say probably 40% of patients having a reduction with augmentation and a lift are going to need some type of revision procedure.
As I mentioned previously, some plastic surgeons would even plan undoing this as a staged procedure.I see absolutely no indication for fat transfer, and I would be careful with removing your implants unless you know you’ll be satisfied with breasts that lack projection.
Best,
Mats Hagstrom MD

10 months post op from a breast reduction and lift with implants, what can be done to go from a DD to C cup? (photos)

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