Poor implant position and uneven nipple - what can be done to fix this? (Photo)

Unfortunately, the malpositioned implant expanded the lower pole skin so that even with proper implant position, the nipple continues to ride high. An inframammary excision of skin will be necessary to 'pull down' the nipple to the correct position of the mound. This diagnosis can be confirmed by measuring nipple to fold distance and comparing side to side. The difference represents the excess amount of skin to excised. The scar would be in the inframammary crease and extend along the bottom of the breast.

Your nipple-areola complex is pointing outward and they are asymmetrical, one is higher than the other. I recommend a mini lift. Using a circumareola incision, your breast tissue is reshaped, elevated higher on the chest wall and more medial to increase your cleavage.

Best Wishes,

Gary Horndeski, M.D.

The implant is sitting too low or bottomed out from its original position. The inferior pocket needs to be raised, and you may need mesh for support. Once it is raised, you may find your nipple is in the proper location.

The anatomy of your breast have beeen changed with surgery. A review of all your photos (before and after) and an examination is necessary to determine the cause and possible solution to your concerns.
Sometimes the best courseof action is to remove the implants and capsule and let the breast heal. Then a new plan can be formulated to augment your size.

Dear Creative,
You've shown us 3 photos, presumably the result after each of your 3 surgeries. But you don't state that. We also do not have the pre-operative photos to confirm or refute whether you had pre-existing nipple position asymmetry. My guess is that you did, and pre-operative asymmetries can sometimes be magnified by breast augmentation. Review your pre and post photos with your surgeon for a discussion. Good luck!

It’s rare for women to have symmetrical breast. Almost all people have it breast asymmetry, and most individuals both men and women have a left breast that typically sits half an inch higher on the chest wall than the right side. To make an assessment on the outcome of a plastic surgery procedure we generally need to see a complete set of proper before, and after pictures. For individuals who had more than one procedure, they should ideally include before, and after pictures for each of the previous operations. From the pictures you’ve included it looks like your right breast implant has bottomed out. This is not an easy condition to fix, but can be restored using internal sutures with or without supporting mesh or cadaver dermis products like Alloderm.
Quality breast augmentation is generally based on three different variables. These variables are the patient’s candidacy for the procedure in the first place, the choice of implants and the technical placement of implants in the correct anatomical location.
If the structure of the inframammary fold is violated during the procedure, then the implant can begin to drop due to gravitational forces and contraction of the pectoralis muscle. We usually refer to this as implants that have bottomed out. Correct and a high riding implant is relatively simple, but raising a bottomed out implant is technically much more difficult.
I suggest scheduling multiple consultations with plastic surgeons in your community and try to find someone who has extensive experience correcting this condition.
Surgeons who don’t have experience correcting this condition are going to have a lower likelihood of long-term success.
The following are some general guidelines for finding the best provider.
To find the best provider, I suggest patient schedule multiple in person consultations with experienced plastic surgeons in their community. During each consultation, ask each provider to open up their portfolio and show you their entire collection of before and after pictures of previous patients who have similar body or facial characteristics to your own. An experienced plastic surgeon should have no difficulty showing you the before and after pictures of at least 50 previous patients. An experienced provider should in fact have hundreds or preferably thousands of before and after pictures to choose from for commonly performed procedures.
Being shown a handful of preselected images, representing the best results of a provider’s career is insufficient to get a clear understanding of what average results will look like in the hands of each provider.
There is no correct number of consultations needed to find the best provider. The more consultations you scheduled the more likely you are to find the best provider for your needs.
Take careful notes during each consultation, especially regarding the quantity and quality of before and after pictures. It’s not a bad idea to bring pictures of your own body/face to use as reference when reviewing before and after pictures.
The biggest mistake patients make is scheduling only one consultation without properly vetting or comparing providers before scheduling surgery.
Best,
Mats Hagstrom, MD