What exactly is wrong with my implants and what will the cost be to fix this? (Photos)

Question

I had a BA in summer of 2024. I noticed immediately after surgery my left breast looked weird. He said don’t worry about it it was normal. Now almost a year later my confidence has went down. I look AWFUL. I’ve had consultations with other surgeons who say I need a lift with new implants and galaflex mesh. I definitely want new and bigger implants! I want closer cleavage, more upper fullness and smaller areolas. I want this left breast corrected of course and same with the right which I’ve been told is “bottoming out” and hanging too low! Pleasea help and tell me if this is true and what exactly I would need done?! Thank you!!

Gary M. Horndeski, MD · Answer

Unfortunately, you have not provided before photographs. However, it is possible that your breasts were low on the chest wall and as a result the implants had to be centered low on the chest wall underneath the nipple-areola complex. This resulted in your breasts bottoming out. Larger implants and GalaFlex will not solve your problem. At this time, I recommend explantation and lift using The Bellesoma Method. The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained if not injured during your previous surgery. The areolas can be reduced to the size you desire. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Daniel Barrett, MD · Answer

Dear Candy266,

tuberous breasts are not simply small or underdeveloped breasts. The appearance of the breast can range from mild to severe, and typical traits include: enlarged, puffy areola, rather wide spacing between the breasts, very little breast tissue, sagging, higher than normal inferior breast fold, and narrow base at the chest wall.
The type of surgery best for you will depend on the severity of your condition.
My preferred technique for tuberous breast correction involves a multistep procedure where the breast tissue is released in a radial pattern to prevent herniation into the areola and placement of a custom implant size is in the breast to allow appropriate expansion of the breast in the restricted dimensions. This can often be done in a single procedure but sometimes may require two surgeries.
That said, it is best that you visit a board-certified plastic surgeon for an in person examination. Only after a thorough examination you will get more information and recommendations.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Matthew S. Kilgo, MD · Answer

Hello and thank you for your question.
Photos taken prior to your breast augmentation would be very helpful in determining the cause of your asymmetry. Often significant asymmetry exists preoperatively, which can make it more difficult to achieve symmetry with breast implants.

It does appear you have a combination of issues contributing to your asymmetry. I would agree that you do have some "bottoming out" on the right side, which can be corrected with removal of your implant and repair of the capsule. Mesh support may be indicated, particularly if you want a larger implant.

The implant on the left is "high riding". Correction requires removal of the implant, release of the capsule and possible additional release of your chest muscle to allow the implant to sit in a lower position. If you had a constricted breast before the surgery, additional procedures may be necessary, including lowering of your inframammary fold on that side.

If you had a wide distance between your breasts before surgery, achieving more cleavage can be difficult with implants alone. I find that this can be effectively done with fat grafting.

Good luck. I hope this helps.

Gianfranco Frojo, MD · Answer

This would require a complex breast revisionary surgery including a new pocket formation, new implants, Galaflex and a lift. I would recommend seeing an expert in revisionary aesthetic plastic surgery.

Brian K. Reedy, MD · Answer

Thanks for your question! The left side has a severe capsular contracture that needs to be fixed. You could possibly replace both implants at that time to get more cleavage. However, the right breast doesn't look bottomed out to me. I would suggest an in person consultation. Find someone you like and trust! Good luck!

Paul E. Chasan, MD, FACS · Answer

Thank you for your question.  I have been in practice for over 30 years, and breast revision surgery is a large portion of my practice.  In your case, most likely you had a hematoma on your left breast and that is why you noticed it immediately.  In those cases, it is extremely important to explore and remove any blood in the pocket otherwise you will be left with a severe capsular contracture.  I believe that is what happened in your case.  You should be able to have an excellent result with capsulotomies, an internal bra on the right side, and you will definitely need a breast lift.  You should be able to have beautiful breast.  Best wishes to you.

Connie Hiers, MD, FACS · Answer

One implant is sitting too high and one is bottoming out from the weight. Do not go larger, or you may bottom out sooner. I would suggest going down in size, tighten the lower pocket on the sagging side and release the inferior and lateral pocket on the higher side. You may or may not need a lift.

What exactly is wrong with my implants and what will the cost be to fix this? (Photos)

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