Bad Breast Lift, any hope? (Photos)

Question

13 months ago, I had a full mastopexy w/ 350cc subpectoral saline implants. They have looked bad since surgery. There is no inframammary fold, the scarring is bad, they sag, the nipples are stretched and are jagged around the edges. The implants are hard and become deformed when I flex. Also, when i lay down, my left breast sticks out while the right one sinks down so much that i cant see or feel it. What went wrong and what techniques would be used to fix them?

Carlos Mata, MD, MBA, FACS · Answer

Hi AlexNel,Thanks for your question and photos. It is hard to say exactly what happened. I can see almost everything that you see except for the displacement of your implants when you lay down since there is no photo of that, but it is a common occurrence after breast surgery based on what was done. Everything CAN be corrected. You will need reconstruction of the inside of your breast implant pockets or location. One way to avoid the muscle flexing(animation deformity) is to put the implants over the muscle. But you may not have enough breast tissue to cover the implants without looking bad. I recommend getting several consultations from board certified breast surgeons that can show you before and afters of similar cases like yours! Good Luck!

All the best,

Carlos Mata MD, MBA, FACS

#breastlift #botchedoutcome

Board Certified Plastic Surgeon

All the best,

Carlos Mata MD, MBA, FACS

#breastlift #botchedoutcome

Board Certified Plastic Surgeon

S. Larry Schlesinger, MD, FACS · Answer

I am so sorry you had to live with this for the past 13 months.  Let's look at what's wrong and how it can be improved.1.  From your comments, it sounds as if your breast implants have gotten a capsular contracture.  If you were my patient, I would remove the implants, do a total capsulectomy, place a piece of Seri in to prevent re-encapsulation, place a drain and use the Keller funnel for the placement of the implant.  Also, I am not a big fan of saline implants because they ripple and eventually leak.  Again, if you were my patient, I would strongly recommend a silicone implant such as Inspira by Allergan2.  The distance from the inframammary fold to the areola appears to be too long given the size of the implants.  This has led to what appears to be star gazing of the nipple areolar complex.  If you were my patient and based on the pictures you sent, I would shorten the vertical limb of the mastopexy, therefore bringing down the nipple areolar complex into a more aesthetic position.  3.  Your areola are too large.  If you were my patient, I would decrease the diameter of your areola by doing a circumareolar reduction with a permanent Benelli suture to keep the areola from spreading. 4.  With reference to the jagged edges around the existing areola, if the areola was not reduced, a smooth edge can be achieved by medical tattooing.  If you were my patient, Jason who does an excellent job of nipple tattooing can match your areolar color and eliminate that unattractive, jagged edge.  I am sure your plastic surgeon is as devastated as you are over the final outcome.  Although your end result would not match what any surgeon would be happy about, the basic concepts of a Weiss pattern lift have been followed to include a dart in the middle of the horizontal limb of the mastopexy to take tension off that area, and therefore decrease potential breakdowns at this point.  I highly recommend you seek consultation with your primary plastic surgeon and allow him or her the opportunity to correct this unfortunate outcome.

Michael Brucker, MD · Answer

It's very difficult to tell what your specific problems are without a full exam.  There is no question that in the right hands your result can be improved.  Rest assured that most of your shape problems, internal scarring, asymmetry and poor inframammary fold can be addressed with a secondary procedure.  The scope of what you would need done is too much to cover based on your photos. I would recommend a few consultations with board certified plastic surgeons for an in-person exam to discuss next steps.  Best of luck to you.

Vishnu Rumalla, MD · Answer

Thanks for your inquiry.  I suggest you get a few in person consultations from board certified plastic surgeons.  Without before pictures it is hard to comment on how this happened. It sounds like you may have capsular contracture on one side and lateral displacement on the other side.

Robert J. Spies, MD · Answer

Hello and thank you for using RealSelf.com as well as sharing your photos.  So important to have women discuss breast lift problems in that not all women get 'perfect' results.I see everything you see and do believe there is some hope.  It seems like the pockets holding the implants have stretched causing you to 'bottom out' and lose upper fullness.  This also can happen where the implant not only drops down but to the side which you see when you lay down.  When the implant drops, the infra-mammary fold becomes distorted as well.The flexing of the muscle on one side more than the other may mean that the muscle was not released enough from the rib cage which then pushes on the implant more than the other side.There are ways to help you attain more natural breasts.  I would recommend repairing the pocket with internal stitches to raise the implant position and create a better fold.  Also, consider a textured implant which seems to lower the risk of pocket stretching more than smooth implants.  Then, at the same time, release the muscle on the side that deforms the implant.Not a simple surgery, but good results can be attained.  Probably never 'perfect' but good enough where you will be happier.See some experienced plastic surgeons for their opinions.   Good luck to you.Dr Spies

Kenton Schoonover, MD · Answer

It is very unfortunate that you have a result like this.  I do believe that there is hope for fixing your problem.  It is not always easy to get a great result after such a surgery, but I'm confident that it could be made much better.  I would plan to revise your scars and the size of the nipple areolar complex in order to get a better, smoother shape.  The pockets for the implants are asymmetric and the muscle edge is more visible on your right side.  If you have an adequate amount of breast tissue, then I would take your implants out of the subpectoral plane and start fresh with a subglandular pocket.  This would eliminate the animation with muscle contraction and would allow me to make better, more symmetric pockets in a different plane.  I would recommend using textured silicone implants in the subglandular plane.  I think that this would give you a much better outcome.

Frederic H. Corbin, MD (license restricted) · Answer

Sorry for your problem and thank you for the photos but there is HOPE!  At a consultation with an expert in the field after a full examination and review of your operative note, an expert will be able to tell you what the problems are and how they can be fixed in one operation.  So go on some complimentary consultations and become informed.Dr. Corbin