Do I need a lift to fix my breast? Do I have a capsular contracture on my right breast? (Photos)

Back in 2008 I had breast augmentation, my Doctor used mentor smooth round moderate profile saline with final fill volume on both breast 450 cc. I had two pregnancies after that, and my right breast is higher and bigger also my nipples are enlarged and I hate it. I notice also that both my breast moved in position when I lift weights or flexing. I am looking to change my implants too, from saline to gel and maybe if possible a little bigger to achieve a full C since I am a small C at the moment.

Doctor Answers 6

Your breast fix is not an easy one

as there are so many issues to consider.  You have asymmetric implant position and whether from a contracture or not, its difficult to tell.  Your breasts are positioned low on your chest.  You have the stigmata of pregnancy with large areolas.  And you have lateralization with animation deformities.  

A lift is needed to reduce to areola size and make them more level with each other.  If you want to elevate your breasts on your chest more, extensive pocket work is needed that is also unreliable in healing and the recovery quite long.  The same would be needed to push your implants more medial when supine. And if you wanted no animation deformity, you would have to change your pocket to above the muscle and repair your muscle at the same time.  The complexity of doing all of this at one time is huge so if you do pursue all of this, you cannot expect perfect results and should anticipate needing a revision down the road.  

Make sure your surgeon understands all of your goals and expectations and can tell you what he/she can deliver so you also know what to anticipate.


Redding Plastic Surgeon
4.8 out of 5 stars 32 reviews

Revision breast surgery for high riding implant malposition with capsular contraction

Based on reviewing the photographs that you provided, I recommend revision breast surgery.  I would recommend removing the old breast implants with a full capsulectomy and replacing new silicone gel breast implants, possibly with Strattice ADM to prevent recurrent capsular contraction.  I have had much success with this approach to capsular contraction and malpositioned breast implants.  I think you can probably go somewhat larger if that is what you desire at the time of revision; however, I do not think you could ALSO do a breast lift at the same time as the revision, especially if the goal is to be a bit larger in size.  I think it is better to stage it and do the breast lift as a subsequent procedure after the implants have settled, softened and healed.  The breast lift will really improve the size of the areolaes as well as improve the shape and nipple position.  It is important to note that a bigger implant will not make the shape better, just make you bigger.  I hope this helps.  Good luck!

Do I need a lift to fix my breast? Do I have a capsular contracture on my right breast?

If the right breast is hard, painful and the implant does not move softly and he may have a capsular contracture.  However when laying down you have lateral displacement which indicates to me that the implant is moving.

Revision surgery with areola reduction, a lift on the right lower side and replacement with silicone gel implants may be her best option.  If your surgeon discovers that she do have a capsular contracture then wrapping the new implant with acellular dermal matrix may help prevent recurrence.

Do I need a lift?

This looks like a case that cannot be answered on an online forum. You probably do have a capsule contracture on the right and you also have some falling of the breast itself off the breast implant and capsule. A combination surgery is what you ultimately may need, but you must be seen in-person for the appropriate diagnosis. Please see a board certified plastic surgeon with plenty of revision breast experience. Best, Dr. ALDO :)

Aldo Guerra, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 190 reviews

Do I need a lift to fix my breast? Do I have a capsular contracture on my right breast?

It appears from your photos that you may have had a circumareolar (or donut) breast lift at the time of your last operation. You have enlargement of your areolas (very common after donut mastopexies), drooping of your breast tissue, and animation deformities of your subpectoral implants. Your situation is complex and would, of course, require a proper physical examination and a good deal of discussion. I recommend you see an experienced aesthetic breast surgeon to discuss conversion of your mastopexies to a vertical, or lollipop procedure, replacement of your implants with lighter silicone gel devices and a look to see whether your pectoralis major muscles were adequately released at the first operation. All the best.

Revision

Thank you for the question and you would obviously benefit from a pocket revision at the time of placement of new implants and possibly an ADM or Siri but an examination is needed to determine whether a circumareola mastopexy would also be advisable.  So see some experts and get some opinions at complimentary consultations 


Dr Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 59 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.