Lacking upper pole fullness. What should I do? (Photo)

Hi, thank you for sharing your question. It seems that the implants may have bottomed out which can be corrected with an internal bra. Fat grafting can be an adjunct to this if you wish for even more fullness.

It appears you have achieve a good outcome from the prior procedure. If you truly desire more upper pole fullness, fat transfers are one option. As things currently look good, I would suggest procrastinating on further surgery, until you are sure this change would be worth the additional trauma, risks, and costs.

The look that you are hoping for will categorically not be achieved with just fat grafting. It will look amazing and fairly full for several months, and then magically, you will see it disappear and you will again be dissatisfied. 380cc moderate projection is not an implant that is going to give you what you are looking for. In my opinion, you need a complete overhaul with pocket change, use of supportive matrix to maximize upper pole fullness and use of a high profile smooth right silicone gel implant (450-550cc) to achieve the result that you are looking for. You have the opportunity to have an amazing result, but in order to achieve this, you will need a complete overhaul. You also have skin retraction and pull on the left lower pole which leaves your left side not looking round with that beautiful shape that it should.

Dear Bright681439,
upper pole fullness is achieved with appropriate implant selection but more importantly, submuscular placement, and precise pocket dissection. The submuscular placement allows the muscle to cover the top part of the implant which allows the upper pole to appear more full. Keeping away from the lateral chest during pocket dissection allows the implant to remain higher and prevents it from falling off to the side.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Hello, thank you for your question. Have you considered switching to high profile implants, this will help a bit with upper pole fullness. Eventually over time with gravity even a high profile implant may drop. Fat grafting can help fill the area, but the changes are minimal. Speak to you plastic surgeon about this concern. See your options.

Hi Bright
I think you are being a bit harsh on your surgeon and may have unrealistic expectations. For a one stage mastopexy augment this is a very good result and is probably the best achievable result. I personally don't think fat grafting will give you the look you desire. The only way to give you the look you want is to go bigger with the implants and use a textured round implant. I wouldnt recommend this as the long term results won't be good as it will cause the breast to bottom out over time. I counsel my patients to use the smallest possible implant if you need a lift and implant.
Regards
Damien

Dear Bright,
I perform a procedure that shortens the distance between the nipple and the bottom breast fold. Ultimately, that shifts the implant up higher. It's difficult to tell from the angle of the photo, but if your nipple is a bit high on your implant instead of in the middle, that indicates that the skin in the lower pole of your breast has stretched. If it continues to do so, you might entertain the idea of using an internal bra material like Strattice to give you better pocket support. Lastly, your breasts sit a bit low on your chest, creating a flatter upper pole in the breast in and of itself—
Wishing you the best.

Hı dear , you can have a few options: you can have fat transplant ınto your upper poles to fill them, or have high round profile implants or you can think about teardrop implants

I believe you have good results. Young women who have never had pregnancies or weight fluctuations can achieve upper pole fullness and more cleavage easily. Unfortunately once a patient needs a lift they will almost never experience a lot of upper pole fullness or a whole lot of natural cleavage (without a bra). You could ask your surgeon if you can upsize your implants slightly. There will be a fine line between upsizing slightly to increase fullness and upsizing too much that the weight causes more droop. From my perspective, I do think you have a little room to upsize before causing more droop. I would ask your surgeon what their thoughts are. If he/she is experienced in fat transfer and can provide before and after photos of similar cases- that should be a decent option for you as well.

I'm sorry you are unhappy with your result. For more upper pole fullness you can consider fat transfer, which has its own risks and benefits, or exchanging the implants for a higher profile. Going with larger implants means they will be heavier and may be quicker to sag. There are options, but also the risks/benefits to consider.