Is this result at the bottom normal after 1.5 years? (Photo)

Question

F36, 1.65 meters tall and 65 kg. 310 cc implants. Lift with implants performed. Scar under the breast is straight and tight. They say it will still drop, but it has been unchanged for almost a year. Will this still happen and, if not, what can be done about it?

Semih Yildiz, MD, FEPOBRAS · Answer

In my opinion, if the lower breast shape and the tight, straight inframammary scar have been essentially unchanged for almost a year, it is unlikely that the implant will still “drop” in a major way at 1.5 years. Most meaningful settling after a breast lift with implants happens in the first several months, and smaller changes can continue, but a persistent tight lower pole usually means the pocket, scar, fold position, or lower breast skin envelope is limiting the shape.
From one photo I cannot diagnose the exact cause, but the options usually depend on what is tight on exam. Revision may involve releasing the lower pocket/scar tissue, adjusting or lowering the inframammary fold if appropriate, revising the scar, changing implant position or size, and sometimes adding fat grafting to soften contour irregularities. If there is pain, hardening, or progressive distortion, capsular contracture also has to be considered. At this stage, I would treat it as a revision-planning question rather than waiting much longer for spontaneous dropping.

Daniel Barrett, MD · Answer

Dear ScarIm,

I understand your concern. However, without a proper assessment, it would be difficult to determine what is wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.

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

Leila Kasrai, MD, FRCSC · Answer

At almost a year after surgery, this issue may not improve sufficiently. You may need to return to your surgeon to discuss your concerns. Revision surgery may be recommended.

Wayne I. Yamahata, MD · Answer

It is difficult to answer this question with a single photo and a limited view of your breasts. In general, patients do not experience a major change a year after a mastopexy. An exception might be persistent tightness due to hypertrophic or keloid scarring. To confirm this would require a physical examination.

Muge Sevindik, MD · Answer

After 1.5 years since your surgery, this is unlikely to change much. Less tissue was left in the lower pole of the left breast compared to the right, which has caused an asymmetry there. Similarly, your left nipple-areola complex is facing more to the side, not towards the midline. On the left side, your implant may have folded and is already positioned lower. I recommend that the implants be replaced and a revision surgery be performed using the same incisions.

Jonathan Heistein, MD · Answer

Hi.  After this much time, it is unlikely that the appearance will change significantly. You will need a surgical breast revision to remove that scar in both the skin and deeper areas. Then, hopefully the implant will fill that space better and make it look more round and natural.  Talk to your surgeon about this surgery and he/she can go over the details and risks as well. Best of luck!

Camille Cash, MD · Answer

Scars do soften over time but it may take several years.  After a year and a half you are looking at your final result.  A revision can be done to help improve the overall contour.  While it may improve some in the future the changes will likely be very slow without other intervention.

Is this result at the bottom normal after 1.5 years? (Photo)

Answers (7)

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