I was a D to begin with. No kids. Just sagging and deterioration from weight loss. Got a breast lift, reduction and 371 silicone implants. 3 years later, they have bottomed out a bit. My nipples face upward and show through every bra. I have itchy scarring around the nipple and underneath. I have no cleavage on top. Would a lift help with bringing the nipples down or would it bottom out again? I originally wanted a perky C not a D. Would smaller implants and another lift solve the above problems?
February 23, 2014
Answer: Breast augmentation redo Dear Nikki, Thanks for submitting your pictures. From observing your pictures, you indeed appears to be a D cup , your upper pole is flat and the submammary creases are too low, more so on the right side. Also, the right breast is larger than the left one. The reason for your , so called , 'bottoming out' condition is inability of your tissues to hold the heavy implants or superior capsule contracture that pushed the implants excessively down. The good news is that it can be corrected with the , so called, 'internal bra' . Through a small sub areola incision , the lower crease can be elevated ( lower capsulorrhaphy ) and if necessary the pocket can be enlarged superiorly and medially ( capsulotomy ). All these procedures are done without external incision exept for the entry incision . I would also recommend to reduce the the implants by 1 size if you want to be a C cup. It is important that you consult with board certified plastic surgeons who have lots of experience with 'redo' breast augmentation. Check their before and after 'redo' pictures to make sure that you like the results. Also, make sure that their pictures are numerous and consistent and they have good reviews. Best of luck, Dr Widder
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February 23, 2014
Answer: Breast augmentation redo Dear Nikki, Thanks for submitting your pictures. From observing your pictures, you indeed appears to be a D cup , your upper pole is flat and the submammary creases are too low, more so on the right side. Also, the right breast is larger than the left one. The reason for your , so called , 'bottoming out' condition is inability of your tissues to hold the heavy implants or superior capsule contracture that pushed the implants excessively down. The good news is that it can be corrected with the , so called, 'internal bra' . Through a small sub areola incision , the lower crease can be elevated ( lower capsulorrhaphy ) and if necessary the pocket can be enlarged superiorly and medially ( capsulotomy ). All these procedures are done without external incision exept for the entry incision . I would also recommend to reduce the the implants by 1 size if you want to be a C cup. It is important that you consult with board certified plastic surgeons who have lots of experience with 'redo' breast augmentation. Check their before and after 'redo' pictures to make sure that you like the results. Also, make sure that their pictures are numerous and consistent and they have good reviews. Best of luck, Dr Widder
Helpful
February 23, 2014
Answer: Breast lift for "bottoming-out" ?? The problem that you have is what is commonly called "bottoming out." Your nipples are in a good position--it is the position of the implant that is the problem. Over time in some patients, the implant can migrate downward causing the nipples to point upward. The treatment for this problem is to elevate the implant by raising the inframammary fold (IMF). The pocket that the implant is in extends too low and needs to be elevated. Recreating the IMF can be difficult and recurrence of bottoming out is not unusual. Sometimes the fold can be elevated and reinforced with a biological material known as "acellular dermis." This material is frequently used in breast reconstruction and allows the surgeon to create a sling or internal bra to support the implant. This material is very effective, but expensive. Some other materials are also available that are not quite so expensive, including Seri Surgical Scaffold. You should also consider decreasing the size of your implant to minimize the weight that must be supported by the newly constructed IMF.You should consult with a board certified plastic surgeon who is experienced with revisional breast surgery. Best wishes!
Helpful
February 23, 2014
Answer: Breast lift for "bottoming-out" ?? The problem that you have is what is commonly called "bottoming out." Your nipples are in a good position--it is the position of the implant that is the problem. Over time in some patients, the implant can migrate downward causing the nipples to point upward. The treatment for this problem is to elevate the implant by raising the inframammary fold (IMF). The pocket that the implant is in extends too low and needs to be elevated. Recreating the IMF can be difficult and recurrence of bottoming out is not unusual. Sometimes the fold can be elevated and reinforced with a biological material known as "acellular dermis." This material is frequently used in breast reconstruction and allows the surgeon to create a sling or internal bra to support the implant. This material is very effective, but expensive. Some other materials are also available that are not quite so expensive, including Seri Surgical Scaffold. You should also consider decreasing the size of your implant to minimize the weight that must be supported by the newly constructed IMF.You should consult with a board certified plastic surgeon who is experienced with revisional breast surgery. Best wishes!
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