I had a BA and anchor lift on 1/12/11. My rt breast developed a capsular contracture and my left breast is falling into my arm pit and is flat in the upper pole and the bottom is flat and pointy and ugly. My right breast has the CC but at least it has upper fullness. Both are still saggy. My PS agreed to do a lollipop lift for free in his office under a local. If I want the CC removed I have to pay $2400 for hosp/anesthesia fees only. Do you think a lift will help and is it ok to ignore CC?
3 Months Post BA and Anchor Lift: Will a Lollipop Lift Help Saggy Breasts?
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Doctor Answers 15
Still saggy after (NOT anchor) breast lift plus implants--what to do?
Just to be clear, from your scars and their position, it is evident that you had a vertical or lollipop lift where the scars extended past the inframammary crease, and the aesthetic appearance of the breast lift was compromised with the skin tightening in one dimension only. Your surgeon then decided to try to shorten the vertical scar with a perpendicular elliptical excision at what he thought the proper crease position would be (this is why the vertical scar still extends past the short horizontal component). This helped somewhat, but your overall result was incomplete and inadequate amount of lifting, unequal and out-of-position scars that still cross the inframammary creases to your chest, and 3-dimensional breast shape that is less-than-ideal (and a capsular contracture on one side). Thus, you did NOT have an anchor lift--you had a modified vertical lift that still did not work out as you (or your surgeon--hence the need to add the additional scars during your surgery) planned. A "standard" of full Wise-pattern (anchor) lift would have continued the incisions (and the resultant shaping and tightening) medially and laterally along your crease (longer scars but better shaping), and the vertical scars would NOT have crossed below the crease scars. A true anchor lift is planned, drawn on the breasts, and incisions made with the pattern carefully measured and the degree of lift calculated to correct as much as possible the droopy or saggy skin looseness of your breasts in 3 dimensions. Properly performed, a Wise-pattern or anchor lift would have given you a much better result in most cases! What you had was a vertical lift that failed to correct your problem, so the surgeon made a modification to try to achieve what might have been obtained by a better choice in the beginning.
In my opinion, you would be very foolish and even more unhappy to have another "free" lollipop or vertical lift that simply tightens the skin again in one dimension, when what you need is careful and skilled breast skin tailoring (full anchor lift designed properly from the onset) AND capsulotomy, partial capsulectomy, or complete capsulectomy to deal with your capsular contracture.
Your capsular contracture had nothing to do with the type of lift chosen or the incision pattern, but when CC occurs this early, it usually related to bleeding in the implant pocket giving rise to the thicker, tight scar capsule around the implant. But now that you have CC, there is one more reason to re-operate.
It is critical to have this operation be the correct one--for an example of a patient who underwent a vertical lift and a donut lift (elsewhere) with two revisions (3 operations by two surgeons) prior to having the proper corrective surgery, click on the link below. I'd suggest several opinions from other ABPS-certified plastic surgeons, and then perhaps a heart-to-heart discussion with your surgeon, who is stepping up to the plate with a no-surgeon's fee revision. It just needs to be the CORRECT and COMPLETE revision. Leaving the CC uncorrected because you like the look a bit better is NOT the way to go! (IMHO, "just saying!")
Breast Revision Surgery
Hello and thank you for the question.
In review of your photographs, I could not agree more with Dr. Verpaele and Dr. Tholen. You have a complex problem and one that requires the correct evaluation and management if you are to maximize your chances of having an acceptable result.
First and foremost, the capsular contracture must be addressed if you hope to achieve optimal symmetry. I would recommend a complete capsulectomy with exchange of implant. Next, you will require a breast lift. A lollipop breastlift will not adequately address all components of your breast sagging and will in all likelihood leave you with a unsatisfactory result. A Wise-Pattern breast lift would thus be recommended in order to create an aesthetically balanced breast mound.
I would recommend you seek a few opinions from Board Certified Plastic Surgeons in your area
Best of luck,
Glenn Vallecillos, M.D., F.A.C.S.
Post op saggy breasts
I think that correcting just part of the problem will leave you uneven. I think it best to treat all of the issues at the same time in order to get the best shot at even breast.
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Based on your photos I suspect the implants are submuscular...
Submuscular implants with mastopexy are challenges for recurrent double bubble and waterfall deformity as the breast descent is common while the submuscluar implant is trapped high by the muscle.
Perhaps you should consider having this addressed by implant exchange into submammary position with cohesive gel and a redo mastopexy.
I am not in favor of simply a mastopexy in the office.
Chen Lee, MD, MSc, FRCSC, FACS
Revision breast lift and augmentation in Ohio
I noticed that no surgeons from Ohio responded to your question. I'm located in Beachwood, Ohio, outside Cleveland.
I agree with some of the other surgeons that a true inverted-T (upside-down-T, anchor) breast lift must at least be considered. You specifically asked if there was any harm watching the capsular contracture on the right. Since it appears mild (and, in fact, may represent an implant malposition, not a true contracture), it can be observed. Another alternative is a simple capsulotomy with can be effective for mild contracture, but not for severe, established constractures. A simple capsulotomy can be done under local anesthesia but with meticulous sterile conditions. The left breast might benefit from a capsulorraphy, or suturing of the bottom of the implant pocket to raise the implant. An early leak must also be ruled out.
I hope this helps. Contact us if you have any further questions.
Breast augment and capsular contracture
In reviewing your photos I would suggest having the capsular contracture corrected at the same time. I believe it will be difficult to make the breast augmentation look symmetrical without it.
Revision augmentation mastopexy.
Thank you for your photos. One of the more difficult procedures to perform is a breast lift with an augmentation. It has the highest reoperation rate of any cosmetic breast surgery. You seem to like the higher implant on the right (even though you have been told it is a capsular contracture). Keeping an implant up high for upper pole fullness is difficult because the inferior breast tissue (especially after a lift) often does not maintain support of the implant. The use of a dermal matrix such as Strattice can help provide an internal bra which keeps the implants supported and allow them to maintain their upper pole fullness. Unfortunately, this is an expensive adjunct to surgery.
For the lift component, it appears you may need a true anchor lift. The "lollipop" removes skin in one dimension, medial to lateral. Looking at your photos, your breast is already narrow in comparison to the height. The addition of the inframammary scar allows for a decrease in the vertical skin dimension. This also leads to better implant positioning as the implant is less likely to "bottom out" into the enlarged lower pole.
Breast lifting, a flexible plan may serve you well.
It is a little early to revise your surgery, since it is only 3 months old. There may yet be some subtle changes. However it is clear that some type of lift would benefit you. Some capsule work should be done, along with a lollypop lift. But it's best to give your surgeon a go-ahead to do more incisions if you need that for a great result. Be flexible, and not limiting with your instructions to the surgeon. It's better to wake up with a slight anchor incision on the bad side than an inadequate lift.
3 months post ba and anchor lift
BA and mastopexy has a secondary"touch up" rate between 25 and 40 percent. The right side may be due to implant position rather than capsular contracture.Either way i would wait a minimum of 6 months and have the correction procedure. You had the operation because your skin was stretched out and lost elasticity. That is why things changed afterwards , because your skin stretches more than either you or your surgeon wants it to. good luck
Lollipop lift revision
Based on the photographs, I think your best solution is a formal wise pattern (anchor lift). The circumvertical mastopexy did not work in my opinion because it was not enough to correct the ptosis. The CC needs to be addressed with an implant and pocket change. Good luck. Bhupesh Vasisht, MD,FACS
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