Thank you for your question and excellent photos. Given how low your nipple-areola position was before surgery, I believe that your surgeon did very well. The implant position appears quite good and symmetry is also excellent. The pariareolar (Benelli) mastopexy is limited in how much it can reposition the nipple and areola. However, as your implants naturally settle into their pocket, the nipple-areola position should come up a bit too. Thereafter, you can discuss your final result with your surgeon to determine if any revision is indicated.
Your breasts were sagging before surgery and even though you got some lift from the areola lift it does not look like it is enough. Your surgeon should have discussed the different options for breast lifts before surgery; so if it is the sagging that is what you don't like then you need to get what is called anchor lift which has more scarring - look at photos to see what the scars look like. It does not seem like you have bottoming out.
The final appearance, shape, and movement are not exactly the same as normal breasts. The surgically enlarged breasts do not move in the same way as normal breasts. They tend to be firmer. The contours are usually somewhat different than normal breasts. In some patients these discrepancies may be rather noticeable. Although every effort is made to place the implants symmetrically, complete symmetry is rarely achieved. Immediately after surgery, the breasts are swollen and firmer. The final shape and size is approximated after 2 to 3 months, but up to one year may be required for the end result.
Your breasts have dropped in nicely; you have to remember that a breast lift and augmentation can safely lift your nipples by a maximum of approximately 5 to 7cm. when comparing your before and after photos, it seems that you have attained a good lift of your nipples; if you prefer to have more of a lift, you will have to wait at least 1 year to safely re-lift them. Overall, I feel that your breasts look great.
Dear Yiyi, given your pre-op photos and the procedure that you had done, you actually got a very good result. A peri-areola lift is not designed to tighten the breasts, at best it will lift the nipple areola complex to a higher position so that they do not point downward. This procedure is usually chosen because the patient does not want the vertical scar, but the only way to tighten the sagginess is to remove more skin, thus necessitating a vertical scar. You are still relatively soon after surgery, and you may notice more changes as time goes on. Please discuss your concerns with your surgeon and if you still feel that your breasts are sagging at 6 months, then you may be a good candidate for a vertical lift. Good luck!
Hello and thank you for your question. I would definitely relay your concerns to your plastic surgeon as most
of us value the patient-doctor relationship and want to know what is
concerning our patients and how to help them. You may still get a nice
result as you also were given implants and they need up to 3 months to
drop and fluff, stretch out the lower pole of your breast, and determine
final implant and nipple position.
There are different ideologies on lifting techniques, and there is no perfect answer, but in my practice I use the following algorithim:
1) If only the nipple-areola complex needs to be moved up, then I use a circum-areolar lift
2) If the nipple-areola complex is low AND there is breast tissue that needs to be moved up, I use either a circum-vertical or in some cases, a full Wise pattern (anchor incision) lift. The reason for this is that the nipple-areola complex is not strong enough to hold the weight of the sagging breast in a circum-areolar lift --> this usually leads to recurrent sagging and/or stretching of the nipple-areola complex.
Recurrent sagging can occur with any lifting technique, but looking at your pre-op photos, I have would done one of the techniques mentioned in option #2 along with implants. If after 3 months you are still unhappy and are not confident with the recommendations made to you by your plastic surgeon, you can seek a second opinion by a board certified plastic surgeon. I hope this helps and hang in there!
Dr. Sean Kelishadi