What should I expect from my revision? (Photo)

I went into a doc for a lift, and had an option of a lift and small aug, or a just a slightly larger aug & no lift. I chose the less invasive aug alone, if it wasnt too big. But my implant is WAY larger than what I wanted and theyre too far apart. He can fix them, but then said that the result I want isn't possible based on the pictures want, and that I have to find photos of a lollipop lift and aug. I originally just wanted the lift, so Im confused. Cant they be smaller & way more lifted?

Doctor Answers 13

What to Expect From Revision?

Sorry to hear about your confusion over your situation. Let's analyze what went wrong here and then address whether a revision will get the result that you are looking for.

Your before pictures are very useful. They show us that you start out with quite a wide space between your breasts and that you have a significant degree of ptosis or sagging of your breast. Many surgeons would have recommended that you have a lift in addition to an implant. Understandably patients would prefer to avoid the additional scars of a lift (I guess you could say less invasive), but that choice means that you will get a certain type of outcome. Very often a surgeon might say that you can have just an implant, but that does not mean that it is the optimal way to treat your situation, or that you will be happy with the result. In fact, your result is EXACTLY what would have been predicted based on where you started and the operation that was performed. It reinforces the understanding that implants do not lift your breast.  This should have been discussed with you before your surgery.

Does that mean that you had the wrong operation? No, It just means that there were certain tradeoffs for the choice of operation that was made. Your result actually looks good given the limitations of what was done, but the result is a bigger implant that is low on your chest wall, that lacks the upper chest fullness that you wanted, and your nipples are rotated downwards. Some patients would find this a satisfactory outcome for being able to avoid a lift. Obviously you do not. Clearly there was a failure of communication of expectations and of what the surgery could deliver. Review of "want" photos after the surgery is done is completely backwards. This should have been done prior to your surgery so your goals were properly communicated. It shouldn't be your responsibility to find photos of lollipop lift and aug, it should be the surgeons responsibility to demonstrate what those results look like.

Can this be revised so that you have a smaller implant that is more lifted? Certainly. You would need to have the implant exchanged for one that is smaller and the internal pocket would need to be revised so that the implant sits much higher on your chest wall. In addition you will also need a lift so that the position of your nipple and breast tissue matches the implant. This revision can potentially narrow the space between your breasts somewhat, but when you start out with a quite wide space between your breasts, there are real limitations on how much that space can be narrowed. This is also something that should be clearly discussed before your surgery. So yes, you can have a revision that will get you significantly closer to your goals. But this will mean another operation at significant additional expense to you. Clearly it would have been better to have had the lift and implant combination the first time around.

Kirkland Plastic Surgeon
4.8 out of 5 stars 53 reviews

Lift or augmentation

In your case I would have suggested the same thing - just augmentation, because you are borderline with your nipples just at the inframammary crease.  But if you feel your breasts are too big now, then I would remove your implants and then do a lift, with no implants.

Malcolm A. Lesavoy, MD
Beverly Hills Plastic Surgeon
3.9 out of 5 stars 11 reviews

If you just wanted a lift

why did you agree to an augmentation as well?  But that is water under the bridge at this point.  If you don't want implants, not is the time to get rid of them and have the lift you wanted.  If you want fuller and larger, then you will need an implant.  Downsizing and/or lift will not make your breasts come any closer together.  Your look is not as bad as you perceive it to be so can you give this time and see if you will eventually like what you have?   If you truly don't like the larger size, then you must make sure you write down your goals so the proper plan can be implemented and you won't be left with something you didn't want.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Wrong Doctor

If you went to a doctor that talked you out of a lift, you went to the wrong doctor.  Please visit a few ABPS certified/ASAPS member surgeons expert in revision breast surgery. You'll need a pocket revision using sutures, smaller implants, both done through an inframammary incision to reduce your risk of capsular contracture, and a formal lift. 
Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 90 reviews

Revision breats surgery

I am sorry to hear of your dissatisfaction. You appear to be a really good candidate for a mastopexy with smaller implants.  You may or may not get enough lift out of the lollipop mastopexy so leave your options open for a traditional mastopexy.  I would recommend seeing some additional Board Certified Plastic Surgeons in your area that perform a lot of revision breast surgeries and lifts. Best of luck to you

Milind K. Ambe, MD
Orange County Plastic Surgeon
4.8 out of 5 stars 42 reviews

The bottom line is you need a lift

You can think it through a million times, but at the end of the day you needed a lift to get you proper medial cleavage, appropriate upper pole fullness, and to eliminate lateralization of your breasts. With the vertical mastopexy procedure you can have any size or shape that you desire. Please see examples below.

Arian Mowlavi, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 67 reviews

What should I expect from my revision?

Thank you for your photos and question.  You need to have a face-to-face consultation with a board-certified plastic surgeon to discuss the nuances and the options available to you.  The greater the size reduction you seek the more likely you will need more skin removal in the form of a full mastopexy.  Your nipples are wide in position naturally and it is not practical or possible to move the implants in to narrow your cleavage without causing distortion of your breast shape.  If you are primarily unhappy with the size of your implants then consider either a vertical or more likely a full mastopexy to reduce skin and allow you to place smaller implants while elevating and narrowing your nipple areolar complexes.Good luck and best wishes.

Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery
Member, American Society for Aesthetic Plastic Surgery (ASAPS)
Beverly Hills, California

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 31 reviews

What should I expect from my revision?

Dear Laurenolivebell
From the photos, you can have an excellent result with a breast lift. Since I haven't since the pictures you want, I cant comment on how realistic your goals are. You might choose to post your goal pictures with your current pictures and then you can get more feedback on what is possible vs not.

Afshin Parhiscar, MD
Bay Area Plastic Surgeon
4.8 out of 5 stars 57 reviews

Can't go closer without going bigger

You can downsize the implants and do a full breast lift if that will make you happier but the one thing you can't do is to get them closer in the midline without going much larger and higher profile. So, try to let that goal go and focus on the rest.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

Redo breasts augmentation

Dear Lauren,
   Thanks for submitting your before and after pictures.
  From observing your after pictures, you appear C cup size with level 2 ptosis, very large areola and wide cleavage.
 I have been in practice for 29 years and did breasts augmentation on thousands of patients. I operate on patients like you on a weekly basis.
     The corrective procedures should be as follows:
 1. Implants size reduction as you wish
 2.  Capsultomy (scar release) with careful attention to the cleavage area. This is best done through a subareola incision , which allows for doing it under direct vision and feel.
 3.  Bilateral mini lift (donut) which will give you a perky look with smaller and more attractive areolas. 
 If you were my patient with the presentation of your before pictures, I would have refused to do the surgery on you without a lift procedure (mini lift or full lift). The reason you are bigger than what you wished for , is because your surgeon tried to lift the nipples with a large implants, which obviously, did not work.
  You have to realize that not all results are the same, especially for redo breasts augmentation, because experience, skills ans aesthetic eye are critical for good outcome.
 So do your due diligence carefully and choose wisely. Financially, redo surgery by your original surgeon is the most economical, however, your satisfaction with your surgery outcome is  more important than the cost.
   Always, consult with experienced board certified plastic surgeons who do lots of redo breasts augmentation surgeries in accredited surgery center for your safety. Most importantly, check the before and after pictures in the photo gallery to make sure that they are numerous, consistent and attractive with nice cleavage, perky, symmetrical and natural looking.
                                     Best of luck,
                                                              Dr Widder

Shlomo Widder, MD
McLean Plastic Surgeon
4.8 out of 5 stars 126 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.