Disappointed with the result of my implants. Will a fat transfer help? (Photo)

Hello, you certainly needed a true, full breast lift, but you received a donut/circumareolar/Benelli lift, and are suffering from almost all the negative effects of applying that type of lift to your type of breast. You don't need fat grafting, you need a full lift. Additionally, there are issues with your implant pockets as well. Regardless of how you manage this issue with your current surgeon, you should see out consultations with other surgeons who are revision breast experts and avoid further surgery with him or her.

Depending on your desires and expectations, I may offer a different direction of treatment. A common goal (not alway) is to have the highest, tightest and shapely breast. if you have ptosis, then a mastopexy is needed with, or without an implant. In your case, to achieve this goal with such large implants can be very difficult and fought with complications and ultimately a unsuccessful expensive adventure. In your case, the most risk free, durable course would be to remove your implants and do a mastopexy. This will provide the highest, tightest breast with the maximum symmetry with little worry of complications. Then, if desires, augmentation (either fat transfer or saline implant) can be carried out in a delayed fashion with predictable, least risky outcome. Of course, there are some very talented, experienced breast surgeons that can do in one step, but you want to vet your options careful moving forward as you have already been through some procedures without the desired outcome. Thank you.

I would highly recommend downsizing implants, placing an internal bra/scaffold (Galaflex) for internal support, tighten the internal pocket, and perform a breast lift (mastopexy). Large implants lead to large problems even though they can temporarily fill out the breast skin envelope. I recommend finding a board-eligible or board-certified plastic surgeon with at least 7 years of training in plastic surgery (6 years of plastic surgery residency and 1 year of accredited Aesthetic Society fellowship).

Dear Yoly1950,
fat transfer breast augmentation is a viable alternative for women who desire larger breasts without the use of implants. Fat transfer is also widely used in reconstruction of the breast after a mastectomy or lumpectomy. It can also be very effective in correcting the size and shape of the breasts due to genetic problems such as tuberous breast or Poland Syndrome, two conditions that look like misshapen or underdeveloped breasts.In addition, the following scenarios are also reason to consider breast fat grafting:• If you have chest areas that appear creased and sunken• If you desire more permanent correction than is provided by temporary fillers• If you wish to improve your body contour, revise scars, fill bodily depressions and rejuvenate the natural curve of your breasts• To fill in contour irregularities or hide obvious signs of breast implantsYou should discuss your concerns with a board certified plastic surgeon and make sure your surgeon understands your concerns and your breast augmentation goals. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Dear Yoly,
You spent 25K and it appears that if you had a capsulectomy that you previously had implants and capsular contractures, or perhaps textured implants, but you have not given us enough information about what is bothering you to answer your question. Send pictures taken from 6' away not with phone so we can see what might be bothering you. Right now there is a suggestion that the nipple position is low, but the breasts are not small, and usually the solution to insufficient volume is a larger implant, not fat transfer. Fat transfer is helpful in filling in edges and hiding irregularities, but not so helpful for volume compared to an implant.

There are few things to be considered in your case; asymmetry of size and position of areolas, asymmetry of inframammary folds (breast crease) and, overall breast shape asymmetry. A combination of vertical (lollipop) breast lift and fat grafting would give your surgeon a chance to correct these asymmetries. Hope this helps. Good luck.

Thank you for your question. A large portion of my practice is dedicated to breast revision surgery. In your case, you probably needed a lollipop lift from the beginning. Donut lifts rarely elevate the areola enough to make a meaningful change. In your case, I would perform a pocket modification-internal bra type procedure as well as a appropriate lift-mastopexy. You should be able to have an excellent outcome with a talented and experienced surgeon. Best wishes to you.

Go back to your surgeon and discuss your concerns. Your surgeon should be able to correct the sagging of the one areola and decrease the size so you will march. Review your paperwork about revisions and costs,

Based on the series of nicely posted photos appears you have: capsular contracture, double-bubble deformity, asymmetry N/A complexes, mis shapen pockets. Only re operation or revision surgery can improve your results, doing open capsulectomies/otomies, possible change to dual plane position for double bubble deformity, bilateral N/A reshaping for symmetry, possible lipo to 1 liter supernatant fat with layered fat transfer. Fee $12,000. Best to virtual consult with.....

When it comes to choosing correct surgical procedures, the process always starts with having a clear understanding about the underlying problem is. Based on an accurate assessment, or diagnosis the correct procedure and then be prescribed.
Who assess the outcome of a plastic surgery procedure? We always need to see proper before and after pictures. If you don’t have before, and after pictures and ask your surgeon to forward, the ones they took. For individuals of had more than one procedure, we should ideally see before and after pictures of every previous procedure to get an assessment of what’s going on. It looks to me like you may still have some issues with capsular contraction but it’s difficult to tell from such limited pictures. Follow up with your provider or schedule in person Second opinion consultations.
I’m not sure what you’re hoping to achieve with that transfer. It doesn’t seem like your problem is a lack of fat in your breast.
Understanding of the underlying problem is the key to choosing the correct procedure. Don’t try to figure out complex surgical issues on your own. Focus your efforts on finding the best provider.
Best,
Mats Hagstrom, MD