Almost 1 yr since breast augmentation and has not dropped into pockets, what to do? (Photo)

Help... In May it will be one year since breast augmentation. My left breast has dropped slightly but not the right breast. Though the left has dropped I still have a pocket of skin below areolas. The surgeon told me I didn't need a lift and my skin was very tight. My surgeon suggests if it doesn't drop in the next few months he will cut muscle below breast in office with local.

Doctor Answers 18

You need a revision

It appears that you have scars on the top of your areolae so I suspect your surgeon tried to do a crescent lift with your augmentation.  That procedure is often inadequate.  I believe you have glandular ptosis and need a proper mastopexy, likely a vertical lift.  Your pockets need to be fixed to improve your implant position and breast shape, and not merely dropped with a local anesthesia office procedure.  Of course, all this would need to be confirmed with a physical exam, but your photos are helpful.  Unfortunately I don't think you can get a nice result at this point without going back to surgery and having a revision and mastopexy.

Breast implant revision

You will need a revision for sure. Since you stated your implants have always been high and failed to drop it makes sense to think that the original pockets were not made low enough to properly position your implants behind your nipple and areola.  You will need to have a pocket modification procedure done to lower your implants into proper position.  This can be done through your old crescent lift scars.
The other alternative may be to leave your implants alone and undergo a mastopexy to lift your breast tissue up so again your nipple and areola are centered on the implant.  This will require additional scars of course.
A consultation and examination is necessary to determine the proper course of action.  It sounds like your surgeon already has a plan in mind which is good.  I hope this information is helpful!
Thomas Taylor, MD, FACS
Pasadena, CA

Unsatisfactory Result After Breast Augmentation


Your incisions tell a story of your breasts being too saggy to begin with, and the crescent lift being a virtually ineffective means of fixing that problem.  The distance from the inferior edge of your areola to your inframammary incision is relatively short as well, making this lift and these oversized implants a poor choice.  In addition, you may have some element of capsular contracture in one or both your breasts, a not too uncommon problem when placing implants through the periareolar route. You will need to be evaluated to see if you do in fact have capsular contracture. 

Your surgeon's plan to 'cut muscle' in the office is a terrible idea.  Not only will it not address any of your issues, it puts you at risk for implant infection.

You will need a reoperation to address these issues. Based upon what I see and what you've said, it would behoove you to find a ABPS certified/ASAPS member surgeon expert in revision breast surgery and all forms of cosmetic breast surgery, not just implants. 

Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 78 reviews

Implants not dropped into pocket

Your implants are riding too high because they are being held up the pectoralis muscle. When large implants are place under this muscle they almost always ride too high and give an unnatural fullness to the upper pole of the breasts. If you like the size of the implants I suggest you consult a board certified plastic surgeon about placing the implants in a natural lower position above the muscle. 

Leon Goldstein, MD
Madison Plastic Surgeon
4.6 out of 5 stars 11 reviews

Almost 1 yr since breast augmentation and has not dropped into pockets, what to do?

Thank you for your question and pictures. So it could be many things here. I do not know if you have a capsular contracture which is scar tissue around the implant making them pulled up higher or if you needed a lift but did not get one or if the muscle was not released and the implants are just high riding. It is very hard to know unless I can actually examine you as well as read your operative report. It certainly an issue that is very fixable but requires an additional procedure. I hope this helps and best of luck. If I can help in any way please let me know. 

Richard J. Brown, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 40 reviews

Revision surgery

Hi and thanks for your question and posted photos.Definetely you need revision surgery to help implants get a lower position. Wether you need a lift or not an examination is necessary, wish you had posted preop photos.
Talk to your plastic surgeon about your concerns.
Best wishes.

Dr. Milla

Hector Milla, MD
Mexico Plastic Surgeon
4.7 out of 5 stars 29 reviews

Not dropped breasts or nipples too low

From your photos, I feel that you need two maneuvers to correct your breasts; first, the right implant is making your breast larger than the left; so I would down size your right breast implant; second, you NEED a LIFT. If you want perfection, you need to move your nipples to the center of your breast mound; This will resolve all of your concerns; An ideal breast requires the nipple to be centered on the created breast mounds and you don't have enough space between your nipples and fold to allow for your implants to settle; as you mentioned, your skin is tight and it will not allow the implants to settle down; you muscle should not be released as your breast mounds are already too high and this will result in the implants moving even higher. Please see examples of breast lift with implants below.

Arian Mowlavi, MD
Orange County Plastic Surgeon
4.9 out of 5 stars 41 reviews

Implants haven't dropped.

Your implants are in the pocket that was made for them.  They could be placed lower, but are much too large for your body.  Smaller implants, placed at a lower level would be the way to improve your result.

Michael Leff, MD (retired)
Bellevue Plastic Surgeon
5.0 out of 5 stars 10 reviews

Almost 1 year since breast augmentation and has not dropped into pockets, what to do?

Hello there, from your photos it appears as though you will require a revision to achieve your desired look. It seems as though your surgeon has a surgical plan to help you. 


Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 415 reviews



Thank you for your question. I recommend that you follow up with your Plastic Surgeon for a revision to help your implants settle in.

All the best

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