What’s wrong with my breasts? Unhappy with the results after 16 months (Photo)

I would recommend a revisionary breast surgery including downsizing to a smaller implant (likely a 250-300cc silicone gel low profile plus, placement of an internal bra (Galaflex), and performing another lift. Without the operative note/details of the procedure, it is difficult to determine what happened or what led to this outcome. I would recommend finding a surgeon with adequate training in plastic surgery.

615 cc implants are quite large. You have remarkably asymmetry of the volume of the breasts as well as the position of the inferior breasts. It may be that your implant has ruptured, if saline. However, you will need a correction. If the implant is not ruptured then you may benefit from removal of implant from the larger breast and either replacement or leaving it out altogether with a simultaneous lift to match the smaller breast. You may also undergo revision of the scar on the smaller breast.

Best Wishes,

Gary Horndeski, M.D.

Based on the photos you submitted, there has been some stretching of the lower pole worse on the right than the left. In my opinion the implants are large and weigh heavily on the skin and breast tissue one suggestion would be to downsize the implant significantly repair the inframammary fold with re-enforcement using mash such as Galaflex or Durasorb

You did not post your before photo, but you are not even. The smaller side does not look like you have the 615 cc size implant. The lift inferiorly on the smaller side is a little tight and uneven. On your larger side, you have some bottoming out from the weight of such a heavy implant. I would suggest going smaller on the larger side, tightening the inferior pocket and removing any excess skin inferiorly on that side. The opposite side can be revised to be a little more smooth. You may need to go a little smaller on this side as well so there is plenty of skin to move around. Please discuss your concerns with your surgeon. This is fixable.

Based on photos posted did you have a complication? Appears as you did? Best to in person or virtual consult with…. You will need at least 2 revision rounds to correct asymmetry and denting.

I think having concerns regarding the outcome of your surgery is reasonable. It looks like your breast are uneven in regards to size. Generally speaking to make a quality assessment regarding the outcome of a plastic surgery procedure we generally need to see a complete proper set of before and after pictures. If your surgeon didn’t forward before and after pictures, then I suggest you ask them to forward the pictures they took. if you want to improve the outcome, you most likely need a breast surgery revision. You’ll need to make a decision if your current provider is the right person for the job. Maintaining continuity care has a lot of advantages, but sometimes cutting bait and finding someone with more skill and experience may be appropriate. These are decisions you will need to figure out. It never hurts to get a few in person second opinion consultations, which is usually what I recommend even before having your primary procedure.
The biggest mistake patients make is scheduling only one consultation and then scheduling surgery. I usually encourage people to have multiple consultations before selecting a provider. During each consultation, ask each provider to open up their portfolio and show you their entire collection of before, and after pictures of previous patients, who had similar body characteristics to your own. And experience plastic surgeon should have no difficulty showing you the before and after pictures of at least 50 previous patients. Being shown a handful of pre-selected images, representing only the best results of the providers career, patients who look different than you do, does not give credence to what results are likely to look like, what your results will look like or understanding of how many of these procedures anyone surgeon has actually done. Being board-certified in plastic surgery does not mean somebody has mastered every procedure.
Provider selection is in the end, one of the most important variables, and one that patients have good control over. Breast augmentation outcomes are generally based on three variables. The first is the patient candidate for the procedure, the second is of choice of implants, and the third is the technical ability of the surgeon to do the procedure correctly.
It looks like the choice of implants were not ideal, because one is clearly bigger than the other and the technical aspects, leave something to be desired as well. That said, augmentation mastopexy is a fairly complex procedure, and does have a moderately high revision rate in the hands of most plastic surgeons.
Best,
Mats Hagstrom MD