4 months post op, very unhappy with my breast augmentation. Do I need to have a revision done or bigger implants? (photos)

Dear Jubilent,I am sorry you are having trouble. I would need to see your preop photos and see if there is a tight fold or sag.  Overall you have a pleasing result.  I have gotten my share of double folds and I do over 300 BA a year.  Try a shoe string around the back of your neck and across the fold 24 X 7 except to bathe or shower for the next 2 months.  Otherwise if still troubled please return to you PS and come up with a plan.  Good luck,Dr. Joe

I am sorry to hear about your concerns. Based on your photos, it appears that you are suffering from the double bubble deformity on the left side. In some cases, this issue resolves itself with time in that the curve stretches out and eventually diminishes. However, at 4 months postoperatively, this issue is unlikely to resolve itself. An in-person evaluation will be necessary to properly assess your case and establish the best course of action. I recommend staying in contact with your surgeon regarding these concerns. Best of luck!

Dear Jubilant7311,
though rare, some women who undergo breast augmentation will develop a minor deformity known as a “double bubble,” in which additional folds appear underneath the breasts due to the implant accidentally shifting or contracting post-surgery. In most cases, the implant simply slipped too far down the chest wall and traveled behind the breast inframammary crease (the area where the lower breast meets the chest), instead of moving forward to fill the breast cavity. If left untreated, the lopsided implant will form unnatural indentations, resulting in an odd “four-breast effect” rather than the full, rounded chest the patient initially desired.
Daniel Barrett, MD

Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

It does take 6 month to a year for breast implants to settle. Having said that - If your plastic surgeon cannot offer you advice that is helpful to you, you may want to seek a second opinion. It is hard to tell from the photos exactly what would be helpful - there is some asymmetry. You can find a board certified plastic surgeon at plasticsurgery.org.Best of luck!

It appears you have a double bubble deformity and that you likely had a short nipple to fold distance with a low nipple position that would have benefited from a procedure to elevate or lift your nipple position.  At this point you require revision surgery and in my opinion will need smaller implants too as the lift and repair will be risky with the same implant size. Unfortunately this will be costly and please seek out several expert board certified plastic surgeons opinions on repair. Good luck!

Hi there and thanks for posting.It is clear in your pics that you have a double bubble. I think your surgeon has used an implant that has a footprint too big for your chest and or has not reinforced your fold enough. 520cc round medium profile implant would have a very large diameter and as a result it has pushed the implant below your fold causing the double bubble.I doubt this will settle on its own, but there are a number of ways to remedy the situation depending on what you want to achieve and your tolerance for additional scars.You need to seek a couple of opinions from plastic surgeons experienced in breast augmentation.RegardsRichard

Dear Jubilant,I'm sorry to hear that you are unhappy after surgery.  I think there are several pieces of the puzzle that would be helpful to know.  It looks like you may have had a tuberous type of breast initially.  A picture before surgery would be helpful here.  On the left breast, there is a crease in the lower pole, which is likely the old inframmary fold.  Your surgeon lowered the fold to accommodate the large implant that was placed.  Generally, I would now recommend waiting a few more months to be sure that things are 100% healed before entertaining a revision surgery.  It sometimes takes 6 months or longer for the implants to drop.  I would most likely have recommended a small implant placed above the muscle to better fill out the lower pole skin envelope coupled with a lift to elevate the nipple position and decrease the areola diameter.  If you are still unsatisfied in 2-3 more months, I would consider seeing your surgeon or a second opinion about a revision.  Best of luck!

Hello. Thank you for your inquiry and congratulations on your surgery!

It is important to have an in-person medical assessment regarding this issue as it is difficult to determine virtually. Continue to update your doctor in the matter and follow their post-op protocol.

It is crucial to get cleared by your doctor before engaging in specific physical activity before the 3 month healing period has ended as the healing stage is important for healthy results.

It generally takes around 6 months to a year to see your final results. Your tissues will take time to relax and allow your implants to "Drop and Fluff" settling into place. Should a revision cross your mind, it is best to wait at least 6 months to a year before doing so.

Our tips for recovery following breast augmentation are to wear a supportive sports bra for 3 months post-operative and refrain from lifting anything heavier than 10 lbs for 3 weeks as we don't want any strain at your incision sites. Make sure to keep the area of your stitches clean by cleansing with hydrogen peroxide daily. Showering is encouraged! But, no sitting in water for 2 weeks following surgery (no baths, hot tubs, pools etc.).

Please note that this response does not substitute patient-doctor relationship. We welcome any and all patients seeking advice to come in for a complimentary consultation available for limited time only.

During the COVID-19, we are offering complimentary online consultations as well as in-office consultation with social distancing and masks. Procedure done in-hospital private surgical facility while taking covid-19 precautions. We utilize UV-light to clean the air of viruses and bacteria during our consultations and surgery. We invite you to come in to discuss your options more thoroughly. Please send us an email at info@drkaraplasticsurgery.com with the subject line: "Attention Meagan" and we will be happy to coordinate your appointment!
M.Kara,MD,FRCSC (27+ years experience) - Specializing in 24 hour recovery/ out to dinner breast augmentation in-hospital private surgical facility for your added safety and peace of mind

Results are always difficult to assess without the benefit of pre-operative photos, but based on what I can see I agree with the assessment that you have a double bubble abnormality. This usually occurs when the breast fold is lowered to counteract sagging and/or a short nipple-breast fold distance. Sometimes these double bubble appearances will soften over time, but it is likely that you will need a breast lift, smaller implants and a reset of the breast fold at the level of your scar.