I had this mastopexy 2 years ago, very unhappy because my breast is not perky and my saline implants are on the bottom of the breast, also I developed skin pigmentation that my doctor said that is produced by the swollen of the skin around the scar. This pigmentation has been treated with Epiquin micro and locoid by the dermatologist with no positive results . So my questions is can this flatness on top of my breast be corrected??? if so, does the skin pigmentation will vanish some day?
Can This Mastopexy Be Corrected? (photo)
Doctor Answers 12
Revision Mastopexy To Correct Bottom Out and Residual Areola In Incsion
Thank you for your question.
Your Breast Implants have "Bottomed Out" after your Mastopexy Augment. This can be corrected with revision surgery which will require opening at least the vertical component of your Mastopexy scar.
I am concerned that the "pigmentation" that you refer to is in fact Areola tissue left behind during surgery- which happens when the Areolae are unusually large.
During your revision most of this can be removed. Treating Areola tissue as pigment with creams and lasers will not work
Need internal and external lift
Your problem is more difficult than just taking out more skin. Skin is a weak tissue and it will not hold up your implants for very long if this is all that's done. Your implants need to be removed and the scar tissue capsule your body has created around the implants need to be sewn together along the bottom and sides to make lift the internal pocket for the implants. The upper part of the scar tissue capsule then needs to be opened up to allow the implant to move up. This, and this alone, will be able to support the implant once it's replaced. The final step is getting rid of the extra skin you have in order to reestablish a proper shape to your breasts.
If you are going to go with another surgeon, please be sure he or she is board-certified by the American Board of Plastic Surgery. See if the surgeon has photos of patients that he's redone that look somewhat like you. Hope this helps.
Revision Breast Augmentation/Mastopexy Possible?
Thank you for the question and pictures.
Yes, the results of your breast augmentation/mastopexy surgery can be improved upon. This will likely require maneuvers to improve the position of the breast implants (more fullness on top) as well as tailoring of the skin envelope at the bottom of the breasts. Scar revision surgery may be helpful; unfortunately, no one can predict/guarantee that pigment changes of the incision lines will not recur.
I would suggest in person consultation with well experienced board-certified plastic surgeons who can demonstrate significant experience helping patients at in your situation.
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Correction of breasts still droopy after mastopexy
Your breasts have experienced bottoming out after an augmentation mastopexy. This can be corrected with better skin tailoring but, depending on your skin elsticity, may require internal support.
I like absorbable, biologic membranes, such as veritas, to create a support lining for the implant and the breast. This technique is very successful.
Yes with a redo mastopexy
The answer is yes by redoing the mastopexy removing the access skin mostly in the lower breast using a smaller high profile implant to give more fullness on the top and cutting out the remaining areolar tissue on the right breast and the vascular scars on both breasts.
Can my breast lift results be improved?
The simple answer is yes!
As you can tell from the varying approaches before me, there are several options that can be used to produce a more perky and youthful result. From the pictures you provided, my first step would be to improve upper pole fullness and overall shape of your breasts. Right now, your breasts are very flattened and square. Definitely not the look you were probably shooting for.
To achieve this, I would replace your current saline implants with the Allergan Inspira gel implants to better accentuate upper pole fullness. In addition, I would revise your lift and excise as much of the vertical component (probably residual areola as mentioned before) in addition to reducing the distance from your areola to the fold by performing a base excision. By doing this, you should have a more shapely result overall and one that will be closer to a more optimal result.
I hope that helps and wish you the very best!
-Gregory A. Buford, MD FACS
Board Certified Plastic Surgeon
Author: "Eat Drink Heal: The Art and Science of Surgical Nutrition"
Revision breast surgery to create perky breasts usually means going smaller
Based on the pictures an improvement is possible. In order to be perky the best thing to do may be to consider using smaller implants. Your breast tissue has proved it can't hold up the current weight (assuming you have a nice result immediately after surgery) and therefore in order to be perky a smaller implant will likely be needed. A repeat breast lift will be needed to remove the extra breast tissue on the lower pole and this will also allow removal of the stubborn scar, which I agree with the other doctor, is likely persistent areola tissue. Best of luck and give consideration to going smaller if your really want to be perky.
Bottoming out post mastopexy
Can This Mastopexy Be Corrected?
The photos show a "bottoming out of the mastopexy due to the weight of the implant and your genetic skin laxity, and the technique in of itself. Options are repeat the inverted T incision with a wider inferior limb of the triangle, remove the implant, use an acellular dermal mattrice support. Best to obtain in person evaluations.
Can you correct this breast lift? (photo)
Depending on skin redundancy on lower portion of breast and nipple position, expect that re-excision of vertically oriented skin ellipse (de-epithelialization only) NOT including areola, but just below the areola, with multi-layer durable coaptation of medial and lateral portions of de-epithelialized dermis, and possibly superior capsulotomy allowing superior re-positioning of implant would be my approach to breast shape and scar problems. Post surgical care should include prolonged taping and strongly supportive bra to prevent recurrence.
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.