I had a breast aug 6 months ago. Is this bottoming out? (Photo)

Question

I had breast aug 6 mo ago. 395 on the left and 415 on the right. I always felt like the right side looked a tad larger despite the small cc difference. At about 2 mo post ofthey did look great though. Suddenly in the last 2 weeks the right breast has had major rippling I can feel clearly and now see, not to mention significant dropping making the right seem saggy and SO much larger than the left! I have an appt with my surgeon but am devestated at whatever is happening.

Gianfranco Frojo, MD · Answer

The soft tissue will relax over the next 12 months following a breast augmentation. If the implants that were placed were too large, the dissection inadequate/overaggressive, or if the implants were placed above the muscle...these factors in isolation or in combination can lead to the problems you are seeing. I would recommend seeing a plastic surgeon with excellent training in breast surgery and particularly revisionary breast surgery as I would recommend exchanging the right implant for a smaller implant with a potential horizontal mastopexy to reduce nipple-to-fold distance. These are just my opinions as an aesthetic fellowship trained plastic surgeon. Best of luck!

Daniel Barrett, MD · Answer

Dear TEMMama,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Farbod Esmailian, MD · Answer

I do see the volume discrepancy that you are describing.  It also appears that the right breast has move skin than the left breast.  I would like to see your preoperative photos as well, as I would bet that there was some asymmetry prior, specially with the skin envelope.

At this point, I would say you need to discuss with your surgeon if he can try to get you move even with placing a slightly smaller implant on the right side or slightly larger implant on the left side to help even things out better. One word of caution is that with silicone implants in particular, when you start with asymmetry, it is very likely that there will be asymmetry after.  However, the idea is to try to get them more even.

Brian Widenhouse, MD · Answer

Thanks for the question. It does not appear from your photo that you are bottoming out.  It may be that your right breast hasn't dropped in the same manner as your left, or you may be getting a contracture on the right side (hence the rippling). Your plastic surgeon should be able to give you some answers after an exam.
Best of luck!

Connie Hiers, MD, FACS · Answer

You do have a larger implant on the right side and will be able to feel more of the implant. Do wear a good supporting bra.  There may be a little bottoming out from the weight of the implant.

Douglas Taranow, DO, FACOS · Answer

Your breasts continue to settle with the right one following your rib anatomy (downward and lateral).  This is not as much of bottoming out as it is descent lower.  The rippling is a factor of placement (above or below the muscle-although this has nothing to do with inferior, medial or lateral rippling) and subcutaneous fat or breast tissue (allowing camouflage of the implant below).
Your surgeon will have better input following their exam.  You may require a revision with suturing of the lower portion of the capsule to elevate the implant.
Best wishes,
Dr. Taranow

David Plank, MD · Answer

A board-certified plastic surgeon is qualified to address your issues. Board-certified plastic surgeons have spent years of training and have the top level of experience and skill. Seek out a board-certified plastic surgeon for your cosmetic needs.

Camille Cash, MD · Answer

In your photo the volume asymmetry between right and left can be seen.  A preoperative photo would be helpful so that the previous asymmetry could be compared to this photo.  Your surgeon should be able to address the concerns that you mentioned as well as advise of potential corrective measures.

Brooke R. Seckel, MD, FACS (retired) · Answer

Thank you for your question. I do see a significant volume asymmetry which is partially explained by the difference in implant size. However the right-sided implant has dropped further in the left side. Usually in cases like this there was a size difference between the 2 breasts before surgery. My suspicion is that the right breast was lower preoperatively and this asymmetry has been accentuated by the implants.

Typically in situations like this if the left side is soft and does not have a capsular contracture and reducing implant size on the right with a modified lift to create more symmetry with a left side may be indicated.

Typically in situations like this if the left side is soft and does not have a capsular contracture and reducing implant size on the right with a modified lift to create more symmetry with a left side may be indicated.

I had a breast aug 6 months ago. Is this bottoming out? (Photo)

Answers (9)

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