Breast Aug Revision? Capsular contracture or breast never dropped or incorrect placement? Will I achieve natural look? (Photo)

BA in 2011. Mentor moderate plus silicone 400cc under muscle. Preop: B, perky, bit of cleavage, no over hang, slight assymetry. Postop: D, don't like fullness on top or top side projection, firmness or how "fake" they look. I always desired the natural/droopy look. Will they ever drop more or look less "shiney"? I want them to be flatter, softer, less full on top & to slope down more from the side. Should I get smaller implants or moderate/low profile/tear drop implants for a more natural look?

Doctor Answers 7

Capsulectomy remove replace

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It is not the implants, it is the shape of the space.  You would need a capsulectomy.  It would be best to remove the capsule in its entirety. Then, the space can be modified going mm by mm seeing what has been done and what needs to be fixed.  After the new pocket is created, a new implant should be placed in the space.  This needs to be done by someone who has vast experience in this area.  Revision surgery requires drains because the fluid is going to be generated when you operate on the scar capsule. If you provide a mechanism for the fluid to be removed (i.e. drains), the risks are lower. If the fluid accumulates because there were no drains, it will most certainly cause problems in the future.

Achieving a Natural Look with Breast Implants

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It's best to begin by consulting with a board-certified surgeon in-person to learn which approach and implant #type is most ideal for you. Other factors which contribute to the outcome are #size, #shape, and #profile.  The #profile is determined by the amount of #projection versus roundness that the you desire, as well as the #size of the implant and size of your chest. Also, the placement or incision location will also have an effect on profile. 

 #Shaped implants are all #textured and should not rotate when used properly. In my practice, about 20% of the patients benefit from shaped implants. Your Plastic Surgeon needs to measure you and determine the best shape and size of any implants that are used.

It is certainly feasible to #downsize to smaller implants and also alter the positioning; if possible. However, decreasing is size may also require a Breast #Lift to to #tighten loose skin, better optimize the end result. Another element to a satisfying result of your #augmentation is realistic #expectations.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Redo breasts augmentation

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Dear LV,     Thanks for submitting your pictures and your goal pictures. Pre operative pictures would have been very helpful. From observing your pictures, you appear to be full C cup with capsule contracture  and low positioning of the nipples with large areolas. Your goal pictures are perky C cup size. Since you are 5 years after your surgery, it is unlikely that your desired look will occur. At this stage you will benefit from complete capsulotomy (scar release) and possibly mini lift that will give you more perky look and smaller, more attractive areolas. You can also reduce the implants size by 1/2 size, to make your breasts C cup, which translate to 325 cc implants , if your chest circumference measurement is 32 inches.   As you can realize from your own experience, not all results are the same, because experience, skills ans aesthetic eye are critical for good outcome. So do your due diligence carefully and choose your surgeon wisely, so you will not need another redo breast augmentation surgery.    Always, consult with experienced board certified plastic surgeons who perform surgery in accredited surgery center for your safety. Most importantly, check the before and after pictures in the photo gallery, to make sure that they are numerous, consistent and attractive with nice cleavage , perky, symmetrical and natural looking.                    Best of luck,                                         Dr Widder     

Options for a more natural look

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hi and thank you for the question. You do have a number of options to change the look to something that would be more appealing to you. One option is certainly to use different profile implants. If you currently have high profile, then switching to moderate or low profile implants will give you a more natural upper pole. Another option is to switch to  shaped implants, what people commonly referred to as gummy bear implants. These give a very natural slope to the upper pole of the breasts. The other factor to consider is the overall size of the implants. The implants you have may just be too large for your frame. Downsizing to a more conservative implant would potentially help you achieve the look you're going for. my suggestion would be to discuss this with your plastic surgeon. You could also get second opinions from other experts in the area. It would be helpful if you brought them photographs of your desired outcome so that they can establish a plan that would best meet your goals. Good luck to you.
Dr West

Justin West, MD
Newport Beach Plastic Surgeon
5.0 out of 5 stars 30 reviews

Cap con vs lots of other variables from surgery

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I can see your concerns in your photos. A Mod+ implant under the muscle is a reasonable implant profile for a primary augmentation and does not always give you the over augmented look(actually quite the opposite, usually gives a very natural appearance). Where you/your surgeon may have went wrong initially was the size chosen based upon your nipple to fold distance and your base width, in addition to pocket dissection possibly(there are many variables in the equation). Implant size/profile is better chosen with the patients anatomic measurements instead of just picking a size/volume. Your implants will not drop at this point as you are 5 years out, they are sitting in a well formed pocket and will not move at this point.IF the breasts are soft, you likely do not have Cap con. The shiny skin is simply from the skin stretch related to implant placement. Also very common. The options you mentioned are all likely reasonable, switch to something smaller in Mod+, switch to a mod profile(you prob won't really want this, but possible), switch to an anatomic/tear drop. You should schedule a consultation to be seen and evaluated by a plastic surgeon to discuss these options.

Breast Aug Revision? Capsular contracture or breast never dropped or incorrect placement? Will I achieve natural look?

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Over the internet requests for the changes you desire are not the correct forum. Best to seek many in person consultations wth examinations to determine if your desires are achievable...

Natural breasts

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Thank you for your question. Based on your photos you have a  very nice result. If you're looking for a more natural upper pole look, I would recommend the teardrop or shape implants. These implants give the most natural looking breast .  The downside of these implants is that it lacks the upper pole fulness that you currently have. There is also a 1% chance that these implants can spin in your body thus creating some deformity or disfigurement of the breast.

Johnny Shea-Yuan Chung, MD, FACS
Allentown Plastic Surgeon

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.