I had a bilateral mastectomy and reconstruction. Am I stuck with lumpy, ripply, uneven breasts? (Photos)

I had expanders for a year then exchanged for silicone implants in April 2016. I had lipo on my stomach to transfer fat to my breasts. I am skinny. 5ft 5ins 116lbs. The surgeon said he did not get enough fat. My left breast shrunk during radiation, which I expected but my right breast also looks oddly misshapen. If I can't get any more fat to transfer to smooth out the shape, is there anything else that can be done? Can I at least lift the right one to be less uneven?

Doctor Answers 6

Treatment of Irregular breast shape and texture after Breast Reconstruction

Have reviewed your photographs and first question.  Are these implants beneath the chest wall muscle.  If they are not I can understand the texture issue after reconstruction.  If they were placed beneath the muscle then the issue is a loss of soft tissue between the implant and the overlying skin resulting in the irregular shape, texture and position.  Since the fat transfer did not suffice then you would be a candidate for the following.  1. Placement of the implants at a higher level.2.Place a layer of Alloderm over the reconstruction to act as a interface between your skin and the underlying implant.  This product is used often by Breast Reconstruction Surgeons and I have found it to be of significant help with patients like your self.  Good Luck 

Eau Claire Plastic Surgeon
4.6 out of 5 stars 18 reviews

Unhappy with breast reconstruction

Hello,Thank you for sharing your photos. It sounds like you have been through a lot with your challenging reconstruction. There are options that could improve your appearance but these largely depend on your ultimate aesthetic goal and patience to undergo one or more revision surgeries.
You are very slim and with the addition of radiation that puts you in a more difficult breast reconstruction category. With little tissue to camouflage your implants they have a stuck on appearance and creating symmetry can be difficult. I would recommend speaking with your plastic surgeon about autologous reconstruction. Using your own tissue with or without a form stable shaped implant may give you a much more natural appearance that you are hoping for. From your photos I assume you have a flat abdomen, but most women, even very slim ones, have medial thigh tissue that can also be used to bring healthy tissue to the chest to reconstruct your breasts. An implant can then be placed months afterwards to increase the volume if desired underneath the flap. There are options that are available to you to improve your current situation. Just make sure to find someone who is experienced with autologous tissue reconstruction.
Best of Luck!
Dr. Rednam


You might benefit from a revision. Often an ADM can be placed to reinforce the fold and camouflage rippling in some cases. 

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Thanks for your question and photos.

There is little doubt that your aesthetic outcome can be improved with revision surgery. Please discuss this with your plastic surgeon. If you wish to get a second opinion please see the advice of an experienced board certified plastic surgeon. Stay optimistic, and best of luck to you.

Ram Kalus, MD
Mount Pleasant Plastic Surgeon
4.8 out of 5 stars 20 reviews


You have a difficult situation due to having very thin skin flaps with little subcutaneous fat and having had radiation on the L side.  You could have the R breast implant raised to improve symmetry as well as exchanged for a shaped textured device that may exhibit less rippling.  The use of a dermal matrix sheet to also reduce rippling could also be considered.  Best wishes, Dr. T. 

Lumpy, ripply, uneven breasts?

Thanks for your question. I can appreciate your concerns. You have a lot going on and there is likely no one simple fix. The first step is to discuss this with your surgeon. That person is in the best position to give you sound advice. They should be able to convey all the options available to you and specific to your situation. The radiation is an unfortunate reality for many patients and I have found that most of them benefit from a completely autologous (all your own tissue) reconstruction or at least a combination of your own tissue (a flap) and an implant. I have also been using the shaped, form stable, silicone gel implants (commonly referred to as "gummy bear"). In thin patients these are particularly useful and lead to a more natural breast shape, although the issue of rippling is still a risk. I often use fat grafting to smooth out post reconstruction deformities with the understanding that it often requires multiple regrafting procedures to achieve the desired result. You might not be a candidate for that based on your description but your surgeon will know. In summary, talk to your surgeon, discuss alternatives including flaps, discuss options for implant exchange, discuss options to address the effects of radiation.  Best of luck 

Bram Kaufman, MD
Cleveland Plastic Surgeon
5.0 out of 5 stars 13 reviews

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.