Misaligned Nipples and Asymmetrical Breasts, 5 Month Post-op - What Can Be Done? (photo)

Your pictures are very helpful in that it shows when you are lying down the pockets are too wide. You also have some bottoming out of your implants. The same incision may be used to  close off the pocket on the sides and bottom. A bigger implant on the smaller side should improve the asymmetry. Your original doctor sounds like he or she is giving you a reasonable fee for revision. Good luck and please see a board certified plastic surgeon.

Everyone has some breast asymmetry and you certainly had it before surgery.  The lateralization of your implants can be adjusted and othere asymmetries can possibly be "tweaked."

Thanks for posting such excellent photos - before/after/muscle function. Yes I see before and after asymmetry BUT in my opinion very minor. It could be addresses with fat grafts and minor nipple relocation. But the lateral pocket displacement would that a true operation of a lateral capsularraphy. The fees are very hard to comment upon. In my practice my charges would be approx. $2,000 to $2,500 to cover costs. Hope that helps. 

From your photos, you did have breast asymmetry pre-op but it seems that you still have asymmetry. However, your breasts will never be exactly the same. The largest issue is the lateral displacement when you are laying down. You would need to have an internal tightening of the breast capsules internally. You might even need larger/wider, similar sized implants to deal with the distance between your breasts. Keep in mind that your right nipple has always been more toward the side and if you push that implant toward the center the nipple will appear even more toward the side. This is a complicated situation that needs to be addressed with your surgeon in person.

Best of luck,

Vincent Marin, MD

San Diego Plastic Surgeon

Hello Julia, some asymmetry is normal and you had it already before surgery. I think the major issue is the pocket location of the implants, which they were located more lateral and higher than what it should be. Revisionary surgery is needed and doable.

Good luck.

Based on your photos, the revision plan is very reasonable to close the lateral pocket on the right and possible elevate it a bit.  Costs depend on the facility, type of anesthesia, and professional fee.  It sounds like your surgeon is not charging you a surgeon's fee...if so, that would typically be in line with what most surgeons would do for a revision like this.   Unfortunately, the costs to do revision breast implant surgery are significant due to the need for sterility.

If you look at your pre-op photo you will see a definite difference between your right and left sides, with the right side nipple being higher than the left.  When you place an implant very often this is exaggerated.  In terms of your result noe, I think there are several items that could be addressed.  The pocket seems to be too large and low on the right and too wide on the left.  This can be improved with a capsulorraphy or closing the capsule.  I also think some of the muscle needs to be released more to stop some of the lateral movement.  The right implant needs to be raised some as well to improve symmetry.  As far as the costs every PS does things a little differently.  In my practice, any revision within the first year is only the OR and Anesthesia costs, usually less than 1000 to 1200.00.  You might want to go on several consultations before making your decision.  Good luck, Dr. Schuster in Boca Raton.

Based on your pictures you had some asymmetry before surgery. Your shape now can be corrected with resizing and moving the pocket and using sutures to provide better cleavage. This can be done through your existing scar and the fee mentioned should cover your anesthesia and facility fees which is appropriate. Best of luck.

Every patient, with or without implants, measures a little asymmetrical when it comes to nipple/areolar location. God given breasts fall to the side when a woman lies down. A good breast augmentation should simulate nature. I think you're making a mistake to insist on a revision. Closing the lateral pocket is fraught with danger from lateral thoracic nerves and vessels. Doing it without enlarging the 3 inch incision is really asking for trouble. Replacing your implants with gummy bears would more safely solve the falling to the side while supine problem but at the expense of eliminating the natural mobility and softness you have now. Be careful what you ask for, you may regret it later. The really experienced surgeons have learned what not to do and when to not do it!  I wouldn't do it.

Dr Foster