No Cleavage 7 Months After Dual Plane Implant Exchange, Anchor Lift & Galaflex. What kind of revision will fix this? (Photos)

Question

Hi doctors, I am 7 months out from a breast implant exchange and anchor lift. My previous implant was slightly larger, but I developed significant sagging after pregnancy. For this surgery, I received 775cc implants placed in the dual-plane pocket, which was reused from before, and Galaflex mesh was added for internal support. Despite the lift and mesh, I still do not have natural cleavage when standing, and the implants feel low and wide on my chest. When I lie down, the implants tend to fall outward toward my armpits, leaving a noticeable gap in the center. While my nipple position appears lifted, the overall breast mound seems to sit too low. I expressed my concerns to my surgeon, but he reassured me that everything looked fine. However, I still feel like the positioning is off. Could this be due to lateral displacement or because the original pocket wasn’t adequately revised? Is it possible the Galaflex is reinforcing a pocket that is too low or wide? Would pocket reconstruction typically be necessary in a case like this to improve implant position and cleavage? I would appreciate any professional insights or advice on what might have happened and what kind of revision could help. Thank you very much.

Wayne I. Yamahata, MD · Answer

Your photos suggest a good aesthetic outcome. It is not always possible to achieve one's ideal, as there are limitations to the improvement that can be surgically attained. It is also not possible to give an accurate ideal of possible improvement with only the benefits of photos. To truly answer your question would require an in-person examination. I would suggest beginning with your surgeon to discuss your concerns. If necessary you can seek a consultation for a second opinion from another board-certified plastic surgeon.

Gary M. Horndeski, MD · Answer

Your results are typical of the anchor lift. The anchor lift only lifts the nipple-areola complex but not the center mass of the breast. The added weight of the implants makes the situation even worse. Your breasts are too low on the chest wall. At this time, I recommend explantation and lift using The Bellesoma Method. The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained if not injured during your previous surgery. Later, fat transfers or small implants can be placed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Gerald Minniti, MD, FACS · Answer

Your photos are insufficient to illustrate your concerns; holding your arms up affects breast appearance. Although less efficient and more costly, in person consultations are your best bet.

No Cleavage 7 Months After Dual Plane Implant Exchange, Anchor Lift & Galaflex. What kind of revision will fix this? (Photos)

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