650 cc silicone over muscle revision (photos)

Started off with tubular breasts. Got a areolar mastopexy 475 cc saline under muscle . i've been having bad muscle flex deformity , a wide gap in cleavage, les upper pôle than desired and i think that m'y areolas have stretched out. I would like to have revision with 650cc over muscle maybe a moderate plus profile for the wide gap , is it a realistic expectation ? I am 5'10 160 pounds with a large frame

Doctor Answers 5

Breast Revision

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Good evening! One of your goal photos is my patient, and you need exactly what she had- a donut mastopexy to reduce your areolas, the Internal Bra to tighten your implant pockets and create better cleavage, and 650cc High Profile silicone gel implants sound awesome! I have attached a link to my Breast Augmentation Revision photo gallery for your review- hope it helps!

650 cc silicone over muscle revision

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Thank you for the question and photos. It will be best to visit with a well experienced plastic surgeon for precise advice regarding your revision breast surgery.  Keep in mind that goal photographs are a communication tool and that no one ever matches anyone else's outcome exactly.
Ultimately, careful communication of your goals (in my practice I prefer the use of goal pictures, direct examination/communication in front of a full-length mirror, and computer imaging) will be critical.   
Generally speaking, the best online advice I can give to ladies who are considering breast surgery ( regarding breast implant size/profile selection) is:
1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work.
2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals.  In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. For example, I have found that the use of know words such as “larger” or "D cup” etc means different things to different people and therefore prove unhelpful. Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice.
3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery, after the use of temporary intraoperative sizers.
I hope this (and the attached link, dedicated to breast revision surgery concerns) helps. Best wishes for an outcome that you will be very pleased with.

Breast revision, tubular breast correction, dynamic deformity

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Hi Emi, Thanks for your question.  Your first picture shows really nice correction of the tubular deformity that you had, but I understand your concern related to the dynamic deformity and the lack of the cleavage you were expecting.  Exchanging the implants out for a subglandular (in front of the muscle) position should correct a patient's dynamic deformity, and can allow for more medial positioning for more cleavage.  But, the implant will then be closer to the the skin surface, and have less tissue covering the implant, and cause rippling to show through the tissues.  In similar cases, changing the saline implant to a cohesive silicone implant can help because the firmer implant has less tendency to ripple.  You may want to discuss these options with a board-certified plastic surgeon near you for a personalized plan specific to your situation.  Hope this helps!
Erik Hoy, MD
Rhode Island Plastic Surgeon

Erik Hoy, MD
Warwick Plastic Surgeon

Animation issue

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If you place them over the muscle and you do not have a lot of soft tissue coverage, you may have rippling. There are trade-offs to both approaches.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Animation Deformity with Submuscular Implants

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Thank you for your question. The treatment for animation deformity would be to move the implants from under the muscle to over the muscle. The larger implants may or may not fix your cleavage and you may want to consider fat grafting medially. Good luck.

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.