I Am 8 Mos Post Op and Feel I Need Revisionary Surgery, What Is The Best Way To Achieve A More Forward Facing Look? (photo)

Concerned about the large chest gap and the nipple position. What is the best way to achieve a more forward facing look(less under the armpits) I am also planning on going to 425cc from my 350cc moderate under the muscle implants.  There is a Lot of Rippling and Areas That Aren't Full. I Am 120lb 5'6

Doctor Answers 7

Needing Revision Surgery after Breast Augmentation/Lifting Surgery?

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Thank you for the question and pictures.  Precise advice would necessitate in-person examination. However, generally speaking it is possible that you will benefit from revisionary breast lifting surgery, which may involve additional skin excision/tightening of the breast skin envelope as well as capsulorrhaphy surgery ( internal sutures used to prevent breast implant displacement).  The use of acellular dermal matrix may also be helpful when it comes to   providing additional "coverageā€ for areas that demonstrate significant rippling/palpability of the breast implants. The use of silicone gel breast implants may also be helpful in this regard.

 I hope this, and the attached link, helps.

Problems after a breast lift / augmentation

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You have thin skin and not much breast tissue to cover your saline filled implants.  You may need a revision of your breast lift with an elevation of the nipples about 2 cm and the use of a gel implant.  Tightening the breast skin will help achieve your goals.  Over all your result does not look bad.    

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

Considering revision

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Overall you have gotten a fairly good result. Your tissues are thin which is contributing to the fact that you have some visible ripples. If you have aline implants, changing to gel might improve the rippling. To get a tighter look you need to redo the lift. I would not increase the size of the implant though. The larger you go, the less you can be made tight. You are already having issues with too much skin stretch. Why add weight/size, which would make it worse? You need to prioritize. 

Implant Problems

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Thank you for your pictures.  You have thin and stretched skin.  The wrinkling can be addressed changing from a saline to a silicone implant and placement of the implant beneath the muscle.  You skin quality will most likely not let you achieve a tighter look.

Dr. ES

I Am 8 Mos Post Op and Feel I Need Revisionary Surgery, What Is The Best Way To Achieve A More Forward Facing Look?

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             This is really a skin envelope and tissue issue.  The lift can be revised to tighten the skin envelope.  The rippling can be improved with the placement of a dermal matrix or fat grafting or change to a form stable implant or all of the above.  Increasing the size of the implant will only hasten descent and tissue thinning.  Find a plastic surgeon with ELITE credentials who performs hundreds of breast lifts, breast lift revisions, breast augmentations, and breast augmentation revisions each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.

Kenneth Hughes, MD Los Angeles, CA

Gap Between Breast Implants. Rippling.

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The gap between the breasts and implants is often due to variations in chest anatomy. A wide breast bone (sternum) can make the distance between the breasts appear large. The width of your breast bone cannot be changed. You do have visible rippling and this is often due to soft tissue thinning and is more likely with saline implants or textured implants. Larger implants may make soft tissue thinning worse. Consult with a plastic surgeon certified by The American Board of Plastic Surgery to learn about your options.

David S. Motoki, MD
Draper Plastic Surgeon
4.8 out of 5 stars 17 reviews

Forward facing

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Dear Groomintam, first of all I want you to know that you made a lot of favorable progress from your before photos to where you are now and often times better is the enemy of good.  Having said that I'm all in favor of improvements.  Your surgeon gave you a very nice shape and form which is not always easy given the loss of breast volume you had experienced.  I agree with you that your implants slide laterally a little too much but the good news is that that is easy to correct with what is called a capsular repair done internally, closing the lateral pockets will move your breasts more centrally.  One little trick I like to use when going larger is to switch from moderate profile to high profile.  This will give you more proyection without increasing the width of your breasts.  Luckily the size increase will improve your fullness where you wouldn't need to be re lifted (I would try to avoid that)  Regarding the rippling, if you already have silicone implants the only way to improve that is with more fat either fat grafting or you putting on some weight.  I know you work very hard to stay trim and toned and you hate me for saying the latter but it would be much cheaper and reliable than a fat grafting procedure... DrBrou

Juan A. Brou, MD
Oklahoma City 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.