460cc, Sientra - are my breast bottomed out or can this be fixed with revision? (Photos)

Question

I’m a 35, female, 110 lbs, 5’4, I had 350cc implants for 13 yrs, have 2 kids breast fed both. I had capsular contracture, sagging, loose skin. I had a reaugumentation mastopexy 460cc sientra under the muscle. I wanted the more fake look with upper fullness. My left breast dropped within a week after surgery. I’m left with loose skin, Breast significantly dropped, no upper fullness. Can this be fixed with revision, did my lift fail?

Gary M. Horndeski, MD · Answer

460 cc implants weigh 1 lb each. The added weight and weak skin envelope has resulted in bottoming out. Your implants are too heavy, your breasts are too low on the chest wall and you will need a revision. I recommend smaller implants placed submuscular with an additional lift.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Paul E. Chasan, MD, FACS · Answer

Thank you for your question.  You do have lax tissues.  Also, appears that your mastopexy was underdone.  A large portion of my practice is dedicated to breast revision.  I would recommend an internal bra-capsulorrhaphy.  I published the first paper on this 20 years ago.  I would also consider redoing the mastopexy as once the implant is higher up on your chest, the nipple will then appear low.  Best wishes to you.

Daniel Barrett, MD · Answer

Dear jordanrsmith123,
bottoming out occurs when the implant falls below the current breast crease or inframammary line. It's more likely to happen with inframammary incisions, which is why I try not to use the inframammary approach to any breast surgery.
Bottoming out can also occur if an implant is too large for the breast pocket. That is why it is important to choose an implant size that's correct for your body. I perform numerous measurements in the office to determine optimal implant size for my patient's bodies.
If you are concerned, please check it with your plastic surgeon for reassurance and to further discuss your options and possibility of revision.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

These implants are too large and heavy for your tissue and are bottoming out because of the weight. I would suggest going back with smaller implants and tightening your lower pockets.

Darryl J. Blinski, MD · Answer

Thanks for posted photos. I recommend a 2 stage re operations. Stage 1 Re lift lower breasts to even out or gain symmetry. Then after 4-6 months healing Stage 2 is an exchange to larger implants in the 600 cc range high profile. Fees total in the $15,000+ ranges. Best to virtual consult with...

460cc, Sientra - are my breast bottomed out or can this be fixed with revision? (Photos)

Answers (5)

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