Muscle Flex Deformity. Unhappy with implants. How can I look normal again? (photo)

Dear mini556,
breast revision surgery is the most difficult plastic surgery procedure performed. Botched breast surgery alters normal tissue planes and laxity, the ability of breasts to heal properly, and leaves scar tissue that dramatically affects the level of difficulty of the corrective surgery.Many patients come in to correct poor outcomes from their initial surgeries. The most common problems are due to implant malposition, bottoming out of the implant, poor scarring, and incorrect implant size.While the type of revision required will depend on the result of the previous surgery and the desired result of the patient, some revisions involve extensive pocket repair that may or may not need specialized external bras.If you are considering breast surgery revision, you should speak with a board certified plastic surgeon and have yourself properly assessed. Only after a thorough examination you will get more information and recommendations. Also, you have to make sure that your surgeon understands your breast augmentation goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery 

Hello,Your photographs demonstrate depressed/tethered peri-areolar scars, high riding, ball shaped implants, and redundancy of tissue in the lower poles of both breasts. Until proven otherwise, you have bilateral capsular contracture. You will need a revision surgery to remove all scar tissue and implants, and replace with new implants. This should be done through an inframammary incision to minimize breast tissue damage/scarring (something that has already happened, but should not be made worse), and minimize recurrent implant contamination. Although you started with a sub-optimal nipple position, you will likely do well without any lift, and certainly not a donut lift. You do not need to stage this into two surgeries. 

The one drawback with placing the muscles behind the muscle is just this.  The breast will deform and look weird when the muscle is contracted.  Once the muscle contraction is stopped the breast will go back to looking normal again.Subglandular or implants in front of the muscle have much more issues than the animation deformity that you get with submuscular position.  Implants placed in front of the muscle will likely lead to capsular contracture, implant rippling, bottoming out, excessive thinning of the soft tissues and so forth.I would recommend discuss this further with your plastic surgeon or see a board certified plastic surgeon to see if any improvements can be made.Hope that helps.

Submuscular implants have many issues, including ones you just described. You will need to start over. Steps need to be: 1. Take out these implants. 2. Let everything return to its natural state. That will take 4-6 months. 3. Re-evaluate as to what needs to be done in terms of breast lift or no lift. 4. Implants if needed, need to go in front of muscles only. Note that natural woman's breasts are never behind the muscle. Thus implants also need to go where the nature intended the breasts to be. That is in front of chest muscles.  

Hello. Thank you for your inquiry and congratulations on your surgery!

It is important to have an in-person medical assessment regarding this issue as it is difficult to determine virtually. Continue to update your doctor in the matter and follow their post-op protocol.

Please ensure to get cleared by your doctor before engaging in specific physical activity before the 3 month healing period has ended as the healing stage is crucial for healthy results.

It generally takes around 6 months to a year to see your final results. Your tissues will take time to relax and allow your implants to "Drop and Fluff" settling into place. Should a revision cross your mind, it is best to wait at least 6 months to a year before doing so.

Our tips for recovery following breast augmentation are to wear a supportive sports bra for 3 months post-operative and refrain from lifting anything heavier than 10 lbs for 3 weeks as we don't want any strain at your incision sites. Make sure to keep the area of your stitches clean by cleansing with hydrogen peroxide daily. Showering is encouraged! But, no sitting in water for 2 weeks following surgery (no baths, hot tubs, pools etc.).

Please note that this response does not substitute patient-doctor relationship. We welcome any and all patients seeking advice to come in for a complimentary consultation available for limited time only.

During the COVID-19, we are offering complimentary online consultations as well as in-office consultation with social distancing and masks. Procedure done in-hospital private surgical facility while taking covid-19 precautions. We utilize UV-light to clean the air of viruses and bacteria during our consultations and surgery. We invite you to come in to discuss your options more thoroughly. Please send us an email at info@drkaraplasticsurgery.com with the subject line: "Attention Meagan" and we will be happy to coordinate your appointment!
M.Kara,MD,FRCSC (27+ years experience) - Specializing in 24 hour recovery/ out to dinner breast augmentation in-hospital private surgical facility for your added safety and peace of mind