Downsized from 415 HP to 405 MPP: how to fix below? Is it my fault I didn’t request pocket and IMF correction? (Photo)

Your surgeon will do what was discussed, agreed upon, and written down on your consent. If something wasn't discussed, it was not done. You do need your lower pocket tightened to raise that implant.

Your breasts are asymmetrical in volume, shape and position. One breast is larger and lower. You will need the smaller implant to be replaced and the inferior fold reinforced with either sutures or internal mesh.

Best Wishes,

Gary Horndeski, M.D.

It is very important that both patients and doctors communicate clearly regarding any concerns or upcoming surgical procedure.
Your doctor should’ve explained exactly what they were planning on doing and likewise you should’ve confirmed exactly what the plan was for the revision procedure.
This includes both verbal communication and signing consent forms, which should’ve included exactly what was done during the surgery.
The surgeon cannot correct the shape of the implant pocket if the patient has not signed written consent for that procedure.
Closing the pocket when implants have bottomed out is a fairly complex procedure.
Doing this well, on a consistent basis without the need for further revision surgery is not always easy or straightforward.
Likewise, primary augmentation should ideally be done in a technical fashion does not leave the implant prone to bottoming out.
Your situation is complex having had previous procedures.
In general to make a quality assessment regarding the outcome of a plastic surgery procedure we need to see a complete set of proper before and after pictures.
Closing the inferior pocket after implants have bottomed out, it’s usually done with permanent sutures with or without reinforcement using mesh or cadaver dermal products.
I’m not sure why you’re swapping implants.
The difference is pretty subtle.
There are generally three variables that determine quality breast augmentation outcomes.
The first is the patient candidacy for the procedure in the first place.
Variables that may alter some months candidacy for breast augmentation include breast ptosis, breast a symmetry, breast sitting wide on the chest wall, or breast divergence.
The second variable is the choice of implants in regards to size shape, and type.
The third variable is the surgeons ability to place the implant in the correct an atomic position.
When patients are unhappy with outcome, the problem is almost always related to one or more of the above variables.
There isn’t much patience can do regarding their own candidacy.
But they have control over his communication about implant size and particularly provider selection.
If you’re going to have your IMF corrected, then make sure your surgeon has done that procedure successfully in the past.
Ask them to open up their portfolio and show you their entire collection of before and after pictures of previous cases.
I generally always recommended patients have multiple consultations before selecting providers.
During each consultation, ask each provider to open up their portfolio and show you their entire collection of previous patients. We have similar body characteristics to yourself.
Being shown a handful of preselected images, representing only the best results of a provider career may be insufficient to get a clear understanding of what average results look like in the hands of each provider, what your results are likely to look like or how many of these procedures they’ve actually done.
There’s no correct number of consultations needed to find the right provider.
The more consultations you schedule the more likely to find the better provider for your needs.
I generally recommend people avoid virtual consultations whenever possible and I generally recommend people avoid traveling long distances for elective surgical procedures if possible.
Best,
Mats Hagstrom, MD