Will lowering my breast pocket cause double bubble? (photos)

Question

I have pectus excavatum, my left breast falls into a dent in the chest wall while my right breast is uneffected, causing asymmetry. I had an agumentation and the right breast is not falling like the left. I’m in discussion about lowering the breast pocket/ fold. I worry of permanent double bubble. Should I be happy with my progress and leave this alone or go for it? I have blurred my tattoo and nipple for privacy. I am 15 months post op by the way.

Connie Hiers, MD, FACS · Answer

For you, I would not try to lower the pocket, but raise the opposite fold and use mesh for support if needed. that side does appear somewhat larger so you might need a smaller implant as well. You still may not be exactly even, but I think you can be made more even. measurements and more photos are needed to be certain.

Mark Eberbach, MD · Answer

Thank you for your pictures. I can understand your concerns.

Both breasts are attractive but they are different. This is a difficult problem to solve.

If you are motivated, I would leave your right breast alone. Your left would need a skin tightening lower pole reduction, possible mesh support to the lower pole and the crease, a smaller implant and fat grafting to the upper medial aspect to blend your muscle shape.

This is an advanced case for an experienced surgeon. You may require touchups after such as more grafting.

Good luck.

Mats Hagstrom, MD (license on probation) · Answer

And most people the left breast sits higher on the chest wall than the right side.
We usually determine the breast position on the chest wall based on the position of the IMF(infra mammary fold) It’s hard to tell the exact position of the IMF on the left side in your before picture because it can be camouflaged by breast droopiness.
You definitely had a symmetry before surgery, which is pretty consistent with your after picture.
Asymmetry is sometimes put on display or amplified with the projection of the implants.Lowering the IMF can have some pretty bad consequences, especially implants bottoming out.
Was the IMF lowered on the left side as part of the augmentation. Plastic surgeons really can’t move the breast on the chest wall.
I think you should accept the symmetry as being baseline and it’s simply being enhanced with the augmentation. 
Breast augmentation outcomes are based on three variables.
The first is the patient candidacy for the procedure.
The second is the choice of implants in regards to site shape and type.
The third variable is the surgeons ability to put the implants in the correct anatomic location.
 When patients are less than ideal candidates for breast augmentation by having variables like asymmetry, breast, diversion or breast sitting wide on the chest wall, then augmenting the breast will simply put this on display As mentioned previously.
Choosing more moderate size implants can help disguise this to some degree.
Using excessively large implants to increase undesirable, side effects, complication rates, and increase the need for revision surgery.
Your asymmetry and the implications of breast augmentation should’ve been discussed in detail during your in person consultation.
Best 
Mats Hagstrom MD

Will lowering my breast pocket cause double bubble? (photos)

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Will lowering my breast pocket cause double bubble? (photos)

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