Why do my breast implants look "off"? (Photo)

I would personally recommend waiting a full year to let the implant settle. If you are still not happy with the shape you can have an implant exchange with a lift or just a lift in isolation. This is just based on the photos and a true plan can only be made with a real evaluation in person or on Zoom/Facetime.

This is a great question. There are many factors that go into a revision. In your case, there are a few things going on.
The implants you have are above the muscle, which may contribute to the look. Sometimes implants above the muscle can give unnatural results with rippling and the edge of the implants visible or palpable. It can also lead to breast or implants sagging over time, and can be malpositioned. One solution is to put the implant behind the muscle for a more subtle and natural result.
High projecting implants can also give an overly augmented look, even in smaller sized implants. Depending on how big or small you want to be, going down on the projection can also help contribute to a more natural look.
It appears that the nipples are pointing out (laterally). Sometimes, if there is a minor asymmetry or if the implant is placed too much towards the middle (medial) in order to get nice cleavage, it forces the nipples to point away. A solution to this would be to go slightly smaller with an implant. If you desire to maintain or keep your cleavage, you can consider getting a fat transfer to the inner part of your breasts to achieve that look without affecting the angle of your nipples.
Lastly, depending on what size you ultimately want to be after your surgery, you may need a breast lift. If you want to be smaller, then there may be extra skin that needs to be removed in order to place the nipples and areolas in the correct position.

The nipple/areolas are on the lower pole of the breast giving them a less than ideal appearance. A periareolar lift or even a vertical lift should be considered.

Dear br4455,
I understand your concern. However, without a proper assessment, it would be difficult to determine what is wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Sorry to read about your disappointment. Although breast augmentation seems to be a straight forward surgery, there is a lot of planning that should go into each case, in particular implant selection in regards to the patients anatomy and wishes and desires. No two breasts on a patient are ever the same and there is always some asymmetry that becomes even more apparent after surgery.
You have a short nipple to crease distance which would limit the size (volume) and perhaps the profile of the implant. Yes you could go bigger, but then there would have to be fold adjustment which is always tricky in someone who has breast tissue. The fold would have to be assessed to see if it is feasible to lower the fold. If adjusting the fold position is not an option to get the nipple better centered on the implant, then generally going with a lower profile implant tends to work better and provide a more natural upper pole contour.
At this point I would discuss your concerns with your plastic surgeon and see what options you guys can come up with. Perhaps changing the profile of the implant would help alter the distribution of the volume of the implant and place the nipple/areola in better harmony.

You had some mild sagging which was not addressed and now have more sagging because of larger breasts. You can get a lift. I would suggest placing the implants behind the muscle for better upper breast fullness, avoiding seeing the implant edge, and more long term support for the implants.

Hello and thank you for the question and the photos understand the concerns that you are having. Although there is nothing wrong with your result I understand you're unhappy with the position of the implants and also the location of where the nipple is. If you look at the before picture there is a clear short distance between the bottom of the breastfold and the center of the nipple. this short distance indicates where the nipple is going to wind up after surgery. Typically implants increase the size of the breast and stretch the skin along with it. it will also sometimes lift up the lower half of the skin too far leading to what's called the double bubble deformity. You do not have that. Instead your implant appears to be slightly too high in regards to the positioning of the nipple. Correcting this can be tricky and may require some form of nipple adjustment or repositioning. typically we would wait half a year to a year of healing before attempting such a process. in addition your subglandular implants pose a problem regarding blood supply to the nipple in case of any extensive lift type procedure is contemplated. Depending on how recent your surgery is, I would wait this out and allow the skin and tissue to adjust then go back to your MD and discuss options. Best to you.

Nicely posted photos. To begin, your breasts were not symmetrical, they were sisters NOT twins. So enlarging the volume magnifies the minor differences to more obvious differences. I might offer lower N/A side a donut lift to get them closer to similar appearances. Best to virtual consult with.....

Breast augmentation results are usually a combined product of the patient’s candidacy for the procedure, the choice of implant, size and shape, and how well the procedure was performed.
Your results can be broken down into each of those three components.
Generally, speaking, smaller implants create a more natural appearance.
Low profile implants, have less projection, and tend to look more natural than high profile implants.
Your breasts sit slightly low on your chest wall, and your right breast is significantly divergent compared to the left.
Most plastic surgeons prefer sub pectoral augmentation no it is a more complex procedure.
In my opinion, there is no fascial layer on the pectoralis muscle, making the term sub facial the same thing as sub glandular.
There is no evidence that the implants pocket was placed in the wrong position, though a sub, pectoral implant would give a slightly different outcome.
Your candidacy for the procedure may be inherently limited to give you the shape you’re hoping for and implant selection and surgical style all contribute to your outcome.
There is no one single problem or thing that was done incorrectly.
Not all patients who want to breast augmentation surgery are ideal candidate And this is especially true regarding getting a certain look. A different surgeon may have given you a slight difference in outcome, but this is only slight. Likewise, a different implant selection would’ve also change the outcome to some degree.
I’m curious why the decision was made to not place the implants sub pectorally.
A sub glandular approach is faster and technically easier, but sub pectoral implants can to do better long-term.
There’s no right or wrong, but most plastic surgeons I know who do heavy emphasis on breast augmentation in their practice prefer sub pectoral approaches to most augmentations.
To get a more accurate assessment and better understanding of your outcome, I suggest having a few in person second opinion, consultations with plastic surgeons who have extensive surgical backgrounds when it comes to breast augmentation surgery
For a second opinion, consultations, I suggest coming, prepared and bringing with you a complete set of proper before and after pictures, a copy of your operative report, and a copy of your consultation note. These are all available from your current providers office if you request them.
The following are some general recommendations for finding the best providers.
The best surgeons at Revision Work are generally the same surgeon, who do the best primary work.
To find the best provider, I suggest patient schedule multiple in person consultations with experienced plastic surgeons in their community. During each consultation, ask each provider to open up their portfolio and show you their entire collection of before and after pictures of previous patients who have similar body characteristics to your own. An experienced plastic surgeon should have no difficulty showing you the before and after pictures of at least 50 previous patients. An experienced provider should in fact have hundreds or preferably thousands of before and after pictures to choose from for commonly performed procedures. Being shown a handful of preselected images, representing the best results of a provider’s career is insufficient to get a clear understanding of what average results look like or what your results are likely to be in the hands of each provider.
There is no correct number of consultations needed to find the best provider. The more consultations you scheduled the more likely you are to find the best provider for your needs. Take careful notes during each consultation, especially regarding the quantity and quality of before and after pictures. It’s not a bad idea to bring pictures of your own body to use as reference when reviewing before and after pictures. The biggest mistake patients make is scheduling only one consultation without properly vetting or comparing providers before scheduling surgery.
Best,
Mats Hagstrom, MD