Breast revision surgery 6 months post op. Saline implants under the muscle 320 cc, small C Cup. What is wrong here?

Question

Moderate profile used. Breast lift on right breast only. Right breast looks flatter and lower even though it was lifted. Very disappointed with the results. I feel the implants used are flatter. I wanted fullness and to be tastefully larger. I am 5'8 and have a medium frame. The breast implants are not proportionate to my body. The surgeon said I could not be larger. Why couldn't he use a fuller implant to achieve a nicer result?

Gerald Minniti, MD, FACS · Answer

However, what I can tell you is the approach was all wrong. You had very asymmetric breasts in both size and shape, hence the unilateral breast lift, and you can now see how the relative contribution of the implant to total breast volume has an effect on breast appearance. Your smaller breast's total volume has a greater contribution from the implant than your larger breast, which is why you like the shape. Your surgeon had an opportunity to do the right thing, but passed, possible because you didn't give him the green light to do a real breast lift (anchor scar) with a reduction. This would have allowed the him/her to place similar sized implants so that the proportion of implant volume to total breast volume would be similar on both side. He also used periareolar incisions to deliver implants, putting you at higher risk for capsular contracture, and causing other scar related deformities, some of which you now have, specifically the areolar indent on the smaller breast. Here's how to get gorgeous breasts that you will love: remove both implants and place larger in both. Reduce and lift the larger breast with an anchor pattern incision. Lift the smaller breast with a lollipop incision. When selecting implant size, focus on the smaller breast and decide how much bigger you want to be. For example, 20%, 30%, 50% larger? This will aid in proper implant selection.

Gary M. Horndeski, MD · Answer

Your breasts are asymmetry in volume, shape and position. At this time, I recommend explantation and lift using The Bellesoma Method. The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained if not injured during your previous surgery. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Paul E. Chasan, MD, FACS · Answer

Thank you for your question. I'm sorry, but your outcome was not optimal.  A large portion of my practice is dedicated to breast revision surgery. Many years ago, I pioneered a technique specifically for patients like you termed "Reductive Augmentation". This involves an internal bra-capsulorrhaphy, mastopexy-lift, and excision of the lower pole breast tissue. Removing more tissue on the larger side, so the same sized implants are placed is an important aspect of the surgery. You should be able to have a beautiful appearing breast with this technique. Best wishes to you.

Ronald J. Edelson, MD · Answer

One sided breast lifts rarely work out well. I would have done lifts on both sides with the same size implants and removal of  breast tissue on one side to achieve symmetry

Daniel Barrett, MD · Answer

Dear Doramom1,
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

Connie Hiers, MD, FACS · Answer

One size is larger than the other. However, with a lift, large implants do not work well over time since the breast sags again from the weight. Sagging breasts to start do not support heavy implants.

Kenneth R. Francis, MD, FACS · Answer

Dear Doramom1,
There are a few things missing and perhaps a few misconceptions.   We do not have a pre-operative photo on which to base your current appearance.  We do not have a lateral photograph to assess the projection asymmetry that you observe (flatter right breast).  We do not know what your previous implants were, or if you even had any.  Your breast cup size does not look to be a small C, especially on the right.  There is a significant size asymmetry however.  Options may involve a reduction of the right breast, insertion of different size implants, changing the projection profile of the implants, or a combination of these options.  Good luck!

Darryl J. Blinski, MD · Answer

Based on your posted Photo you have a symmetry to lift and volume. Only revision surgery can correct. I recommend smaller implants using high profile of different volumes with a smaller implant by 100 cc on the right, and rewrite breast lifting. Best of virtual consult. Expect to range from $10,000-$20,000.

Breast revision surgery 6 months post op. Saline implants under the muscle 320 cc, small C Cup. What is wrong here?

Answers (8)

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