Transgender breast implant revision to lower IMF? (photo)

Question

I had my my primary breast aug 1.5yr ago with 250cc + 270cc HSC+ Moderate Profile. They never dropped and my nipples pointed to the ground. My revision was 4mo ago with donut lift 305cc + 325cc HSC Mod+. Though improved slightly they aren’t dropping so my surgeon tells me he needs to perform another surgery to lower the IMF since he never did that. Is my problem this complex or is it time to seek another surgeon’s help? Any guidance to help me get closer to my wish Pic is appreciated.

Gary M. Horndeski, MD · Answer

Yes, your implants are too high and you will need the inframammary fold lowered.  One of the complications of lowering the inframammary fold is that the implants can herniate inferiorly and laterally and bottom out.  You may benefit from a repeat donut mastopexy to lift the nipple-areola complex higher and inframammary fold release.

Best Wishes,

Gary Horndeski, M.D.

Ellen Ozolins, MD · Answer

Thank you for your question. The implant pocket wasn’t adjusted adequately during your previous surgeries and the IMF wasn’t lowered when needed. The implants are sitting too high, and the nipple-areola complex is low, so lowering the IMF could help balance the position. A revision to lower the fold may be necessary. However, since this is a third procedure, a second opinion from a board-certified surgeon with experience in transgender breast surgery is recommended. They can evaluate whether lowering the fold alone will correct the issue or if further pocket or implant adjustments are needed.

Daniel Barrett, MD · Answer

Dear Gregarious236767,

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

Gianfranco Frojo, MD · Answer

You had a constricted lower pole/inframammary fold prior to surgery. You need an incision planned much lower in the "new fold" with obliteration of the previous fold. This is on the spectrum of tuberous breast deformity. This requires a very experienced aesthetic breast board-certified plastic surgeon.

Brian K. Reedy, MD · Answer

Thanks for your question! It can never hurt to get another opinion. You should feel comfortable with the plan going into a third surgery. Good luck!

Transgender breast implant revision to lower IMF? (photo)

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Transgender breast implant revision to lower IMF? (photo)

Answers (7)

Answer: Breasts

Answer: Breasts

Answer: Second opinion

Answer: Second opinion

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Recommended reading

Everything you need to know about Breast Augmentation

Our mission is to create a world where every investment in modern beauty is Worth It.