6.5 months post silicone mod+ issues with drop & size discrepancy (Photo)

Question

Highly frustrated with my breast @6.5 months post op. My surgery was 2/6/23 Mentor smooth round, Silicone under muscle 300cc (both), mod+. 12.5 bwd Pre existing asymmetry - pics(x2) attached - left breast IMF fold lower + breast slightly larger- was told right pocket needed more done /dissected Asymmetry right off table & more noticeable Right breast still not dropping enough to appear more like sisters. Will it? Left looks too low. Should I have had HP? Diff cc for each?

Connie Hiers, MD, FACS · Answer

Your left breast is naturally larger than your right and sits a little lower. To be more even, you can add volume to the right breasts and lower the pocket (not a fan of lowering pockets), or make the left side smaller and raise the pockets.  However, there is a risk that the nipples will not be symmetrical if this only is done. Ideally, the lower pocket would be lifted and the implant changed for something smaller. Then, your surgeon would sit you up and see if and which areola would need to be raised.  Since you have the same size implants and the pocket was not addressed, you can see more asymmetry with larger breasts.

Shana Kalaria, MD · Answer

I would recommend bringing the breasts closer together to give more cleavage and also exchanging the implants and possibly use different sizes to give more symmetry. Please visit a board-certified plastic surgeon as revision surgery is complex. Good luck!

Mats Hagstrom, MD (license on probation) · Answer

Implant augmentation, sometimes emphasizes both asymmetry and breast position. In that sense, the larger, the implant, the more obvious, the issues become. Both your implants look fairly well centered around each nipple areola complex.
The asymmetry of your outcome is in someways and exemplified version of the baseline asymmetry you had before surgery. The breasts were divergent, and this is exemplified with the increased size.
When the implant pocket is not created correctly, and the implant sits high or low, the breast will show more tissue on one side of their nipple areola complex than the other. This can be either to the left or to the right or upper versus lower. When more skin shows on the lower half of the breast we generally referred to that as the implant “bottoming out”. This indicates the implant was placed too low. When more skin shows above the nipple areola complex implant is riding high and may need to be lowered. 
In your after picture, both breast show the implants being fairly well centered in relationship to each nipple/areola complex, which indicates the procedure is technically done well.
In your case, I think the problem is based on unrealistic expectations with baseline, asymmetry and breast divergence. Perhaps this should’ve been discussed more thoroughly during your consultation. In your case, the bigger the implant, the more obvious the problem becomes.
Despite not being happy with the outcome, sometimes patients can get some relief, simply knowing that the procedure was technically done well. Living with the belief that the procedure wasn’t done well can lead to ongoing chronic frustration, which is unhealthy and potentially unfair.
When the distance between the two breasts is wide or breasts, are more divergent, patients may benefit from having lower profile implants with a wider diameter base.
Some of this may be subjective and different plastic surgeons will have different opinions. I’m looking forward to hearing what other providers have to say.
I don’t see any evidence of technical incompetence or inappropriate surgical work. If there was anything done wrong, it was more related to a potential failure of communication regarding your candidacy for the procedure in the first place.
I suggest getting a few in person and a second opinion consultations. At six months your results are probably pretty close to the final outcome.
Whether a second surgery is indicated or not it’s a pretty complex topic, but there’s no clear obvious evidence that it is at this point other than a potential change in implant size or shape.
BestMats Hagstrom MD

6.5 months post silicone mod+ issues with drop & size discrepancy (Photo)

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6.5 months post silicone mod+ issues with drop & size discrepancy (Photo)

Answers (3)

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Everything you need to know about Breast Implant Revision

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