Do my breasts look too wide and big? Are they going to be right for my frame? (photos)

Eight weeks after silicone implants with lift on left breast. Hematoma removal after two weeks in. Also had a lower back lift without tummy tuck which same Dr did five years ago. Lost 130 pounds and was looking for D cup. They feel heavy and uncomfortable.

Doctor Answers 5


I think they look too large. You probably need a lift and maybe a smaller implant?  At this point you have to left things settle down.  Best of luck.

New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Augment result

I think they are too wide and too low on your chest. Given the weight loss, you needed more of a lift.  This is what my pre operative reduction patients look like in all candor. Before photos might be very useful.

Breast size and shape after your surgery

Whether your breasts are too wide or larger for your frame is really a personal preference. I personally think that they do appear large for your body, especially after your weight loss. I imagine that your surgeon may have discussed just a lift with small reduction on the larger breast....instead of a lift and an implant on the smaller breast.

You should have had a lift/reduction

You should have had a lift/reduction.  A lift with an implant is controversial for two reasons.  First, when you perform a lift you are making everything tight and closing the wounds under tension.  It you add the expansive forces of the implant at the same time, you are fighting against yourself.  There are forces on the wound which try to make them separate, which results in wider, thicker, more irregular scars.  In the worst case, the wounds will open.  So compromises are usually made in the operating room by the surgeon because they cannot close the lift wounds over the appropriate sized implant.  Either less of a lift is performed so that the skin is not as tight and therefore there is less tension on the closure.  Or a smaller implant than would be appropriate is used so as to decrease the expansive forces.  Either way, you are compromising the aesthetic outcome.  Often the outcome is so compromised that a second revision surgery is required.  If however, you plan to have the lift first and then the augmentation after everything has healed, then you have two operation that are planned, both with much lower risk than the combined mastopexy/augmenation.  The outcomes of the two meticulously planned operations are much better and a more aesthetically pleasing, and a safer outcome is achieved. The second reason the combination of mastopexy and augmentation is controversial is because of the risk of nipple necrosis (death of the nipple).  By making the skin tight for the lift, you are putting external pressure on the veins that supply the nipple.  By putting an expansive force on the undersurface of the breast with an implant, you are putting pressure on the thin walled veins that supply the nipple.  If the pressure by squeezing the veins between the implant and the skin is greater than the venous pressure in the veins, the flow will stop.  If the venous outflow stops, the arterial inflow is stopped.  If the arterial inflow is stopped, there is no oxygen for the healing wounds and the tissue dies. Placing the implant on top of the muscle in combination with a lift puts the blood supply to the nipple at a much higher risk because in addition to the issue of pressure on the veins, you have to divide the blood vessels that are traveling from the pectoralis muscle directly into the breast (and to the nipple) in order to place the implant between the breast tissue and the muscle. This adds a third element of risk to an already risky operation.  Mastopexy/augmenation with sub glandular implant placement is by far the riskiest way to address your anatomic question.

Post-Op Healing fro Breast Lift

Healing will go on for 2-3 months for the early period.  There may be some swelling, bruising, malposition, color differences.   Sensation will be abnormal.  Scars will be changing. If my patients have concerns that something is unusual about their healing process, it is important for them to call the office and discuss these concerns or come in to be examined. While you may still be healing and in need of a little more time you should not hesitate to see your surgeon in person with questions and concerns about any discomfort. It is good to have the area evaluated for proper healing and determine whether a revision will be helpful in the future. Good luck!

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 94 reviews

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