Indent on breast - is this common? (Photo)

Question

I have this horrible indent on my breast after a lift/implant. I cannot find anything about this online. Is this common? I feel disfigured

Semih Yildiz, MD, FEPOBRAS · Answer

In the photo, there is a visible contour depression on one breast, most noticeable along the lower/inner breast contour. A small amount of asymmetry after a breast lift with implants can be common, but a distinct indentation is not usually considered an ideal or expected final shape. It can come from several causes, including scar tethering, tight or uneven lower-pole skin, implant position, a fold or pocket issue, capsular contracture, fat thinning, or tissue being pulled by the lift closure.

The timing matters a lot. If this is early after surgery, swelling, tissue tightness, and scar maturation can change the appearance over several months. If it has been many months and the indentation is stable, it is less likely to smooth out completely on its own. Correction may involve releasing tethered scar tissue, adjusting the implant pocket or inframammary fold, fat grafting, scar revision, or a combination, depending on what is found on exam. I would bring this directly to your surgeon and ask what structure is causing the depression, because the best fix depends on whether it is mainly skin/scar, implant position, capsule, or soft-tissue deficiency.

Daniel Barrett, MD · Answer

Dear Boo3469,
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

J. Timothy Katzen, MD, FACS · Answer

Hello Boo 3469,

Thank you for reaching out with your concerns about the indentation on your breast following a breast lift and implantation. I appreciate the history and picture you've provided, as it helps in assessing your situation.

The indentation you're experiencing at the 6 o'clock position of your breast, while not uncommon, is likely attributed to scar tissue formation. Scar tissue naturally contracts over time, which can result in the tightening and lifting of the skin, leading to such indentations. This condition could be related to excessive scar tissue in the lower part of the breast or around the breast implant, known as capsular contracture.

If this indentation is causing you concern or discomfort, I recommend considering a surgical revision. This procedure would involve removing the excessive scar tissue, either from the skin or surrounding the implant, and can usually be performed through your existing anchor breast lift scar. I strongly advise consulting with your original plastic surgeon to discuss the best approach for your revision surgery.

Your concerns are important, and addressing them can significantly improve both the aesthetic outcome and your comfort. I hope this response provides clarity on your situation and the potential corrective measures.

Wishing you the best in your journey towards resolving this issue.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS
Plastic and Aesthetic Surgeon

Connie Hiers, MD, FACS · Answer

This dent is fixable by removing some excess tissue at the bottom. The other breast can also be revised so that they are more even. Please discuss this with your surgeon.

Darryl J. Blinski, MD · Answer

Based on the 1 posted photo only my guess is this "indent" (not really an indent but over excision of tissue) was due to surgical technique. Only full bilateral revision can improve. Expect fees in the $8,000+ ranges. Best to virtual consult with.....

Mats Hagstrom, MD (license on probation) · Answer

To make an accurate assessment regarding the outcome of any plastic surgery procedure we generally need to see a complete set of proper before and after pictures. Significant breast lifts are done surgeons have to manage removing what is sometimes a significant amount of excess skin. So can lead to contour irregularities. a master augmentation has a fairly high revision rate. Some surgeons prefer to do these procedures as staged operations. It’s not all that unusual to have to go back and make some adjustments. And your case on your right breast removing some of the excess skin on the horizontal limit on each side, should even have the contour. Talk to your plastic surgeon about revision surgery and see what they have to say. If you don’t get the help, you need from your provider to consider getting a few in person second opinion consultations. For second opinion, consultations come prepared to bring with you a complete center of proper before and after pictures, and a copy of your operative report. These are all available from your card providers office if you request them.
Best,
Mats Hagstrom, MD .

Indent on breast - is this common? (Photo)

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