Attached is pre op, 1yr Post augmentation and 19m Post augmentation. I’ve posted before basically just giving up on fixing them but I cannot continue to hate them more with each passing month. I completely regret not doing better research and trusting my PS who gave me completely unsatisfactory results after schmoozing me into trusting I’d get what I paid for. I want upper pole fullness, not saggy melons
Answer: The Answer to Your Problem is not Bigger Hello,Round smooth implants have a tendency to drift over time, especially larger and high profile implants, and sometimes rather quickly as in your case. The simple solution frequently chosen is to have bigger and/or more high profile implants placed, only to be in the same situation afterwards. The notching you see is the implant bulging below the attachment of the muscle to the sternum; your implants are too low, and adding back more implant won't help. You really need to see a few ABPS certified/ASAPS member surgeons expert in revision breast surgery. I cannot tell you exactly what needs to be done, other than some form of pocket modification - capsulorrhaphy/mesh reinforcement. Consideration for implant selection should include switching to textured and possibly smaller devices. Finally, there may need to be some modification of your soft tissue envelope as well (mastopexy). All of this would be determined by physical examination. Best of luck!
Helpful 1 person found this helpful
Answer: The Answer to Your Problem is not Bigger Hello,Round smooth implants have a tendency to drift over time, especially larger and high profile implants, and sometimes rather quickly as in your case. The simple solution frequently chosen is to have bigger and/or more high profile implants placed, only to be in the same situation afterwards. The notching you see is the implant bulging below the attachment of the muscle to the sternum; your implants are too low, and adding back more implant won't help. You really need to see a few ABPS certified/ASAPS member surgeons expert in revision breast surgery. I cannot tell you exactly what needs to be done, other than some form of pocket modification - capsulorrhaphy/mesh reinforcement. Consideration for implant selection should include switching to textured and possibly smaller devices. Finally, there may need to be some modification of your soft tissue envelope as well (mastopexy). All of this would be determined by physical examination. Best of luck!
Helpful 1 person found this helpful
Answer: Pocket revision and implant exchange: I want upper pole fullness, not saggy melons Thank you for your question, and I'm sorry that you have to undergo a revision. A large portion of my practice is dedicated to performing revisionary breast surgery. Obviously an in person exam is important to establish a final plan of action. Based on your pictures, you would need to have an implant exchange to a larger ultra high profile silicone implant, a lateral and inferior capsulorrhaphy (suturing of the pocket), and lollipop mastopexy (lift). I completely disagree with made opinions expressed below that suggest that you can get the result that you would want without performing a lift. You have a significant drooping of skin known as pseudoptosis and this does not respond well to capsulorrhaphy alone. Typically, placement of mesh implants did not help the capsulorrhaphy or change the result. Additionally, I would also like to fix the indentation on the right upper quadrant of your abdomen by releasing scar tissue and fat transplantation. I hope this helps and wish you well.
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Answer: Pocket revision and implant exchange: I want upper pole fullness, not saggy melons Thank you for your question, and I'm sorry that you have to undergo a revision. A large portion of my practice is dedicated to performing revisionary breast surgery. Obviously an in person exam is important to establish a final plan of action. Based on your pictures, you would need to have an implant exchange to a larger ultra high profile silicone implant, a lateral and inferior capsulorrhaphy (suturing of the pocket), and lollipop mastopexy (lift). I completely disagree with made opinions expressed below that suggest that you can get the result that you would want without performing a lift. You have a significant drooping of skin known as pseudoptosis and this does not respond well to capsulorrhaphy alone. Typically, placement of mesh implants did not help the capsulorrhaphy or change the result. Additionally, I would also like to fix the indentation on the right upper quadrant of your abdomen by releasing scar tissue and fat transplantation. I hope this helps and wish you well.
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January 15, 2018
Answer: Implants need support to maintain upper pole fullness Without knowing what size your implants are, they appear to be on the large side and you have bottoming out. This means that your body has not been able to make a strong enough capsule to hold them in place. For that reason, pocket revisions with a capsulorrhaphy may not work. Consider adding mesh such as Galaflex for long term internal support.
Helpful
January 15, 2018
Answer: Implants need support to maintain upper pole fullness Without knowing what size your implants are, they appear to be on the large side and you have bottoming out. This means that your body has not been able to make a strong enough capsule to hold them in place. For that reason, pocket revisions with a capsulorrhaphy may not work. Consider adding mesh such as Galaflex for long term internal support.
Helpful
January 15, 2018
Answer: Kind of tough!! Thank you so much for the photos and we all can certainly see what you’re talking about and why you have concerns! Your before pictures just didn’t look as if you would have that much difficulty keeping your implants a pill… But you do. We often talk to patients needing revision surgery about implant exchange, capsule work, or breast tissue tightening. My guess without an examination is you may need all three.... I know that sounds very discouraging but for you to get the fullness and perkiness you want, it may require that. I’m sorry we cannot all be more specific but take your time and find a surgeon who has a large revision experience!!!
Helpful
January 15, 2018
Answer: Kind of tough!! Thank you so much for the photos and we all can certainly see what you’re talking about and why you have concerns! Your before pictures just didn’t look as if you would have that much difficulty keeping your implants a pill… But you do. We often talk to patients needing revision surgery about implant exchange, capsule work, or breast tissue tightening. My guess without an examination is you may need all three.... I know that sounds very discouraging but for you to get the fullness and perkiness you want, it may require that. I’m sorry we cannot all be more specific but take your time and find a surgeon who has a large revision experience!!!
Helpful
January 16, 2018
Answer: Wanting more upper pole fullness Thanks for your question. If you are wanting upper pole fullness and more roundness to your breasts with better cleavage, you would have to either go with a substantially larger implant - 200 to 300cc larger, which I don't recommend for your body size, or do a full lift. The lift is the only way that the bottom tissues can be tightened to force the implants higher and more in the center to give you the shape you desire.
Helpful
January 16, 2018
Answer: Wanting more upper pole fullness Thanks for your question. If you are wanting upper pole fullness and more roundness to your breasts with better cleavage, you would have to either go with a substantially larger implant - 200 to 300cc larger, which I don't recommend for your body size, or do a full lift. The lift is the only way that the bottom tissues can be tightened to force the implants higher and more in the center to give you the shape you desire.
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