Do I need a new lift? Are my areolas to large? (photos)

I had surgery the end of May. BL, TT, explant, fat graphs to breasts. I was very pleased with the initial outcome but much of the fat died off and I feel as though it ruined my lift. I was a full c immediately after the surgery but I am now almost a mid b cup. My nipples also seem just as large as their were before surgery, and pointed out, rather than center. I am assuming this is from the loss of volume in the sides. I also have a mini 2nd bellybutton. Can this stuff be fixed under a local?

Doctor Answers 5

Small modifications: breast lift and umbilical tag should be feasible

#SIEF (Simultaneous implant explantation and fat grafting) is an emerging "hot" topic, as is staged fat grafting to "salvage" breast volume.  The standard protocol for harvesting, grafting, predicting volume retention and limiting side effects, such as fat necrosis, oil cysts, microcalcifications is still being defined and many of us are contributing our cases to the GRAFT registry, which will track best techniques. That being said, there isn't yet a consensus of how to do it.  Revision of your breast lift (downsize areolas, tighten skin envelope) is probably best conducted under sedation (IV or oral) rather than local anesthesia.  I agree with your assessment that the loss of volume contributes to the "outer" orientation of the nipples but am uncertain whether another attempt would be worthwhile.  The "mini" belly button can definitely be revised under local.   

Orange County Plastic Surgeon
4.8 out of 5 stars 58 reviews

Revision under local?

Different surgeons have different beliefs as to what can be done with only local anesthesia without sedation or general anesthesia.  My thoughts for the following in office procedures follow.  Belly button can be revised in the office with local anesthesia.  Areolar reduction can also be performed in office under local anesthesia.  It is best to have your breast size where you desire prior to areola reduction.  If you decide you want larger breasts and opt for breast implants, do the implants first followed by an areola reduction 6-12 months later.  Doing an augmentation after areola reduction can stretch out the areola or stretch out the scar around the areola. To do much more breast work requires general anesthesia, excise or tighten excess skin, mobilize breast tissue, etc…  Discuss your case with your plastic surgeon who can determine what can be done in the office for your specific needs.

Vanessa Voge, MD
Wichita Plastic Surgeon
4.6 out of 5 stars 10 reviews

Do I need a new lift? Are my areolas to large?

Fat transfers to the breasts are useless for breast augmentation purpose... Please, read my blog attached re/itYour nipples appear low but with newest Inspira implants placed over the muscle- It should look really good. Your belly button needs a repair. Hope this helps

Thomas Trevisani, Sr., MD
Orlando Plastic Surgeon
4.9 out of 5 stars 64 reviews

Mommy make-over - do I need a new lift?

Thank you for asking about your mommy make-over.
  • I am so sorry your fat transfers didn't work - results truly are unpredictable.
  • Although I have done some that worked, I always tell patients to expect nothing from them - because that can often be what they get.
  • It is hard to comment on the difference before/after without photos
  • It looks as though you will need saline or silicone implants to get the look you want.
  • If so, postpone any areolar reduction since implants make areolae wider -
  • Have areolar reduction done 6 months after your implants - if you have them.
  • Yes, areolar reduction can be done with local anesthesia.
  • The close up of your belly button suggests that a minor revisoin will be needed which can be with loca.
  • Your breast surgery should be done in an accredited OR either with sedation or general anesthesia.
Always see a Board Certified Plastic Surgeon. Best wishes  - Elizabeth Morgan MD PHD FACS

Elizabeth Morgan, MD, PhD
Atlanta Plastic Surgeon
4.6 out of 5 stars 43 reviews

Fat transfer to breasts with lift

There is no way in my opinion to get your early postoperative result permanently with fat transfer. If you like that look you should consider implants. It is possible to improve your shape under local anesthesia by tailoring the skin but just moderately. I'd have to see the belly button in consultation to accurately answer that part of your inquiry.

Gregory J. Stagnone, MD
Dallas Plastic Surgeon
4.6 out of 5 stars 40 reviews

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