Do I Need a Pocket Revision? (photo)

I'm at 6 months post op now and my implants have hardly dropped. They are still very high (as you can see in the picture), extremely firm, and my nipples are still pointing downward. At this rate... does it look like I might need a pocket revision? I have a follow up appt with my surgeon tomorrow. What should I expect or ask him?

Doctor Answers 5

Do I Need a Pocket Revision? (photo)

Yes I think you will...This far out, your implants will not change much and your breast shape is not ideal. You will need your pocket lowered and possible smaller implants...

Phoenix Plastic Surgeon
4.6 out of 5 stars 45 reviews

Implants at 6 months

It might be that your impalnts are too large for your frame. You may need to be resized smaller and have the pockets opened up more in the lower pole. An exam in person would be critical.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Revision Breast Surgery


I am sorry you are having problems after your breast augmentation surgery.  The problems you are having are unfortunately very common when the choice has been made to use an implant size and profile that is too large for your anatomy, leading to a multitude of problems, in your case: implant malposition in the superior and medial directions, asymmetry of breasts, and nipple ptosis. Given enough time, you might also add capsular contracture and severe rippling to the list.

Yes, you will need a surgery to correct this result.  You could choose to have only an adjustment of your implant pockets, which in your case would entail openning up the pockets in the inferior direction, allowing the implants to drop.  The problem with this is that the lining of the these larger, lower pockets will only be the thickness of your chest skin, an unreliable floor to lay these implants on, putting you at risk for further asymmetry or malposition in the downward direction, and increasing your risk of rippling.  You would be best suited to reduce the size of your implants while revising your implant pockets to obtain a better long term result with a lower risk of further complications.

Revision surgery is more complicated, and prone to higher rates of new complications.  You should make sure the surgeon you choose is appropriately qualified (certified by the ABPS, member of the ASAPS) and skilled (renowned for complex breast surgery as well as routine breast surgery).

Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 90 reviews

Do I Need a Pocket Revision?

Thanks for posting the excellent series of photos. Yes you need revision. The nipple to infra fold distance is too short. Options for revision need to be discussed in person so you can understand them. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 174 reviews

Pocket Revision Surgery Necessary after Breast Augmentation?

Thank you for the question and pictures. Your concerns about the breast implant  positioning are valid.  Given your description of the breast " firmness” your plastic surgeon will be in the best position to rule out complications such as breast implant encapsulation ( excessive scar tissue around the breast implant)  that may be responsible for the firmness of the breasts as well as the breast implants'  failure to descend.  Regardless, it is very likely that revisionary breast augmentation surgery will help improve your situation.

I think that the questions you are asking online are appropriate questions to ask your plastic surgeon during your follow-up visit.

Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,499 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.