I had a BA/BL one week ago and they are not lifted, bigger or perky. What do you Doctors suggest I do next?

Unhappy BA/BL.... Please help. The doctor said because of my size 193lbs and 5'3 I wnt be able to achieve the like the other females have and also with only 400 cc. He didn't want to go bigger because I had reduction seven years ago. So 400 cc silicone moderate and a peraelor lift did nothing for me. Maybe a litter fuller. Do I need a complete anchor lift. Two other docs recommend it but I was afraid of more scaring. What can I do to achieve the high perky breast and upper pole fullness?

Doctor Answers 5

Breasts not lifted, bigger or perky after breast lift plus implants.

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I have looked at your photos and posts, and feel sorry no one took the time to sit down with you and actually discuss IN DETAIL what you wanted vs. what could be achieved. This is a classic case of unmet expectations, though your surgery appears to have gone well technically. Yet, it failed miserably in achieving your goals. Thus, that's an obvious problem in either the surgical choices made (by you AND your surgeon), or your goals being unrealistic (or simply not achievable).

Let's be clear; it's evident you were excited about surgery before, and you wisely decided to not go to the budget-surgery center. You worried about scarring with a full lift, but had the exact same scars with a previous breast reduction, so hopefully your surgeon advised you this was an incorrect concern. Then it became a cost issue, trying to achieve a "real" lift with only a crescent incision. I have to say that I personally believe you had a periareolar incision breast augmentation and that any skin removed amounted to a tiny sliver of skin that would have not "lifted" your breasts by more than a millimeter or two. (So just how much did you pay for the"lift" portion of your procedure?) So I agree you didn't get lifted at all, but did you really expect to with only a tiny sliver of skin removed above your areolas?

Secondly, you DID get 400cc implants, so your breasts are bigger. But in a 5'2" or 5'3" woman who weighs nearly 200 pounds, and still has the loose breast skin after pregnancy and breast feeding, this is indeed a "minimal" augmentation. Nicely done, and at $6100, the right price for a breast augmentation, but hardly a breast lift or substantial increase in size proportionate to your present frame.

It sounds as if you want high, round, Baywatch-type breasts, which may not be possible with breast skin that has been stretched several times (before your initial breast reduction, and with your pregnancies and breast-feeding). You can certainly achieve more skin tightening with a full Wise (anchor) breast lift (same scars as with your reduction), which will make your breasts higher and tighter, at least for a while until the stretched skin again softens and re-stretches. Higher and tighter also makes it difficult to enlarge your breasts very much more with larger implants, so there is this additional limiting factor. Bigger implants will make you bigger, but in the same skin brassiere, you will still have teardrop-shaped breasts, just somewhat larger Having both bigger, and higher and tighter, may not be possible at the same time without significantly increasing your risk or wound breakdown, severe scarring, or exposure of your implant(s).

So, there is always a "judgement call" with regards to safety and "tolerable risk" of complications. I don't think what you are asking for is unreasonable, but clearly your surgeon placated your concern about scarring by selling you on the idea that a crescent lift is really a lift, and then didn't do a very good job of determining what size increase you felt was desired. Perhaps your surgeon really felt that 400cc was all you wanted or all that was safe. Somehow I doubt that. He took the "safe and easy" route and hoped you would be happy.

The only problem now is for you to decide if that is your surgeon's or your fault. Or a bit of both. With renewed realistic expectations, you obviously need to decide if you want to pay a different surgeon the full price for doing what he or she can do to achieve closer to your goals. And, you need to have a detailed discussion about what can and cannot realistically be achieved. Of course, there is always capsular contracture, which no one TRIES to achieve, but which will give the high, round look you ask about (but at the often-forgotten "cost" of hard and painful breasts). This look is unfortunately not always the result of a good push-up bra, but a tight, thick internal capsule scar around your implant(s). Not really what you want.

For high perky breasts with upper pole fullness you need both a repeat full breast lift, and as large of implants as you and your surgeon feel is safe. Discuss in detail just how high, just how perky, and just how much bigger you want vs what can be achieved. Maybe even in two stages for improved safety and perhaps bigger implants. I hope this helps! Best wishes for the New Year! Dr. Tholen

Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews

I had a BA/BL one week ago and they are not lifted, bigger or perky. What do you Doctors suggest I do next?

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After reading most of your postings and reviewing ALL your posted photos, it seems to me you are not being realistic with your expectations! First a breast reduction now you desire an increase with lifting. But there is the scar issues and of course your excess weight. I think your chosen PS was correct in trying a average volume implant and easier lifting to avoid scarring. Now after only a few days you are unhappy. If you used the other surgery place (STRAX - cut rate surgery like DR) and had a severe complication of wound dehiscence or infection I wonder the remarks you would be writing? In patients that are swinging from one side to the other in  volume it is ALWAYS best to be conservative... 

Get another opinion

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Based on your height and weight I would not expect you to see much with 400cc.  If you wanted to go larger and the surgeon did not, you should look for another opinion.

Breast augmentation and lift

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I think that in order to be properly evaluated, you need to be seen in person.  However, at one week out, it is too early to consider a revision.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

I had a BA/BL one week ago and they are not lifted, bigger or perky. What do you Doctors suggest I do next?

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I am sorry to hear about your disappointment after breast augmentation/lifting surgery. My best suggestion: achieve your long-term stable weight, if you are not there already prior to proceeding when any additional surgery. Then, seek consultation with a few well experienced board-certified plastic surgeons, who after careful physical examination and a full communication of your goals, will be able to advise you. Ask to see lots of examples of their work and make sure that your selected plastic surgeon can achieve the types of outcomes you will be pleased with long-term. Again, careful communication of your goals will be key as well. Best wishes for a happy new year and a long-term outcome that you will be pleased with.

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.