Puckering & a flap - can my breast lift be corrected? (Photos)

Question

Hello, I am looking to see what can be done to fix my breast lift. It is as if the skin was pulled to tight and now there is puckering and a flap or second breast beneath my right breast and the other is much bigger with similar issues and more puckering. Thank you

Alan Gonzalez, MD, FACS · Answer

Hello @dreamer2, thank you for your question. In your case, there is a double breast mammary fold that needs to be corrected. This requires a complete revision of your surgery so that the underlying issues can be resolved. It is important that you have a consultation with a board certified specialist to determine a surgical plan according to your needs. It is essential that you consult with a plastic surgeon who has experience with this procedure if you are considering breast revision surgery to ensure optimal results. Best wishes! Alan Gonzalez MD, FACS. American Society of Plastic Surgery Member (ASPS), International Federation for Adipose Therapeutics and Science” Member (IFATS), Colombian Society of Plastic Surgery member (SCCP)

Salvador Medina, MD · Answer

Hello! To think in a breast correction, first we should wait for at least 8 months from the first surgery. If after that the breast still has this issue, a breast correction can be done. We would have to re do all the scars and shorten the vertical scar and adjust better all the skin and breast tissue.

Christopher Pannucci, MD, MS · Answer

Hi dreamer2,
The photos are very helpful. It appears that your surgeon used a vertical or lollipop pattern, with out a horizontal scar. This minimizes the incision length, but as you see, can produce some initial abnormal contours in the lower pole of the breast. This vertical type technique typically creates an upside down looking breast initially, with the expectation that the breasts will settle over time to better fill the lower pole skin.
I would definitely suggest discussing these concerns with your surgeon.
If the breast does not settle like you would prefer, and specifically if the distance from the nipple to fold remains long, a horizontal or right to left incision, placed under the breast in the inframammary fold, could improve the situation.
Hope this helps.
Best,
Christopher Pannucci, MDBoard Certified Plastic SurgeonPlastic Surgery NorthwestSpokane, Washington

Fernando Ovalle Jr., MD · Answer

Hello, it appears you had a vertical breast lift performed (no horizontal incision). This appearance of an "upside down" breast with a narrowing and some "puckering" at the bottom is very normal and expected for this type of breast lift and it takes time for the breast tissues to settle and for this to improve. It looks like you are still fairly recent post op. I would return to see your surgeon with your questions, but this best thing to do now is to hang tight! I would not advise revision surgery until 9-12 months post op.

Gerald Minniti, MD, FACS · Answer

A perennial problem with a vertical lift, aka 'lollypop lift', is that in some individuals there is too much skin in the vertical vector (direction) that was not or could not be adequately addressed. This leads to the 'flap' at the bottom of the breast where the vertical scar ends. As the breast implants drop and fluff, usually after 3 to 6 months, the flattened and pleated lower pole fills out to a more normal curve, almost always eliminating the pleating (your pleating is partially due to stretchmarks though). Once you've reached the 6 month mark, you can assess the shape to determine if that 'flap' is still present. If so, then you will need a minor revision to excise that flap of skin, leaving you with an small anchor scar pattern.

Daniel Barrett, MD · Answer

Dear dreamer2,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went 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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Shana Kalaria, MD · Answer

The reason why you have this is because there is no horizontal incision at your breast fold. The surgeon tried to do the lift through a "lollipop" incision when you were a better candidate for a full anchor breast lift. It is still possible to fix with adding the horizontal incision in the breast fold. Please see a board-certified plastic surgeon as revision breast surgery is complex. Good luck!

Hilton Becker, MD · Answer

You have a common problem seen after a breast lift is done with only a vertical incision.
Correction would involve  a horizontal incision in the breast fold in order to excise the excess tissue

Ian MacArthur, MD, FRCSC · Answer

Thank you for your question. It appears from your photos that you may require a revision breast lift. It looks like there is excess skin along the bottom of the breast that should be removed and tightened. If you are fairly early in your post-operative recovery there is a chance that some of this may improve with time. I suggest you follow-up with your operating surgeon to discuss your concerns and discuss potential revision surgery if needed. Take care.

Connie Hiers, MD, FACS · Answer

If you are past 3 months from surgery, a small incision underneath can remove the excess tissue. This can be done in the office under local anesthesia.

Puckering & a flap - can my breast lift be corrected? (Photos)

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