For women with moderate to severe breast sag or asymmetry, a breast lift (mastopexy) may be recommended to ensure the best result and longest lasting result. Failing to have a breast lift when necessary will only lead to a less than ideal result leaving the patient unhappy and needing a revision surgery. A larger breast implant can help lift the breast, but the low hanging breast tissue will still be present causing a disconnect between the implant and breast tissue located at the bottom of the breast.Now, here is the thing about yours of the augmentation/implants were completed without a lift in both of your procedures then possibly there is an increase in asymmetry. You may want to talk to your surgeon ASAP about the lift that should have been done for this. Best of luck to you!
Thank you for your question and photos. At 4 months, you are about where you will be long term. If there are small differences (or larger differences) in the breasts, this will need to be adjusted surgically. Best to discuss your options with your surgeon, depending on what bothers you the most (nipple position, implant position or both).
can come from a variety of causes but in my practice, my focus is on having level upper poles first and foremost since that is what the world sees when you wear tank tops or tube tops. You do have some asymmetry that is aggravated from the implants and possibly an excessive lateral pocket. With your shoulders level, it appears the upper poles are level as well but if not, then you will need revisions (capsulorrhaphy) and even a lift on the side that looks fuller with nipple lower. Make sure all of your concerns will be addressed before jumping in with your revision.
I think my best advice is to be patient and discuss options with your plastic surgeon after sufficient healing time (6 months after surgery). He/she will determine whether the higher side failed to settle and needs revision or if you're better off considering a mastopexy with capsulorrhaphy on the lower side. I'm generally against placing such large implants but would not have expected such asymmetry based on your pre op photo.Regards and best wishes,Jon A. Perlman, M.D. FACS
Certified, American Board of Plastic Surgery
Member, American Society for Aesthetic Plastic Surgery (ASAPS)
Beverly Hils, Ca.
Thank you for the photos and clearly your breasts were asymmetric prior to surgery and it would be expected that implants would only magnify the difference but if you have concerns relate them to your surgeon
You very well may require a revision with a lift on the right Breast in the future. A capsule sling to elevate the fold may also be needed for bottoming out
I am sorry to hear about your concerns after breast augmentation surgery. You demonstrate and describe your concerns nicely. Although some “falling to these sides” of breast implants is quite normal when you lie down, if this occurs “excessively”, it may be a concern to patients. This phenomenon is called lateral displacement of the breast implant; it may be of concern from the visual and the discomfort standpoints. Surgical correction is an option (and given your concerns, will likely be necessary).
Generally, the lateral breast implant (and/or bottoming out) displacement can be corrected using an internal suture technique, decreasing the size of the pockets and moving the implants toward the midline. In my practice, I use a 2 layered suture technique to close off the space laterally (towards the axilla). The use of acellular dermal matrix is an option (although not usually necessary) especially if significant implant rippling/palpability is present.
I hope this, and the attached link (dedicated to revisionary breast surgery concerns), helps. Best wishes.