I really think these are too big for me and way too low. I wonder if saline can be removed? But they are too low, so I either would like the implants removed entirely - but will I sag even more (even though I was supposedly lifted)? Maybe I should just start over with smaller implants and more lift? Will my PS CHARGE FULL price for revision??? I told him I didn't want to be huge, but look what he did! He keeps trying to convince me they are as high as can be and just the right size for me!
Removal of Implants Entirely or Replace W/smaller-Will I Need a Lift Again? (photo)
Doctor Answers 10
Revisionary Breast Surgery; Best Option?
Thank you for the question and pictures.
The breast implants do appear to sit somewhat low on your chest wall ( right side more so than left). Removal of your breast implants altogether ( I think) will leave you with relatively low/empty breasts; you may very well be disappointed with the results of the surgery. I think you may be better off by downsizing of breast implants, internal ( capsulorrhaphy) suture work and revisionary breast lifting surgery.
I would suggest that you communicate your concerns in a calm/constructive fashion with your plastic surgeon. Make sure that he/she can demonstrate experience helping patients in your situation.
Removal of implantts entirely or replace
The first step is communicating your concerns with your plastic surgeon. While there will be a cost for revision, the more important issue is establishing an understanding of the issue and treatment plan. It appears the whole breast is low on the chest wall and not a true "bottoming" out. Even a smaller implant may cause the breast to appear low.
The revision is complicated and involves multiple factors, best to understand the options first. There are factors such as the breast measurements that will play factor. Also, the PS may consider interanal capsule work or even mesh support.
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Revision of breast lift with larger implants
It is hard to tell for certain from pictures alone, but I think it is very likely that if you just remove the implants you will have an emptied out breast that sits low. It should be reasonable to reduce the size of your implants and carry out an additional lift, but everything depends on your history and physical examination. There are many different types of breast lift, and some provide better anchoring. There is a technical discussion of these issues on my website in the structural mastopexy section
Removal of Implants Entirely or Replace W/smaller-Will I Need a Lift Again?
The photos show a "bottoming out effect of a poorly done lift. Best to repeat the lift with or without the implants. Implants are your choice
Your breasts do sit low on your chest, and the right one looks lower than the left. Removing the implants alone will make the breasts look flatter and probably lower. Using a smaller implant will not accomplish your goals. A revision lift may be necessary to raise them a bit higher.
Too large implants and low breasts
according your pictures, you are right. these saline implants are too large, and you have the beginning of " bottoming -out ". because of their weight, they have stretched your breast tissue lower. Most likely they are placed in a sub-glandular pocket ?
In order to answer you adequately,I would need to perform a full examination with measurements. We need more information re. the size and make of the implants, and the position: sub-muscular vs sub-glandular.
you will need a new surgery with new, smaller implants, to be most likely placed sub-muscular, and a revision of the lift. Yes, this will incur additional costs.
you will need to sit down with your doctor to review all this.
Florence Mussat, MD
Breast sag after implant removal
The skin envelope of the breast is quite full, and it is likely that you will be unhappy with the skin laxity if you remove the implants alone. We cannot see under the breast, however a revision with a 'T' pattern to take up more skin and a smaller implant might just be the way to a better you.
Saline removal after implantation is not a good option
Saline removal to downsize to a lesser volume following previous breast augmentation is generally not a good idea. Downsizing will require re-operation and another set of implants with its associated expense. Your photos do suggest elongation of the of the lower breast pole or low lying implants. Since photos may distort the true circumstance, an examination is necessary to precisely define the issue and determine the appropriate surgical intervention (capsulorraphy, redo lift with anchor type procedure, etc). Regarding the fees for revisionary surgery, each surgeon has their individual approach. You should discuss this with your treating surgeon
Removal of Implants Entirely or Replace
When I see patients come in with this problem, which is essentially too great a distance from the areola to the bottom of the breast I have had good success in simply removing more skin from the bottom of the breast. We actually deepithelialize the pattern that is to be removed and tuck it up under the skin that is to be left. Your surgeon will know what I mean. It's a pretty easy recovery and utilizes the existing scars and as long as the distance from the top of the breastbone to the nipple is appropriate, the nipple/areola does not need to be moved. If the areola measures too low, however, the entire lift can be redone. Can't tell from pictures alone.