Breast implant revision in Los Angeles
There appear to be functional problems with your breast implants depending on position and use of the pectoralis muscles. These may be appropriate for correction, but an examination in person may be necessary to plan the details of the breast implant revision.
Raffy Karamanoukian MD FACS
Breast revision surgery within the first year
There are several options for your breast revision - it would probably be wise to see your original surgeon and discuss your concerns before you choose to obtain second opinions. This is often the most economical for patients as the original surgeon often will charge no surgeon's fee or a greatly reduced fee.
Do I need revision surgery?
Best to obtain ONLY IN PERSON evaluations. From the posted photos you are high riding or deficient inferiorly due to your anatomy or poor surgical judgement, have lateral open pockets, may need lifting.
Options for correction of implant malposition
Definitive advice would require an in-person evaluation, but it appears that the pocket has weakened laterally allowing the implant to slide to the side. This is not related to high-profile implants although implants under the muscle might be more likely to do this because the action of the muscle pushes on them. correction of this may be successful with a capsulorrhaphy to close up the scar capsule but if the muscle is still pushing on the implant it can recur. Reinforcement with an internal bra such as Strattice, SERI scaffold, or Gala FLEX mesh can be useful in that instance.
Something wrong with breasts
I believe that the problem is not the implant because I have used high profile implants in the submuscular position without any problem when appropriate. It looks as though the pocket has enlarged causing the implant to be slip laterally giving the hollow in the center portion of the chest. This can be repaired by closing the pocket laterally. Speak to your surgeon and discuss it with him to see how this can be repaired. Good luck, Dr. Schuster in Boca Raton.
Attaining a natural appearing breast augmentation with subfascial placement
unfortunately your results are very typical results in breast augmentation with high profile implants in the dual-plane submuscular position. This is why I never use high profile implants and never use the pectoralis major muscle. I use a technique called cold-subfascial breast aumentation that allows me to use the strong layer just above the muscle to deliver very natural results. I also see many patients like you who are unhappy with the results of under the muscle breast augmentations for similar reasons and convert them to cold-subfascial. The reality is that most breast augmentations are done the way yours were and most have some of the features that bother you but most women accept this. I find it unacceptable and that is why I do things differently. If you wanted correction I would advise a lower profile anatomically shaped "gummy bear: implant in a subfascial plane. I hope this helps!
All the best,
Rian A. Maercks M.D.