Breast augmentation revision gone wrong? (Photo)

Question

Hello. I had my first BA in Oct, I went from an A ( I am 5'2 105lbs) to a DD with 450cc MP. 2 months post I developed medial rippling and bottomed out. In late Jan I had a revision. He replaced implants with 375ccMP and used dermal matrix to reenforce medially as well as underneath. Initially I had beautiful 1.5 inch medial separation, now I have None and the right Breast is crossing over the middle making them crooked. What should I do now? What a nightmare it's been. :(

Thomas A. Mustoe, MD, FACS · Answer

I agree that you have had some recurrence of medial displacement of your implants.   Although it is not ideal, you do not have symmastia. Your revision surgery was well thought out, and unfortunately medial malposition is the most difficult to correct.  Your inferior breast position looks good. I would consult with your surgeon, and wear appropriate support for many weeks.  However, the position is not going to improve, and if it bothers you enough the only solution will be another revision.   I would wait several months before making a decision.   Overall you have a nice shape and some people naturally have their breasts very close together.  It is possible that you have some degree of pectus excavatum ( where the rib cage slopes inward towards the breast bone, which tends to make the breasts fall together), and if that is the case, that is not correctable.

Dirk Lazarus, MD · Answer

If they are on top of the muscle moving to a dual plane position will help separation, but ideally you should wait a year before contemplating surgical revision. What you can do in the interim, as Dr. Mustoe says, is wear support. The question is what type of support and to increase separation you need unconventional support that applies gentle pressure on the breast bone, the sternum, between the breasts, something like wearing the support bra back to front. You need to provide the support between the breasts (as well as the usual breast support required).

Steven Wallach, MD · Answer

Are your implant over the muscle?  I might be a better idea to have them under the muscle. If they are under the muscle you may need a capsule repair as well. Good luck.

Tom J. Pousti, MD · Answer

Having followed your  previous posts,  I am sorry to hear about the difficulties you have experienced. Based on your history, it appears that the revision breast surgery was well thought out and appropriate. However, based on your photographs, it does appear that you have some recurrence of breast implant displacement, both  medially and inferiorly.   Why you have had a recurrence, is hard to know; sometimes, despite best efforts, the recurrent breast implant malposition does occur. It may be, down the line, that additional surgery will be necessary to improve your situation. In my practice, capsulorraphy and use of acellular dermal matrix (or  biosynthetic mesh) are the best tools to help patients  in your situation (sorry there are not a lot of other  acceptable alternatives). Best wishes.

Breast augmentation revision gone wrong? (Photo)

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