Unhappy with breast lift/augmentation and brachioplasty, visble scarring and asymmetry. Options? (Photos)

Question

After significant weight loss, I underwent a brachioplasty, breast lift, and breast augmentation. Unfortunately, I am very unhappy with my results, and my surgeon agrees that the areas require revision. However, I am being quoted only about 20% less than the cost of my original surgery for the revisions. I am especially unhappy with my breasts. I was hoping for a very natural-looking result, but I was left with very visible scarring, uneven nipples, and a result that looks very different from what I had hoped for. I would really appreciate advice on what options may be available for revision and whether it would be better to have this corrected by a different surgeon. The brachioplasty also did not turn out as we had discussed. Instead of a more straightforward incision, a V-shaped incision was used in the armpit area. This has left me with very visible scarring, residual loose skin, and an unusual fold at the back of my arm. I have consulted with several other surgeons about revision. Because this is now a much more complicated case, I am being quoted roughly double what I originally paid for the procedures. I would really appreciate hearing from surgeons or anyone who has experience with complex revision cases. What options might I have for improving the breasts and arms, and would you recommend seeking out a different surgeon for the revisions?

Gary M. Horndeski, MD · Answer

It is unfortunate that your breast incisions are below the inframammary fold as they are highly visible. It is possible to re-position the scars closer to the fold and can be done under local anesthesia at a minimal cost. In terms of your arm scars, these will need to be revised as well. They may or may not be able to be done under local anesthesia.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Mert Demirel, MD · Answer

After significant weight loss, breast lift/augmentation and brachioplasty revisions can be more complex because the skin quality is often weaker and scars may stretch more. Improvement is usually possible, but it is important to separate what can realistically be corrected from what may only be improved.
For the breasts, revision options may include scar revision, areola/nipple repositioning, implant pocket adjustment, implant size or profile change, tightening of the lower pole, fat grafting for contour irregularities, or revising the lift pattern. If the nipples are uneven, the surgeon needs to determine whether the issue is nipple position, implant position, breast tissue asymmetry, or all three.
For the arms, the V-shaped axillary scar and back-of-arm fold may need scar revision, removal of residual loose skin, or conversion to a more standard brachioplasty scar pattern. However, arm revisions must be planned carefully because aggressive skin removal can cause tightness, widened scars, or limited arm movement.
It is reasonable to seek another opinion, especially if you feel the result and surgical plan were very different from what you expected. That does not mean your original surgeon cannot revise it, but complex revision surgery requires trust, clear communication, and a very specific plan.
Revision pricing can feel frustrating, but these cases are often more difficult than the first operation because the surgeon is working through scar tissue, altered blood supply, stretched skin, and existing implants. I would focus less on discount percentage and more on who has the best revision plan.
My advice would be to consult at least one or two plastic surgeons experienced in post-weight-loss breast and arm revision. Bring your operative reports, implant details, before photos, and healing timeline. Ask exactly what can be improved, where the new scars would be, whether the breast and arm revisions should be staged, and what result is realistic before committing to another surgery.

Unhappy with breast lift/augmentation and brachioplasty, visble scarring and asymmetry. Options? (Photos)

Answers (2)

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