What can be done to help me achieve a larger, perkier bust? Unhappy with previous breast augmentation results (photos)

Question

Hi - i had “bilateral implants removal, capsulectomy and dual plane breast re-augmentation with 450cc round textured, high profile mentor silicone implants and “inverted t” mastopexy” And I absolutely hate my results. The operation was supposed to give me added volume, projection and cleavage and I have lost all 3. I previously had 390cc and 410cc round high profile implants - and the aim was a larger, perkier bust. What can be done?

Benjamin Baker, BMBS MBA FRCS(Plast) · Answer

Hi, sorry to hear that you are dissatisfied with your results and thanks for the question. If it is more volume that you wish to achieve then you could consider exchanging your implants for larger implants that are a better fit for your frame, or fat grafting over your existing implants. You may also need some subtle adjustment of the skin envelope and the position of the inframammary fold. You would need to consider the implications of a larger implant volume, which is an increased risk that the skin will stretch again in the long-term. This can be assessed more accurately and recommendations tailored to your desired outcome at a face to face consultation.

Daniel Barrett, MD · Answer

Dear Friendly79788,
based on your photos, it looks like your surgery was recently. So, it is best to wait until you are fully healed prior considering another procedure. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Gerald Minniti, MD, FACS · Answer

your perception of your breast size is inaccurate because of the placement of the volume. Before, most of your breast volume hung from your chest and were also projecting. After, with even larger implants, your breast volume is higher on the chest wall and compressed by a tighter soft tissue envelope. If at least 6 months has transpired, you can replace these implants with ones that are at least 40 to 50% larger. To be sure though, get sized.

Gary M. Horndeski, MD · Answer

At this time, the position of the high nipple-areola complex makes it more difficult to repeat the lift. You may benefit from scar revision using the inferior incision to generate more tissue from underneath the breast and place the implants higher on the chest wall.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Ronald J. Edelson, MD · Answer

You actually have a good result. There are several options for revision depending on what about your result specifically you don’t like

Oliver Harley, FRCSEd(Plast) · Answer

Hi thanks for your question.  I am afraid your is a difficult case because i think skin / breast tissue is quite soft / stretchy due to your natural biology and also stretch from previious implants - so its difficult to get good firm breast shape. I would say breasts are greatly improved and this result is as good as could be achieved - but it is of course difficult if you expected more from this surgery.   Also scar is fresh and red (and clearly still healing on one side) so things will look better overall once this has matured (will take 12 months).

Connie Hiers, MD, FACS · Answer

First, naturally your breast sit somewhat low on your chest and the bases cannot be moved. You will never be very "perky" because of your anatomy. Second, you could go some larger and place the implants behind the muscle for more upper breast fulness.  However, please do not go too large for your original sagging tissue will just sag again from the weight.

Mats Hagstrom, MD (license on probation) · Answer

Breast augmentation outcomes are generally based on three variables.
The first is the patient candidacy for the procedure. The second is the choice of implants and the third is the surgeons ability to place the implant in the correct an atomic location.
If a breast lift is added, then, there are obviously more variables involved.
Still, patient candidacy, and provider selection are the two key ingredients.
If you look at your before pictures, then it should be obvious that you have a tendency to have skin that stretches overtime.
The more tension your skin has the more likely to stretch.
Your implants are correctly placed sitting just above the IMF.
To me, you’re off, looks like a significant improvement from where you started.
Secondary surgery is always going to be much more difficult and unpredictable.
This is especially true if an individual has capsular contractions, or the implant was not placed correctly during the first procedure.
Once the tissues have been distorted around the implant pocket stabilizing, the position of the implant becomes very difficult.
Patients who are not ideal candidates need to have expectations that are lined up with what’s possible for your body.
A patient who is an excellent candidate for a plastic surgery. Procedure has the potential of having an excellent outcome.
That same patient can also have a mediocre outcome if the procedure is not done well.
A patient who is not a good candidate, does not have the potential for having great outcomes regardless of who does the procedure.
Failure to understand your own candidacy can easily lead to patient disappointment because patients can have expectations that are not lined up with what is possible.
Considering where you started, your outcome is not bad at all.
It’s most likely better than average and average is what the great majority of patients get.
At this point, I suggest you either follow up with your provider and discuss your concerns with him or her.
Alternatively, you can schedule a few in person second opinion consultations with other providers in your community.
To get a quality assessment on the outcome of a plastic surgery procedure we generally need to see a complete set of proper before and after pictures.
If patients have had more than one operation, then we generally need to see before and after pictures of each of the previous procedures.
 Without understanding what was done previously or where the patient started it’s hard to have quality understanding which helps us understand what is possible and not possible with any surgical situation. It looks like you’re still fairly early out from the procedure.Working with excessively large implants tends to increase the chance of undesirable side effects and increases complications, and the need for revision surgery.
Despite having a desire for large, projecting breasts, making decisions in that direction can very easily set somebody up for outcomes that are not sustainable, long-term.
I think most people who look at your before, and after pictures would say you received a substantial improvement.
Once the scars fade, I don’t think the result is that bad considering where you started.
Did your provider show you a lot of before and after pictures of previous patients who had similar characteristics and their preoperative photographs?
Best,
Mats Hagstrom, MD

What can be done to help me achieve a larger, perkier bust? Unhappy with previous breast augmentation results (photos)

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