350cc Sientra, bottom heavy with unnatural appearance & movement, what's wrong? (Photos)

Your implants have settled. The left implant has actually dropped below the previous breast fold. You need a revisionary surgery to provide more support. In my opinion, I would place an internal bra (Galaflex) to support the breast/implant. In addition. you would likely need an inferior mastopexy to shorten the distance from the nipple to the breast fold. Regardless, these are all my own opinions based on the photos provided. I would recommend seeing a plastic surgeon who has great training and experience in aesthetic breast surgery.

Thank you for your pictures and questions. I would say that nothing is "wrong" but what you are experiencing is settling of the implants. This always leads to loss of upper pole volume and shifting. However, it can be abundant in some cases and cause psseudoptosis, or stretching of the lower pole of the breast, while the nipple stays in the same position, leading to an elevated appearance of the nipple compared to the breast mound. To correct this, you may need revision surgery and in most of these cases I prefer additional soft tissue support with a mesh internal bra (Galaflex). See your board certified plastic surgeon to discuss a revision.
Good luck!
Dallas Buchanan, MD
VIVIFY plastic surgery
Tampa, FL

It does appear that the implants have settled. Typically the implants start up high and once the skin and muscle accommodate about 4 months time, the upper pole is less and you have more in the lower pole. A higher profile implant as well as Sientra HSC+ would maintain the upper pole more so than a moderate plus. Also you may benefit with tightening of the lower pole skin which would help as well.

I would recommend you seek out your plastic surgeon to discuss this further.

Hope that helps.

Dear pacnw77,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Your implants are too heavy for your tissue and are sagging. Your inferior aspect could be tightened and supported with and internal mesh bra. You might need to go down in size as well.

Thanks for posted photos. Appear you have a "boxy" lift on one side with limited natural fall. Only full revision with exchange to a non Sientra implant would be my recommendation. Fee $10,000. Best to virtual consult with...

Bottoming out or inferior implant displacement following breast augmentation and mastopexy is NOT a failure of the implant, it is due to the lack of support of the breast. Any patient that undergoes a breast lift or mastopexy must realize that as many as 20% will require a revision of the lift within the first two years following surgery. The fact that you required a lift in the first place, means that you are in a high risk group of patients that have lost support of the breast tissue. In my practice, this is seen commonly after pregnancy and lactation but also related to smoking and tanning bed treatments. In addition, it is commonly seen when implants are placed under the pectoralis muscle and patients continue to work out with exercised like push-ups, bench press and military press that isolate the pectoralis muscle action and push the implant down and out from under the muscle.

It does appear that your breasts have settled and you have bottomed out SLIGHTLY. This is a normal progression following lifts and some patients settle more than others.
There is nothing 'wrong' with your breasts, just that they are lower than immediately after your augmentation-lift.

It appears from the photos that your implants have settled and are beginning to bottom out. The photos indicated you had an anchor lift, not a lollipop lift. I encourage you to return to your surgeon to discuss your results and correction .

Dear pacnw77,
First let's establish that you did NOT have a lollipop breast lift. That is a full anchor incision, unless you've had 2 breast lifts. We also do not know how long ago your surgery was. Suffice it to say that maybe neither of these things may have anything to do with your apparent breast implant bottoming out. Return to your surgeon for an examination and discussion of your options for correction, if there is any needed. Good luck!