Silicone Implants After a Bilateral Mastectomy? (photo)

The photos appear to be very early in the post-op period and pretty normal at this point.  Unfortunately, almost all breast reconstruction patients exhibit less projection than ideal.  It is the nature of the mastectomy and the inherent softness of the gel implant.  There are high profile and newer ultra-high profiles that can help.  In addition the true cohesive gel, form stable implants can maintain better projection in some patients.  At this point, I would not do anything.  Let them settle and heal.  In 3-6 months if you were still unhappy, an implant exchange to change volume, type, shape, and projection should be an straightforward 30 minute operation with little downtime.

Allergan now makes a smooth round cohesive gel implant that will give you more projection and be a little softer the the textured anatomically shaped implants.

It is common to overexpand your tissue expanders prior to your second stage breast reconstruction.  This amount of overexpansion is typical, along with accounting for the size of the port within the expander in that volume.  Depending on which projection expander was used and which implant projection was used will also determine the amount of projection that you have during and after your reconstructive procedure, respectively.  It is common to have a little less projection with the implant than with a tissue expander, since the expander is doing just that - expanding your tissue.  Once your final implant has been placed, it will have a softer, lighter, and more natural feel and appearance.  

Looking at your photo, it appears that you are recently postoperative.  This flattening is usual, especially since your previous atop the breast was used.  Allow the swelling to subside and the implants to settle for several months before your final results will be seen.  Thank you for your question!  Hope this helps!