Fix for concave cleavage? (Photo)

Question

Had submuscular 457cc mod smooth round natrelle place 10 years ago. 6wPO revision-subfacial 485cc HP natrelle smooth touch. They have almost a concave shape at the top of the cleavage and worse when leaning even slightly. Right side is worse than left, can feel the implant sticking out of cleavage and the cleavage looks unfilled with any wired bra. Would pocket revision with internal bra fix? What procedure would have highest chance of success?

Daniel Barrett, MD · Answer

Dear Cool773544,
I understand your concern. However, without a proper assessment, it would be difficult to determine what is 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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Daniel Butz, MD · Answer

This might require a proper consult/physical exam to determine what the best procedure would be. 
I'd be curious to know why you changed to the subfascial plane. You upsized a few CC's but also went to a high profile implant - which is narrower with more projection.  This tends to be less optimal for cleavage. 
If they're sitting too lateral - a pocket repair could help improve the cleavage. But it also seems like you're seeing too much implant in the cleavage. Fat transfer could help but I would need to see you in person to determine that. Or going back to a moderate profile implant, which might give you less of that steep transition to the cleavage line.

Connie Hiers, MD, FACS · Answer

Your implants are large and you have little breast tissue to hide the implants. It would have been much better to go with smaller implants behind the muscle. Mesh might be helpful to give a little more tissue in the thin areas. Do not go bigger for this will look worse.

Sharon Y. Giese, MD · Answer

You can transfer fat into your breast / cleavage to give more volume to the cleavage area. You will need to get fat from another part of your body via liposuction.

Kenneth R. Francis, MD, FACS · Answer

Dear Cool,
A key piece of missing information here might be why did you  undergo a breast implant plane change from submuscular to subfascial 6 weeks postop.  You may benefit from a plane change back to under muscle.  Keep in mind that it is 10 years later and your breasts have aged as expected, look pretty natural and seem to move naturally as well.  Consultation with an American Board of Plastic Surgery board certified plastic surgeon for an examination and discussion of your options will give you some guidance.  Good luck!

Mats Hagstrom, MD (license on probation) · Answer

To make an assessment for the outcome of any plastic surgery procedure we generally need to see a complete set of proper before and after pictures.
We make assessments based on patient in an upright standing neutral position.
If you don’t have proper before and after pictures, then ask your surgeon to forward the pictures they took.
Without knowing what you look like before surgery, we can’t make an assessment regarding your outcome.
Not everybody seeking breast augmentation is an ideal candidate for this procedure if your breast sit naturally wide on your chest wall and they’re going to still sit wide on your chest wall, even if you get implants.
Follow up with your provider or schedule you in person second opinion consultations with other plastic surgeons in your community.
We can’t really make an assessment based on the information you provided.
For a second opinion consultation, always come prepared to bring with you a complete set of proper before and after pictures and a copy of your previous operative report.
These should be available from your previous provider If you request best,Best, Mats Hagstrom MD

Fix for concave cleavage? (Photo)

Answers (6)

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