Why Won't my Surgeon Do my Breast Revision the Way I Want?

Breasts are assymetrical post lift/reduction with 400cc silicone implants done over 1 yr ago. Left breast is still 100cc larger than right sits lower & moving towards armpit in pocket. Dr has agreed to redo the lift on left, tighten the pocket but wants to remove more breast tissue instead of putting a larger implant on the right to even out. I prefer fullness of left and want right implant increased by 75-100cc but he won't do this. Is there any reason why?

Doctor Answers 5

Revising Combination Breast Implant-Lift Surgery

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When it comes to revising the combination procedure of augmentation-mastopexy (implants-lift), of which the revision rate is quite high, there are numerous variables that come into play. As you have pointed out, you can remove more breast tissue, tighten the lift by removing more skin, or increase the size of the implant. Any or all of these may be acceptable and there are advantages and disadvantages to using the different approaches to a breast lift-implant revision surgery. While you would prefer to exchange an implant for a bigger size, your plastic surgeon has recommended otherwise. I would make the assumption that he/she has a lot more experience in doing this surgery and has a good reason for making a recommendation that you do not prefer. I would suggest you sit down with your plastic surgeon and discuss your differences. Unless the final result is perfect, and it is likely that it won't be,  you will never be happy with any outcome unless you understand and agree with the revisional plan.

Reduce larger breast or augment smaller breast

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The best person to ask this question to is your surgeon.  It looks like you are definitely having surgery to your left breast to lift it and so it would not be too difficult to reduce it at the same time.  If your surgeon were to change the implant on the right, then that would increase your risk of complications because you would be having surgery to both breasts instead of one.

Of course it is your decision because they are your breasts, but I would be more comfortable doing what your surgeon is suggesting, to just operate on the one breast and remove some tissue when doing the lift (or put a smaller implant in).  However, if you are not happy with the plan, go back to your surgeon and do not go ahead with it until you are satisfied that it is going to be the right operation for you. 

Good luck.  Jonathan Staiano

Agreeing on a surgery plan

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Hello, Your plastic surgeon may be concerned about the additional weight of the larger implant. You should be able to discuss this with your plastic surgeon to arrive on a plan together. Ask him/her the same question and discuss the advantages and disadvantages of both plans so that you can both agree on the best plan for you.

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 173 reviews

Why Won't my Surgeon Do my Breast Revision the Way I Want? Answer:

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Hard to say. Many times when redoing a lift, tissue is removed from the breast and by doing this,  it would make your left breast smaller. But if you want to keep the size you have now, he would have to go to a bigger implant, which is harder to keep in place with suturing (which it sounds like you need on the side and bottom)  and which means he would then need an even bigger implant on the right as well…Sounds like a lot of changes and extra cost…

John J. Corey, MD
Phoenix Plastic Surgeon
4.7 out of 5 stars 48 reviews

Breast asymmetry after Augmentation/Lift

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Your plan sounds fine but your surgeon may be worried about placing a larger implant on the right.  Large implants have a higher risks of "bottoming out", breast sag, implant malposition (moving over into your armpit), and rippling.  There is no definite size that this risk increases but many plastic surgeons believe it is at about the 400 cc mark.  Good luck!

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.