Is been 4 months since my subglandular BA with high profile 350cc textured implants. Is it too early for a revision? (photo)

Dear Lola73, I'm sorry you've had a troubling time regarding your surgery. Breast augmentation has one of the highest patient satisfaction rates and I'm sure with a minimal revision, your surgery will prove satisfactory as well. Subglandular implants tend to have a very attractive appearance with very pretty definition, however they do tend to have slightly less support than a submuscular placement. This is especially true with a larger implant, and migration can occur. The textured implants due to their frictional coefficient do tend to minimize implant mobility as long as the pocket disection for the implant has been precise. In your situation, what needs to be done is either a capsulorophy (a tightening of the pocket) along the lateral and inferior aspect, or a change to a submuscular position with a new pocket. Timing of this reoperative procedure varies greatly from surgeon to surgeon as well as in the literature. A change to a submuscular placement can be performed earlier. However for a capsuloraphy, a more mature well formed pocket lining, i.e. capsule is necessary. As you are four months out now, this procedure can likely be done now. Most cosmetic surgeons with a complication this early would perform this revisional surgery at no or minimal revisional cost. Best of luck, I'm sure in the future a more satisfactory result may be obtained. 

You should wait 6 months before considering any revision surgery. Speak with your plastic surgeon regarding your concerns

Thank you for your pictures. I think you have one pocket that is slightly larger than the other.  This will require surgery. How this is worked out in reference to cost is up to the surgeon.

When can revision surgery be performed to correct a breast augmentation problem? As soon as it is recognized and the tissue has healed sufficiently to undergo the specific corrective procedure.Based on your photos it looks like the pocket of your right breast has shifted "down and out". Four months out from surgery I am unaware of anything other than pocket revision surgery that can correct this.When researching a plastic surgeon you should always ask about complication and revision rates (how frequently they occur).  ALL plastic surgeons have complications, unexpected problems, and unfortunate outcomes. This does not necessarily mean error or incompetence on the part of the surgeon because there are some components of the healing process that are out of everyone's control. However some surgeons tend to have more complications than others and every patient should know before surgery what their chances are for needing another surgery.Patients should ask how frequently revision surgeries are necessary and what the policy is regarding payment for the surgery. Typically there will be more costs - it just depends on your surgeon as to how much that will be.

Normal breasts will fall to the side when lying down. The larger they are, the more they will fall to the side. Large breasts that are the result of implants can also fall to the side when lying down. The primary reason is a pocket that is larger than the implant, allowing the implant to move laterally. It is a difficult situation to correct unless you were to consider getting new implants which had a wider base with the same amount of projection.  Your results are very acceptable. The best scenario you could hope for from your surgeon would be for your surgeon to do the next procedure without a surgeons fee, but most of the time you would be responsible for implants, facility fee and anesthesia fee.

Appears as over dissection of the lateral pockets. Revision by the initial surgeon in my practice no fee from me but a fee for operating suite and anesthesia provider (approx $3,000). Best to discuss with your surgeon... 

I am frankly having trouble seeing a problem here. Natural or implanted breasts fall to the side and the cause is gravity.  Your areolas seem to be rather widely separated, and that will exaggerate the effect. Four months is not to early for a revision, but I do not see any indication for one. Fees are determined by the surgeon, so an opinion from surgeons this site will not be applicable.  Almost all surgeons charge for operating room and anesthesia. Professional fees will vary from zero to full price.All the best. 

From your photos, the right implant appears to be displaced laterally and inferior laterally.  This will require revision surgery to reposition the implant and reinforce the pocket.  you should discuss your concerns with your surgeon and address their revision policy, which should have been discussed preoperatively.  

Hi Lola. The first comment that I would make is that the last photo in the series - the one in which you are standing up straight, actually looks fine. Overall the implants appear to be well positioned in each breast, and the breasts look relatively symmetric. In the photos in which you are laying down the implants do fall out to the side a bit. This is not at all uncommon. Without seeing your photos from before surgery and without examining you it's hard to give a great answer, but this is seen in few different settings. First, if you had a loose skin envelope prior to surgery (as we see in patients who have breast fed or lost weight), then you might not have had good support to keep the implants from falling out to the side. If you had a tighter breast but the surgeon opened up the pocket too much along the sides then the implants can drift out. The third scenario is someone who has a great result for several years, but the implants slowly shift out to the side. Obviously not your situation. You can certainly address this by suturing the pockets tighter to shift the implants  closer to the middle of your chest. The issue in your case is that this may have a bad impact on your nipple position. Looking at your photos of you standing upright you can see that your nipples are already positioned out towards the sides of your breasts. If you shift the implants closer to the middle of your chest the nipples may look too far out and that's not a pretty look. See your plastic surgeon and go over your options. If you don't like the answer you get then get a second opinion. Four months out is a reasonable time to start having these conversations. Good luck.Dr J

It appears that your breast implant pockets are too large which allows the implants to follow the side and also to the bottom.  A revision is required to fix this.  I would wait until 6 months.  You'll have to discuss with your surgeon any financing arrangement.