Will I Need to Have Revision Surgery? (photo)

I had breast augmentation surgery 11 months ago, I got 550cc HP Silicone implants under the muscle. My right implant settled fine but my left implant never did, so I went back to my surgeon who did an in-office procedure called open capsulotomy 6 weeks ago and i was advised to wear the strap, which i did but I still else to see no difference and my nipple is really low. I dont know what to do. This is depressing. I hvent been able to enjoy my implants since I got them. Any Advice?

Doctor Answers 11

Revision Needed-Jonathan H. Sherwyn, M.D., F.A.C.S.

Unequivocally, this is the result of inaccurate position and placement of the implant. With implant surgery, the breast implant drives the position of the nipple and your implant is malpositioned to a higher location which is driving your nipple downward. The postoperative use of straps can not correct this. This can be the result of improper technique and inadequate pocket design or contracture of the pocket itself.

New York Plastic Surgeon
4.7 out of 5 stars 8 reviews

Will I Need to Have Revision Surgery?

    If the implant truly never descended then the pocket will have to be opened and opened more generously than during the first revision.  If you are happy with your right breast, then a lift may not be necessary.  Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 496 reviews

Revision is Necessary

You will need revision to achieve a better breast shape.  This will require a capsulotomy (internal softening) to help the implant settle in a lower position.

Dr. ES

Revision surgery for high riding implant

Your asymmetry will have to be addressed if  you cannot live with it. Your surgeon should be able to educate you as to what happened during the first surgery and why the second surgery was not successful. Any revision would necessitate a removal of the scar tissue in the breast, change of implants and thorough release of the lower breast tissue to allow the implant to sit lower in the pocket. I'm not sure you really need a lift. I suspect you just have a short distance from your nipple to the breast fold. Another option is reducing the size of the implants to better fit your chest wall. I am sorry you are having this problem. It is very frustrating. If you would prefer to not live with the asymmetry until the scarring subsides a last option is to remove both implants now and redo the surgery in a year or so.  Best of Luck  Dr Harrell

Jon F. Harrell, DO, FACS
Miami Plastic Surgeon
4.9 out of 5 stars 49 reviews

Will I Need to Have Revision Surgery?

Yes you will ned a lifting operation plus open capsulotomies to achieve a better appearing breast. Seek in person second opinions. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 174 reviews

Capsule issue

It looks like your implant is still too high. It would have been helpful to see your original pre-ops as well. Best to follow closely with your surgeon.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Revision breast surgery

It looks like you will need type of revision based on your photos.  As others have mentioned, it is hard to say without an exam but it looks like you may have encapsulated again.  I would go so far as to say that you may need a breast lift to get your nipples more symmetric and centered.  You should certainly discuss with your plastic surgeon what your next step should be. Good luck!

Tiffany McCormack, MD
Reno Plastic Surgeon
5.0 out of 5 stars 40 reviews

Revisional Breast Surgery

There are a couple of concerns in your photo.  A breast lift may be considered along with implant repositioning or capsulectomy.  A breast lift may have been discussed but not desired at this time.  I think discussing your concerns with your plastic surgeon is needed.  Your left implant has too much upper pole of chest fullness and needs to be revised.

Thomas P. McHugh, MD - Account Suspended
Houston Plastic Surgeon
3.6 out of 5 stars 22 reviews

Breast Revision Surgery

Based on your photos, it appears you may need breast revision surgery.  Schedule an appointment to discuss this with your Plastic Surgeon.

Robert E. Zaworski, MD
Atlanta Plastic Surgeon
4.8 out of 5 stars 62 reviews

Will I Need to Have Revision Surgery?

Unfortunately, it does appear from this photo that you'll need a revision.  You may need to have some scar tissue removed or adjusted (a partial or total capsulectomy or capsulotomy) in order to have the implant repositioned correctly.  A capsultomy alone may not be adequate or may need to be done more extensively.

Sorry but I hope that this helps,

Dr. E

Alan M. Engler, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 125 reviews

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.