Breast reconstruction after breast reduction? Had reduction when I was 18 years old, I was a 36H cup. (photos)

Question

I got a breast reduction when I was 18.I was a 36H. Post surgery I ended up w/ lots of scarring, large areolas & asymmetrical nipples. I'm so insecure about them. Im 26 and thinking to get breast reconstruction surgery.my questions are: By the pictures, do you think I got botched? Would you suggest breast reconstruction surgery or breast augmentation surgery? Not sure if I'll have kids, but should I wait to see if do before the surgery? Any other additional information is MUCH appreciated ☺️

Gary M. Horndeski, MD · Answer

The
technique I recommend is The Bellesoma Method. 
This will reshape your breast tissue creating upper pole fullness
without implants, elevate them higher on the chest wall and more medial to
increase your cleavage.  Vertical scars
are avoided, nipple sensation and the ability to breast feed are maintained, if
not injured during your previous surgery. 
At the same time or later, fat transfers can be performed if additional
volume is desired.Best Wishes,Gary Horndeski, M.D.

Daniel Butz, MD · Answer

Based on your photos it appears you have a very acceptable breast reduction result. Everyone scars very differently and it's important to explain that ahead of time. Your scars are a little wide but this is likely due to your genetics. If you were to undergo a revision I would recommend using something like embrace to try to counter your tendency to widen. The areola stretch a varying degree and this can be asymmetric at time. Areola, like breast, are never symmetric to begin with. Performing a small periareolar lift might be able to reduce the areola size and improve the symmetry to some degree. An aug would give you more upper pole fullness and a perkier look. I would talk to your surgeon about your concerns but understand that it's impossible to do surgery without leaving scars.

Omar Fouda Neel, MD, FRCSC, FACS · Answer

Good day Snowbunny88,Thank you for your photos and questions.  Just from looking at the photos it does not appear that you were "botched".  Scarring and healing is very individual and unique, and this should have been explained to you.Depending on what you're looking to have done, breast augmentation and breast lift will make your breasts more "perky".  If your areola(s) bother you and feel asymmetrical this is something that can be discussed with your surgeon and possibly fixed.  It is advised to consult a board certified plastic surgeon, take the time to discuss your surgical options and have them explain the possible outcomes.Best of luck

Nick Masri, MD, FACS · Answer

Thanks for your question, snowbunny88.
To be honest, I don’t think that you had a botched surgery. Maybe you and your former plastic surgeon haven’t really discussed and managed your expectations when it came to breast reduction. Scarring is also highly dependent on genetics and ethnicity, so the amount varies from person to person.
Anyway, if you want to make your breasts perkier, I suggest doing a breast augmentation with lift instead of breast reconstruction surgery. It all depends on what you want to achieve.
It’s always better to wait until you have kids, but skilled surgeons will make sure that you’re still able to breastfeed even after your surgery if that’s your concern.
It’s best to go to a reputable and board-certified plastic surgeon for a personal evaluation.
Best of luck!

Susan Buenaventura, MD, FACS · Answer

It sounds like you are interested in revising your breast reduction.  You can have the areolae reduced again, to about 4 cm, excess skin from the bottom of the breast removed and the scars revised.  This will make your breasts more lifted, improve the shape and make them look younger.  It is not possible to do surgery without scars, and healing has many factors.  I think you can proceed now with a revision to create breasts you are happy with.  I wouldn't recommend implants unless you want to go up a cup size or more.  Best wishes.

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