Uneven Results After Capsulectomy of 30 Y/O Unilateral Implant on Right Side. Will Two Revision Be Enough? (photo)

Five weeks ago, I had a capsulectomy of a 30 year-old unilateral implant on right side (done at ~age 20 for symmetry), along with BL and BA on both breasts. Very uneven results (see photos). Surgeon now says the right breast has scar tissue keeping the new implant from dropping, so revision #1 will correct that. Later, after we see the result of that, I will have revision #2, which will include at a further lift on the left breast. Will these revisions be enough to achieve reasonable symmetry?

Doctor Answers 9

Breast asymmetry and revisions.

From the photos you have provided, it appears the your right breast has a very natural appearance. If you have a true capsular contracture, the question is whether it bothers you. You left breast is ptotic and appears to need more than the "crescent" lift you seem to have been given. If you are happy with one breast, I would recommend correcting only the breast you are unhappy with.

Boca Raton Plastic Surgeon
5.0 out of 5 stars 25 reviews

Assymetry post aug

It seems as though your right breast is bigger and your nipple areolar complexes are differant.I think this can be accomplished in one stage especially if you are niot a smoker.If you are staging a reconstruction is better.No one in my 34 years has been symmetrical.

Robert Brueck, MD
Fort Myers Plastic Surgeon
4.9 out of 5 stars 64 reviews

Revision lift

Perfect symmetry is impossible. Certainly things can get closer, I suppose it depends upon the surgeon you choose.

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

Asymmetry following breast surgery

It is very difficult to give you an absolute answer to your question.  You do have a fair degree of asymmetry.  If you are happy with the right side I would recommend a breast lift / reduction of the left side to achieve a more symmetrical result.  You may be able to tell if your implants are subglandular or submuscular by placing your hands on your hips and pushing down firmly.   If the implant moves up and out then the implant is most likely submuscular.  I hope this helps you.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 19 reviews

More surgeries

You have uneven breast because you had very uneven breast to start with. You will need full lift and reduction over the left breast for symmetry. I would wait at least 6-8 weeks.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.7 out of 5 stars 124 reviews

Uneven Results After Capsulectomy

I am not sure why so many "planned" revisions are considered. 

It does appear that the implant is not filling out the lower pole of the breast, but at 5 weeks I would not rush to surgery, as the implant can take 3 months or so the settle. 

At that time, something should be considered to get the sizes even. Either a larger implant or a reduction on the left. I think those can be done at the same time. Yes, another revision may be needed, but that is automatic if the procedures are separated.

All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.6 out of 5 stars 45 reviews

Breast revision

It's hard to tell from the photos but it really doesn't look like the problem is with the implants as much as it is with the dramatic tissue asymmetry you possess.  A bliateral full lift will make you much more even and the larger breast needs to be reduced down to match the smaller one.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

Asymmetry 5 weeks after unilateral breast implant capsulectomy

Hello 'mellj', thanks for your question.  Based on your description, it sounds like you have a complex history of breast asymmetry issues.  If the original implants were placed to correct a baseline asymmetry, it is usually very difficult to perfectly match the two sides despite reconstructive surgery.  The fact that you had your implants in for 30 years is notable since as you may know, the lifespan of most implants is 10-15yrs, and rarely to 20 years and beyond.  Once implants remain that long, the risk of rupture and capsular contracture becomes significantly higher.  Unless I misunderstand your description, I am curious why you did not have bilateral capsulectomies with bilateral implant switchout at your second surgery?  Other things that would be helpful to know are whether your surgeon has two different sized implants placed, and whether he used any acellular dermal matrix to add support to your breast envelope and implant pocket.  Regardless, I think 5 weeks is still too early to jump to any conclusions and you need at least 6 months to let things 'settle'.  If you still have significant asymmetry at that time, you can address your concerns with your doctor and discuss further revisional surgeries.  Although correcting asymmetries can be a challenging problem, your board-certified plastic surgeon should be well-trained and adept at handling these complex situations to help you achieve better symmetry. Good luck! -Dr.92660

Parviz Goshtasby, MD, FACS
Newport Beach Plastic Surgeon
5.0 out of 5 stars 2 reviews

Uneven Results after Capsulectomy 5 Weeks Ago

   It is hard for a patient to provide all of the necessary information in a forum like this, and an exam is not possible.  I think that at 5 weeks waiting until at least 3 months postop would be prudent to determine implant position. If any implant pocket alteration needs to be done, it can be done with the breast lift at that time.  Kenneth Hughes, MD Los Angeles, CA

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