What Type of Revision May Be Necessary?

Hi, It is most of the doctors opinion here that I may need an inferior release in order for my 325cc mod+gel implants to drop more after submuscular insertion (10 months post op vertical mastopexy).If so what is involved. Will it only involve a re-cut under the breast with no need to reopen any vertical scars etc, and merely a reposition of the implant and release of muscle?If so is there a danger of implants then dropping too far later on. Approx 20mm lower would be perhaps ideal?Thanks.

Doctor Answers 2

Breast revision surgery

Thank you for the question and pictures.

I think that you may be correct in that “lowering” the breast implants may be sufficient to improve your results. This can usually be done through a small section of your previous incision lines.

If revisionary surgery is decided upon, it will be very important to communicate your size goals with your surgeon.  In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or “C cup” or "fake looking" means different things to different people and therefore prove unhelpful.

Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.
I use  intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the press implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison.
I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible.
By the way, the most common regret after this operation, is “I wish I was bigger”.

I hope this helps.

San Diego Plastic Surgeon
5.0 out of 5 stars 1,487 reviews

Breast Implant Revision

It is difficult to say exactly what is going on here without examining you.  At first glance, it looks like your implants are larger than 325cc, but apparently they are not.  Perhaps you had large breasts before your augmentation/lift, and even 325cc implants are "filling" you up more than is ideal.  I cannot tell if the bottoms of your breast are not filled out by the implants because the implants are simply too high, as they appear to be, or whether there is scar tissue causing the indentations in the lower poles of your breasts (worse on the left side) or perhaps missing tissue due to the way the vertical mastopexy was performed.  If the implants are high and not filling out the lower poles, then release or excision of the scar tissue capsule and repositioning the implant lower would help, and this would only require a recut under the breast.  However, if the lower portion of the breast does not expand with this maneuver (due to the scarring at skin level, a too-low nipple position from the last mastopexy procedure, etc.), then your tissues may need to be reshaped with a redo mastopexy.  If your tissues are just not going to "give no matter what you do, and the implants are repositioned lower but you STILL have an unnaturally overfilled upper pole contour, then perhaps you need to put in much smaller implants! An examination by a qualified plastic surgeon would give you more information. 

Robert M. Grenley, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 87 reviews

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