You have a very nice augmentation result, but I can see why it does not meet your wishes. The implants you have aren't available here in the States, but there are several good options for your revision. First you should be evaluated to rule out capsular contracture, but from your pictures this seems unlikely. Most augmentations of the size & profile you're requesting with a round implant provide a convex, less natural result, especially in the sub glandular position. One option is to have a smooth round silicone device in the subpectoral position, which would give a more natural upper pole slope. Another option would be a cohesive gel, anatomically shaped implant which imparts a natural upper pole slope, and could be placed over or under the muscle. Either way, you could have a very natural-appearing, beautiful result. Best regards,
-Erik Hoy, M.D.
Thank you for your question. I'm sorry you are disappointed with your results, but there is hope. The implants you have are likely made of highly cohesive gel, making them more stiff than other types of gel implants. For some women, this is a good thing. For you, it's not. The textured surface of your implants mean they aren't as mobile as smooth-surfaced implants, which is why they don't move as naturally as a smooth-surfaced implant. To address these two issues: stiffness and immobility, I would consider changing to round, smooth gel implants.
Now, to address your desire to have a large implant placed---that may be a bad idea. You are quite thin and appear to have little tissue coverage over your implants. In addition, the size you have appear wide for your chest wall--going larger usually means going wider, and that would make you appear to have "side-boob" or "uni-boob", neither of which is ideal. There may be options for you, but you'll have to carefully discuss them with your surgeon, who should make decisions based on your tissue thickness, chest wall shape, and desired size.
Nagor implants are not available in the US. But from your photos and your story, it appears you have a high profile implant that is most likely one of the higher cohesive gel types. In small breasted women, these can feel stiff and unnatural. It does not appear that you have a capsular contracture, but the type of implant may be causing these issues. Textured implants do not move around in the breast pocket the way that smooth implants do. You may be better off changing the implant to a Mentor MemoryGel or Allergan Natrell smooth, round gel type of implant which is softer and more flexible. These will also allow the breast pocket to settle so the breasts are not so high. You can still achieve a very projected, large and augmented look...but it most likely will be much softer.
Dr. Salvatore Pacella
I am sorry you're disappointed with the results. Based in your photograph your breasts do look symmetrical. The first thing is to rule out a capsular contracture. If you do have capsular contracture then a significant revision is needed. On the other hand cohesive gel textured implants do feel firmer and less mobile than smooth walled breast implants If this is the problem simply replacing your current breast implants with smooth-walled breast implants may be all that you need.
For more information on breast augmentation please read the following link:
Thanks for your question.
First of all, let me try to cheer you up a little: that is not a bad breast augmentation outcome. They look pretty good and the size is harmonious with your body.
That said, here is why the pre-op conversation has major value in understanding what the patient wants and making sure the patient and the surgeon are on the same page (I normally put my patients the awkward task of looking for what they consider "ideal breast" on the internet, so I understand what are they looking for).
In your case, you seem to be a very slim lady and probably (assuming) you had very little breasts. In these cases, if the patient is looking for a natural appearance, then the surgeon must grab on to tools like an implant with less projection and/or placing the implant in a submuscular position. That way, the implant won't be so apparent ("fake look") specially in the upper pole of the breast.
Again, I completely understand it's not what you expected but it's still an aesthetic outcome.
Hope I cleared your mind of your doubts. If not, feel free to contact me at any time.
Take good care of yourself,
Dr. Fernandez Goico