Unusual Appearance to Breasts After Bottoming out Repair? (photos)

Im 5 weeks post op from a remove and replace with correction of bottoming out as well as a pocket repair on the left due to the implant sliding into the underarm area. I had NO breast tissue to start and went from 450 cc saline to 385 cc silicone gel.My left breast is noticeably larger to me and has a puffy area on the side below the underarm and my right breast seems to have been sutured in more on the inside cleavage and almost has a puckering appearance there. It is all pretty soft to touch.

Doctor Answers 8

Bottoming out Repair

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Thanks for your question and posted photos. On the frontal view that shows both breasts, the only one on which I can evaluate size, these look pretty even in volume, and the breast folds look even. 

I can see the irregularity on the inner side of the left (?) breast (some but not all appear to be mirror photos). It is not uncommon to see irregularities at the suture lines of capsule revision operations, and often these improve. 

Do discuss in person with your surgeon, but do also have some patience for several more months as you continue to heal.

Best wishes. 

Seattle Plastic Surgeon

Unusual Appearance to Breasts After Bottoming out Repair?

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I do NOT see unusual result in your posted photos. Maybe you need to discuss with your surgeon. But in my opinion you have a very nice result. 

Breast augmentation

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At five weeks you probably still have alot of swelling and you should give it a few months to heal.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

5 weeks post-op remove and replace

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At 5 weeks post-op you have residual edema that usually resolves around 2-3 months.  I do see what you are worried about.  The swelling you see on the left lateral breast may be from the extra work the surgeon performed (capbulorraphy).   Looks as if a capsulorraphy was carried out on right medial breast also tha tthat may be a the reason for the skin being tact down in that area, more so than the left medial.  I am not sure why the left breast looks that much larger, although it is too early to assess at this time.  That edema will more than likely resolve and the breasts be equal in size.  Try not to assess for another 6-8 weeks, if you can help it. The shape will change and hopefully for the better. 

Thank you

Nana N. Mizuguchi, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 55 reviews

Concerns after Revisionary Breast Surgery?

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As you have probably heard, it will take many months ( and even up to one year) for the breast skin to fully redrape  over the repositioned breast implants. Therefore, it is too early to evaluate the results of the procedure performed.  Some of the concerns you have may be related to issues such as “redundant” skin;  hopefully, these issues will resolve as the skin retracts back.

 On the other hand, some of your concerns may be related to ongoing breast implant malposition problems;  whether or not this is a case cannot be determined online. Physical examination will be necessary. Therefore, your plastic surgeon will be your best resource when it comes to providing you with more meaningful/specific advice.

 Best wishes.


Early result problems after repair of bottoming out and size change

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It's hard to say exactly what is happening here without a picture of what you had before and knowing exactly what was done internally.  But it looks like the suturing of your capsule to repair the bottoming out may be uneven and not far enough.  It looks like the left is bulging laterally above where it looks like the internal suturing stopped.  That in conjunction with some looseness at the upper muscle tail may be making the whole implant filling the upper breast more, so seems larger.  The lower inner right side also may have benefited from going higher up the medial capsule so there is less of a transition.  Stay with your exercises and this may all still resolve.  This could all be due to artifacts or exaggeration from swelling.

Myles Goldflies, MD
Seattle Plastic Surgeon

Puckering after repair

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You are probably tired of hearing this, but you should wait before you pass final judgment on your result.  Time is on your side.  I believe the depression on your right side will soften and possibly completely release over the next few months.  Good luck.

David Marcus, MD
Santa Rosa Plastic Surgeon
4.9 out of 5 stars 34 reviews

Funny contours after revising breasts...

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You do have a bulge laterally and if this was what was supposed to be fixed, you need to see your surgeon about it.  When having capsule surgery to improve implant position, I have my patients wear a cut out bra 24/7 to help support suture lines and when done that way, the healing usually preserves the new contours quite nicely.  If your breasts are different shaped, you do need to discuss this further with your surgeon.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 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.