6 Weeks Post Op Breast Augmentation. Can This Be Fixed? (photo)

Question

Not happy with right breast! Too soft on inside and bottom... Left looks better. Ps can revise.. What should I expect? Can't wear low cut bra shirt or bathing suit.. This was reason I got lift with silicone unders...

Vincent N. Zubowicz, MD · Answer

The picture demonstrates very little subcutaneous fat or breast tissue to camouflage the normal occurring undulations in a breast implant. I'm not certain the problem can be solved by revisional surgery. Fat grafting of the area would be a consideration.

Angela Champion, MD · Answer

Although it's hard to tell with the photos you provided in a bathing suit, it appears that your right breast may need to have the pocket tightened with a capsulorrhaphy, but again pre-op photos and photos without bathing suit on would be more helpful. It's too soon for a revision because your breasts will continue to change up to 3-6 months. Try to be patient and continue following up with your PS and go from there. ac

Darryl J. Blinski, MD · Answer

Photos are of NO help! Best to be seen IN PERSON by your surgeon or second opinions!!! And YES very early to be considering revision.

Jeffrey Zwiren, MD · Answer

It is a little early to consider a revision but looking at your photos it appears that you are very thin. The more soft tissue that covers the implant the more natural the appearance. Your result may be about the best you are going to be able to achieve with implants alone. If you what some improvement it is possible that you need to consider a breast lift. Hard to know without an examination.

Joseph L. Grzeskiewicz, MD, FACS · Answer

I have a few general comments that I can offer; more specific recommendations are hard to make on the basis of limited information and photo documentation. First, 6 weeks is VERY early to plan a specific revision. While you may already see things that you don't like, and those things may not change with time, there will be other changes in the breast tissues over the next few months, and those could affect the overall results of any revisions done prematurely. Second, you have VERY little body fat and native breast tissue, and this makes creating a soft contour to the breasts difficult if not impossible. Based upon your appearance in these images, I doubt very seriously that you would be a good candidate for autologous fat transfer to camouflage the implants because you don't appear to have enough fat to harvest for an adequate graft. Sometimes we can use a kind of graft material called "ADM," or acellular dermal matrix, internally in the pocket to create some thickening of the pocket and hide ripples of the implants, but this does not provide volume, and I would say that its usefulness in this setting is questionable. Third, from the images that you have shown, you appear to have an asymmetry, not only of the breasts, but of the chest wall too, and this is very common. In fact, as we speak I am getting ready to operate on a young lady with a similar chest wall asymmetry. The right side of your chest, the right hemithorax, is wider and has different bony architecture than the left. This in turn will create some differences in the way that the soft tissues, like muscles and breasts, will drape over the underlying scaffolding of the skeleton. This can often be camouflaged, but sometimes only partially, and an asymmetry will persist. The one truth in the matter is that if it is not recognized and planned for, the only way that it will be corrected is through luck! Lastly, it is hard to tell about the actual breasts as you have only shown images with your clothing on. Thus things like breast projection asymmetry and nipple position asymmetry will be impossible for us to assess, and these things are very important when discussing revisions like we are discussing here. Additionally, there may be entirely different "tone" or elasticity between the two breasts based upon differences in breast glandular tissue amounts, fibrous ligament amounts and tone, and the like, and these things will definitely contribute to what we're seeing here. It is impossible to assess these things over the internet at all, let alone from the limited pictures we have here. Based upon what I am seeing here, I might be likely to suggest that all you will need (or rather should have done ) would be some kind of lifting procedure to the right breast to improve tone and projection, position the implant a little more medially, and cover the now apparent rib architecture a bit more. It may be impractical to attempt anything more aggressive as it just may not be possible to gain much from it. The bottom line is that you need to have a very thorough evaluation with a board certified surgeon who is very experienced in not only primary breast surgery, but revisional breast surgery as well, because you really want things done right the first time. The reason why I have gone to the trouble to give you this lengthy discussion is that I hope to impress upon you and any other ladies reading this that this type of surgery is not just a "cut and dry," " cookie cutter" type of thing. It requires a thorough understanding of anatomy and the way that it is changed with the various surgical techniques we use and a careful detailed analysis of the individual factors involved in each individual case. You can certainly "shoot from the hip" and try things out; putting in breast implants as a technical exercise is not that difficult and most plastic surgeons can do this easily. Rather, to get excellent results reliably you have to spend the time and effort to set yourself up for success and plan things appropriately. Give things another couple of months to heal, and then get a good consultation, if not with the original surgeon, then with someone who can really sink his or her teeth into your case. I hope this helps. Good luck.

Remus Repta, MD · Answer

Hello Italian princess,

	Thank you for the question and the photos.  There are various implant revision procedures available and there is one or more that will provide the result that you want.  Based on your information and the swimsuit photos you provided there are two issues which are likely to be present.  The first is the thickness (or lack thereof) of your existing breast and subcutaneous tissue.  The second is likely the implant pocket, meaning the pocket may be overdissected on the side, underdissected towards the center, or both.  There is the potetential for a third issue which relates to the width of the implant but since you are happy with the other breast shape that is less likely the problem.  The implant pocket can be repaired with a capsulloraphy (pocket repair).  The thickness of your tissue can be addressed with far grafting or ADM (acellular dermal matrix).  Hang in there.  There is a solution out there for you.  Discuss these with your plastic surgeon as well as your goals.

	All the best,

	Dr. Remus Repta

Raj S. Ambay, MD · Answer

It can be fixed if need be. However, I think that 6 weeks is too early to make a definitive decision. Wait at least 3 months before you decide to consider a revision.

Pablo Prichard, MD · Answer

Dear Italian Princess,

	Thank you for your question/photos.  Yes, this can be fixed.  You seem to be very fit with very low body fat.  This make you very difficult as every little imperfection shows.  In fixing this issue, (which appears to be an issue of rib exposure rather than implant rippling). I would choose a wider implant and dissect the pocket more toward the cleavage point (i.e. lift the muscle up more centrally) to get the implant to sit more toward the center of the chest to give good cleavage.  This can be done too far, however, and needs to be done causciously to avoid symmastia.  The following is a photo of a somewhat similiar patient who needed extensive lifting of the muscle to get the implants to sit toward the center of the chest.

	Best Wishes,

	Pablo Prichard, MD

Katherine Feliz Camilo, MD · Answer

There is always the possibility of doing a revision of a breast lift surgery . Most doctors will agree on waiting at least 6 months to let the tissues heal and obtain the best results .

	Best wishes

Dennis Dass, MD - Account Suspended · Answer

Breast implant revision surgery can be performed about 3-6 months after a previous surgery. Revision surgery may involve adjusting the breast implant pocket by tightening it, placing an acellular dermal matrix to improve support and reduce rippling, and fat grafting to improve rippling.

6 Weeks Post Op Breast Augmentation. Can This Be Fixed? (photo)

Answers (12)

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