9 Weeks Post-op Breast Lift/augmentation, and Breasts Are Terribly Uneven? (photo)

Question

9 weeks ago I had a lift/augmentation and my right breast has always been higher up and more deformed looking than the other. I thought by now things would have settled. I do not do the massage I was told to do - it hurts and I don't like to do it. Is that the reason? Do you have any suggestions? I will be back in Mexico for a tummy tuck in 3 weeks so I can see my doctor then, but in the meantime I am freaking out! Thanks in advance.

Richard H. Tholen, MD, FACS · Answer

Katie, I find myself so angry that you have chosen to put yourself in this situation (live in Canada, have surgery in Mexico, and ask trained, experienced plastic surgeons in the US and Canada who are donating their time to answer questions online). And that's not all!

	Your photo does indeed show one implant higher than the other, but you are wearing an elastic sports bra that covers your breast scars, and completely invalidates any assessment of implant position inferiorly near your (eventual) inframammary creases. It's impossible to know if the "high" implant is too high because it's pocket is not open enough inferiorly, if your "low" implant has bottomed out, or if you have early capsular contracture or inadequately-created pocket size. No one can give you good advice with this information or without personal examination, which is not possible when you travel out-of-country before ALL of your follow-up visits are complete. Did you receive a reduction of cost because follow-up is not included (nor even possible without more travel)?

	Finally, you admit you aren't following your surgeon's advice because "it hurts and I don't like to do it." What other recommendations or follow-up instructions have you decided not to follow? Surgery involves pain, swelling, discomfort, medications, limitations of activities, recommended healing measures like implant movement exercises or wearing of elastic bands, not wearing of bras, etc. Elective cosmetic surgery is not like picking out your desired operation from a vending machine, paying the money, and after some magical things that happen inside the machine, getting your "final result." It involves time and effort and compliance with advice on YOUR part. And, if you "don't like it" and choose to not follow advice and recommendations by the surgeon you traveled to and paid for the surgery, why would you even listen to "free" advice?

	I'm sorry, but you should be freaking out. I'm freaking out that you didn't learn your lesson the first time and anticipate doing this again for a tummy tuck. Is your Mexican surgeon so "cheap" that you are willing to risk even MORE "freaking out?"

	You should reconsider and see any of many properly-trained and certified plastic surgeons closer to home, both in Canada and the US. BTW, what is the cost of re-operation, re-do surgery, or treatment of complications? You can't get that online, and any monetary savings via surgical tourism is more than offset by even one re-operation for ANY reason.

	I'm sorry if this answer sounds harsh, but those of us plastic surgeons in border states end up taking care of all too many surgical tourists who think vacationing and elective surgery is a great idea, and a way to save money to boot! Yours is just a minor example of why this is totally erroneous thinking. What happens if you get a blood clot on the long flight home? Or an infection in your abdominal incision? Or dead skin or belly button from second-hand smoke in the Mexican airport? Who will you ask to "fix" those issues?

	Please rethink this and see a plastic surgeon in your own area to ask about your breasts, and find out about a tummy tuck by a local expert. Commit to following all advice, even if it hurts or you don't like it.  Even if you had the "King of plastic surgery of Mexico" as your surgeon (and somehow I doubt this if you're going for "cheap"), how can you get evaluation of any problem when you're in Edmonton, and your surgeon is in Mexico? Best of luck--I fear you may need it with the choices you are making. I truly wish you well. Dr. Tholen

Ali Sajjadian, MD, FACS · Answer

Dear Katie,

	I am sorry that you are not happy with your results and that you are having trouble due to your surgery.

	 

	With this photograph, it is not possible to provide you with an assessment. I believe that your best bet at this time is to share your concerns and inform your surgeon of the type of pain you have been enduring, especially when "massaging" your breasts.

	 

	At this point, your surgeon is the only one who could provide you with the best advise/solution as he/she knows the details of your surgery.

	 

	Best of wishes.

	Dr. Sajjadian

Martin Jugenburg, MD · Answer

Sounds like your surgeon is in Mexico and you live in Canada?  Perhaps it's lucky that you are scheduled to see him/her in 3 weeks again so that you can review your case with your surgeon.  On the bright side, you're only 9 weeks after surgery so your body is still going through changes and there is still a chance that the two sides will equalize over time.

Tom J. Pousti, MD · Answer

It will be in your best interests to discuss your concerns with your plastic surgeon who, after direct examination, will be able to give you good advice. It is possible that revisionary breast surgery will be necessary to improve the symmetry of your breasts; this may be something that can be done during your tummy tuck operation.

	Best wishes.

Remus Repta, MD · Answer

Hello,

Your photo shows the right breast higher than the left but we cannot determine the reason for this from your photo since we cannot see the lower half of your breasts.  If you are having a tummy tuck in the near future your plastic surgeon can take that opportunity to revise your breast surgery as needed.  It sounds like you will need to have your right breast pocket opened to allow the breast implant to sit a little lower.

All the best,

Dr Remus Repta

Fatema S. Alsubhi, MD · Answer

Thank you for the question,

	First of all don't be worried, everything can be solved.

	I think the massage that you were adviced to do could help on the first 6 weeks after surgery. Although, that can't guerntee  any improvement. Now, you are more than two months post op, so any nonsurgical intervention can help. Revision surgery for BA is relatively common, and still you need to be examined by the your surgeon, and most likely he or she will do it with your next operation. 

	Best of luck on your next operations

Steven Wallach, MD · Answer

Sorry to hear about your issues. It is difficult to answer this question without seeing pre-op and post-op photos. Since you are goind to see your surgeon in a few weeks, it is best that you review things with him/her to decide whether surgical intervention is warranted.

Mahmood Kara, MD - Account Suspended · Answer

Hello. 
Thank you for your inquiry and congratulations on your surgery! Final results will take longer.
It is important to have an in-person medical assessment regarding this issue as it is difficult to determine virtually.
Continue to update your doctor in the matter and follow their post-op protocol.
It is important to get cleared by your doctor before engaging in specific physical activity before the 3 month healing period has ended as the healing stage is crucial for healthy results.
It generally takes around 6 months to a year to see your final results. Your tissues will take time to relax and allow your implants to "Drop and Fluff" settling into place.
Our tips for recovery following breast augmentation are to wear a supportive sports bra for 3 months post-operative and refrain from lifting anything heavier than 10 lbs for 3 weeks as we don't want any strain at your incision sites. Make sure to keep the area of your stitches clean by cleansing with hydrogen peroxide daily. Showering is encouraged! But, no sitting in water for 2 weeks following surgery (no baths, hot tubs, pools etc.). 
Please note that this response does not substitute patient-doctor relationship.
We welcome any and all patients seeking advice to come in for a complimentary consultation available for limited time only.
During the COVID-19, we are offering complimentary online consultations as well as in-office consultation with social distancing and masks. Procedure done in-hospital private surgical facility while taking covid-19 precautions. We utilize UV-light to clean the air of viruses and bacteria during our consultations and surgery.
We invite you to come in to discuss your options more thoroughly.  Please send us an email at info@drkaraplasticsurgery.com with the subject line: "Attention Meagan" and we will be happy to coordinate your appointment!
M.Kara,MD,FRCSC (27+ years experience)
- Specializing in 24 hour recovery/ out to dinner breast augmentation in-hospital private surgical facility for your added safety and peace of mind

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