Follow-Up/Addition to previous post/question. - Breast Augmentation Dissatisfaction. (Photo)

This post is in addition to my previous post/question. I thought I should add pics showing what the breasts look like when laying down. I've experienced wrinkly skin, additional large stretch marks & the breasts fall to the sides, nearly under my arms. This is post op 1 year. Please see both posts. Thanks!
This is a follow-up to an earlier question. Click here to read it.

Doctor Answers 7

Pocket revision

The pocket may need to be modified if the implants fall so far out laterally. Best to be evaluated in person.


New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Follow-Up/Addition to previous post/question. - Breast Augmentation Dissatisfaction.

As stated in your first question- ONLY re operation can impr9ve the results. Fees from $8,000 would or should be anticipated.

Secondary Surgery

Hello,

Your implant pocket may be too large and/or you may require a breast lift to address excess skin. Stretch marks cannot be treated surgically unless the affected skin is actually excised. They cannot be prevented or predicted,.

I recommend that you speak with your Plastic Surgeon in person and plan for revision with a physical exam and discussion of goals.

All the best

Implant displacement.

The issues you are having is implant displacement or malposition. The pocket which the implants sit in is too large which allow the implants to shift to the sides when you lie down. Correction requires tightening the internal pocket. In some cases, the addition of a dermal matrix is necessary which prevents the implants from stretching out the pocket again. This requires an operation to correct.

David Bogue, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 19 reviews

Post op

I have looked at your other post and these pictures. You need to include some preop photos to be able to give an informed opinion. It is not unusual for there to be some excess skin in what looks to be a vertical only scar uplift.
Overall you have a pretty good result and of course one could always revise / improve things but you must realise that things will continue to age - both the breasts and the implants. You must also realise that you may never be able to 100% get what you want in the long term as you cannot hold the same result for ever.
Yes you could raise the fold - excise the infirmary skin and create an internal hammock to try and raise the footplate of the breast - with a capsulotomy / capsulorraphy you could raise the implants and you could also consider a larger implant. You could also elevate the nipple height. All of this would require a complete revision - opening all the previous scars and creating new ones. 
In deciding whether this is for you - you need to consider what you have already and the pros and cons of a revision. At the moment I would question whether now is the right time to consider a revision as the result is pretty good.
I would see your PS again and I would get a second opinion with a face to face consult with an experienced surgeon who can run through the pros and cons. 

Gary L. Ross, MBChB, FRCS
Manchester Plastic Surgeon
5.0 out of 5 stars 142 reviews

Breast Augmentation Dissatisfaction; Displacement

I am sorry to hear about the problem you are experiencing. Based on your description, it seems like you are dealing with a breast implant displacement/malposition problem. Generally, these types of complications are treated surgically with an adjustment of the breast implant capsule (capsulorraphy).  This procedure serves to decrease the size of the pockets and moving the implants toward the midline. In my practice, I use a 2 layered suture technique to close off the space laterally (towards the axilla). The use of acellular dermal matrix is an option ( although not usually necessary) especially if significant implant rippling/palpability is present.
 
You may find the attached link helpful to you as you learn more. Best wishes for an outcome that you will be very pleased with long term.

Breast Augmentation Dissatisfaction.

So there are a number of issues to consider here and the answer is not simple.  There is also more information that would be helpful such as your pre surgical photos and what was your goal size..  There are some patients who have loose skin and loose breast tissue.  In this case there are many issues to consider.  Anyhow..in my opinion, you will need revision surgery to try to achieve your stated goals.  What you need is to make your breast envelope smaller..translation..more aggressive lift...translation...an anchor-shaped scars.  In terms of the size, you can also go to a larger implant but that will correct some of the problem such as loose skin but you will then just have larger breasts that fall even more to the side and droop more.  My suggestion is to have a revision with a more aggressive lift.  Hope this helps. Good luck.
Dr Vasisht

Bhupesh Vasisht, MD
Voorhees Plastic Surgeon
5.0 out of 5 stars 77 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.