Breasts Don't Look Right After Augmentation

I had PS breast augumentation and lift in July 2010 with basically same results as pictured. Flew to PS in January 2011 b/c he said implants needed to be "dropped" in place. He opened me up, found tissues around nerves- oh! so, the intense pain I'd had WAS real, and also ended up re-doing the lift.

Now,PS sees results of recent (March 2011) photographs, and says I just need to come in and have the implants dropped! I think it's more complicated. SOMETHING IS NOT RIGHT!

Doctor Answers 14

Breasts don't look right after lift and augmentation

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Your results demonstrate the 'waterfall deformity' that is often seen after an augmentation/mastopexy in which the implants have been placed under the muscle.  The muscle holds up the implant, but the breast sags below. This sets the stage for numerous revisions of the lift, and is the main reason for the great number of poor results with this procedure.

We are all well acquainted with the advantages of retropectoral (under the muscle) placement of implants. In the US, in particular, surgeons have been forced to go under the muscle because they have been largely restricted to saline devices.

However, I firmly believe that if you want the implant to stay together with the breast over time, you need to put them together in the operating room. For this reason I nearly always place a tear-drop shaped cohesive silicone gel implant over the muscle when I combine this with a breast lift. It is dramatically easier to get a good result initially, and the result ages well in that the breast and implant stay together over time.

Some will say that the prepectoral augmentation might endanger the circulation to the areola and nipple. I will not do this operation in smokers, and have not seen any circulation problems in at least 75 procedures.

I disagree categorically with those who say this operation must routinely be done in two stages. For goodness' sake if we can (or at least could!) put a man on the moon, we can do breast augmentation/mastopexy in one stage.

Breast implants with snoopy dog deformity

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Tough situation for you to be in.  I agree with Dr. Marosan that you should find a ABPS certified surgeon close to where you live.  Although, tough to assess without an examination, you might be better off having the implants removed and stage the augmentation.  The other option is to change your implant pocket to a subglandular  plane or dual plane augmentation to prevent the snoopy dog deformity.  

Dr. V 

South Shore Plastic Surgery

Bhupesh Vasisht, MD
Voorhees Plastic Surgeon
5.0 out of 5 stars 94 reviews

Undesirable results following a breast enlargement and lift

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As noted by the multiple comments of the other plastic surgeon respondents, you definitely have several issues that need to be addressed. It appears that your breasts are cascading off the implants which do not appear to have been placed at the same or appropriate level. The lift performed has been inadequate in several ways. It also seems that the implants chosen were not ideal for your situation.

Your photos are quite helpful. A physical examination will allow for more precise delineation of the issues contributing to your less than desirable result. I would suggest that you consult 2 or more board certified plastic surgeons in your area for assessment and recommendations.

Steven Turkeltaub, MD
Scottsdale Plastic Surgeon
4.7 out of 5 stars 33 reviews

Unsatisfactory result post augment lift

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From your pictures it appears that there is a discrepancy between the implant pocket which is sitting higher than the skin pocket.  The best approach to address this it to re explore your breast and at that time verify if the muscle has been released in the inside lower corner and then remove the inferior pole scar tissue capsule, a partial capsulectomy, to allow the implant to drop into the skin pocket.  This would fill out the lower pole and eliminate the upper pole fullness.

Roger J. Friedman, MD
Bethesda Plastic Surgeon

You will need revision and breast lift

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I have to say that your problem is very common and more frequent than reported in our plastic surgery publications. You have your implants under the muscle and your breast tissue is falling off the implant. You already had one revision and I would suggest that you get more one opinion before your next surgery. I specialize in redo breast implants and I been offering my patient implant removal and fat grafting . Please check my web site for examples.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.8 out of 5 stars 154 reviews

When breasts don't look right after breast augmentation

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You are right. When breast don't look right after breast augmentation something is wrong. It is evident from your photos that the breast implants are high on your chest projecting over the nipple, and it is not clear if the pocket is over or under the muscle. The implants appear too large and oval on your chest, and you are right, this is probably nothing to do with simply dropping the implant. We suggest a different surgeon, different implant, and different pocket well centered under the nipple.

Best of luck,


Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Breasts Don't Look Right After Augmentation

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It appears to me that you still have skin laxity and that perhaps your surgeon did not tighten the skin enough over the breast mound and implants; additionally the implants may have not been lowered enough in the pocket.  You should consult with surgeons who post exceptional photos for aug/lift procedures.  Good luck!

Amy T. Bandy, DO, FACS
Newport Beach Plastic Surgeon
4.9 out of 5 stars 109 reviews

Breast Don't Look Right After Augmentation

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High riding breast implants are a common complication of sub-muscular breast augmentation. Consistently right after the operation implants seem a little bit higher when the implants are placed under the muscle, but the majority of the time they drop in their natural position and given a patient a more natural look. Frequently, the plastic surgeon advises the patient to massage the breast downwards during the few weeks after surgery. Rarely one or both of the implants may not drop into their position and they may remain high under the muscle, that will require surgical intervention to be lowered.

Breast augmentation and lift done at the same time, is it OK for all?

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Thank you for your photo. I personally stopped doing augmentation and lift together years ago. You can read my previous answers about this and the reasons. Here you are after two surgeries and still do not look like you had a good result. You have a snoopy deformity, the breast tissue slides off the implants. Your right areola is already larger than the left and your nipples are below the crease. You need to see a local board certified plastic surgeon and not "fly in" to some distant place for your surgery. It is difficult to provide you with good postop care unless you are committed to stay in the area for at least one week. My personal preference would be to remove the implants at this time, allow your tissues to recover and do an augmentation later. You need to discuss this with your surgeon or get a second opinion. Good luck.

Breast augmentation -getting it right the first time

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Your concerns are valid in that the photo shows high implants that are squeezed into a rectangular contour. Possible causes of this capsular contracture, include implants that are too large in terms of base diameter for your chest, pectoralis major muscle pull and deformation of the implants, creation of too small a pocket for the implant to fit into or some combination of these factors. What is needed to correct the situation depends on which of these is present.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Aaron Stone, MD
Los Angeles Plastic Surgeon

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.