Bilateral Breast Revision (Plane Change Using Same Implants) to Correct 'Double-bubble' and Animation Deformity

Almost two years ago I underwent a full...

Almost two years ago I underwent a full abdominoplasty and breast augmentation (aka, a 'mommy-makeover'). You can see my first review for those procedures here:

I selected 371cc round silicone implants and opted to have them placed under the muscle.

About 4 weeks after my surgery I noticed an unsightly bulge under my left breast and a smaller but still noticeable bubble under my right breast. I was also noticing some severe distortion when barely flexing my pectoral muscles (often I wasn't even trying to flex, I was simply carrying a grocery bag or otherwise using my arms in a very relaxed manner (such as passing a dish at the table or lifting my laptop). I raised my concerns with my PS and she told me that the tissue under my breasts was tearing, unable to hold the weight of the implants. She didn't address the animation deformity at all, other than to say that it was completely normal and expected. She advised that I should wear a modified underwire bra with the cups cut out 24/7 for a couple of weeks, explaining that the pressure from the underwire may assist in the tissue 'reconnecting' under the implant. She also told me not to 'look at the internet' which seemed super shady to me, but she explained that I could get the 'wrong idea' from reading horror stories about failed implants. I followed doctor's orders to the letter, wearing a support bra with high underwire - the center of the bra was higher than most of the shirts I wear - and wearing the band as tightly as possible. I normally wear a 34 band, closed at the loosest clasp, this one was a 32 and I wore it on the tightest clasp as often as possible. This caused significant discomfort but I had just invested 15K in major surgery and wanted the best possible outcome. I even abstained from researching the issue on my own.

Dr. Peters requested that I return to the office two weeks later to see if there was any improvement, but when I saw her at the follow-up, she backtracked, saying it would take 6 weeks or more to see any results from this 'intervention'. She dropped another bomb on me as well: she was transitioning to Swedish and would no longer be able to honor her revision policy after the end of 2014. This was a punch in the gut because when I submitted payment for the original procedure, I signed a patient/doctor agreement that stipulated any revision procedure would be covered for 12 months after the initial surgery. So, if I wanted to schedule a revision surgery, I'd have to do in the the next 2-3 weeks, otherwise I'd be looking at an additional $5K to cover Dr. Peters' surgical fees (and I needed to schedule sooner, rather than later since a number of her patients were clamboring to get in the same window for their own revisions, especially because I was in school and would only be able to schedule the procedure during the last 2 weeks of December).

--- But wait! You may be thinking what I was thinking: A) What the actual FUCK!? and, B) If I needed to give this rib-crushing cupless bra torture device another 4 weeks to work, how was I going to know if I needed surgery? At this point it was late September, and I was going to have to make a decision about an additional surgery AND come up with the $$ for the strattice mesh, operating fee, and anesthesia fees, totalling almost $7,000 in the next 3 weeks?! To top it off, Dr. Peters was being a giant jerk about the whole thing. Her bedside manner had rapidly deteriorated and, on multiple occasions, she audibly sighed as I was asking for clarification and literally rolled her eyes. **And let me just point out that I am an extremely laid back and respectful patient (I know, I know, we all say that, but really! I am!)

I was finishing up my second year of grad school and couldn't fathom having to deal with capstone research and recovering from a second cosmetic procedure inside of 5 months, so I threw in the towel. I decided to finish school and see how everything had settled, so to speak. I also didn't really trust Dr. Peters to get it right, and I didn't really want to continue seeing a surgeon who sucked when it came to dealing with negative surgical outcomes and didn't honor her own revision policy. BLECH.

When I graduated in June, my breasts looked the same. I'd been doing my own research and wasn't encouraged. I considered moving my implants from under the muscle to under the breast tissue, but everything I read about capsular contracture scared the ever-living shit out of me. It didn't seem like it was going to get any worse so I figured it wouldn't hurt to wait for another year (or 10) while I decided what I wanted to do.

BUT THEN!!! I saw Dr. Baxter's revision before/after photos and it was the first time I saw another set of boobs that had both the double-bubble (what he referred to as 'window-shading') *AND* animation deformity. Those boobs looked like my boobs! And, according to Dr. Baxter's website, the two issues were connected. The under-muscle placement used by many surgeons often results in the problems I was experiencing. His solution was surprisingly simple: correct the distortion by moving the implants from from dual-plane subpectoral to split muscle plane. I ruminated on that for a few months, and finally made an appointment a couple weeks ago to see if my issue was as straightforward as I hoped it was.

So far, it's been good news. My tissue isn't tearing, as Dr. Peters believed. And I don't need the pricey internal mesh to support the implants. Rather, my muscles weren't adequately separated (barf) during the initial augmentation procedure and as a result, the tension from the muscles creates pressure over the implant, resulting in a permanent double-bubble and significant animation deformity.

My surgery is scheduled for August 4th (why wait, right!?) and I am tentatively hopeful. Another upside to the plane conversion is that my previously separated muscle will be reattached and I'll regain full functionality in my pectorals.

I've uploaded some "before" images. Who knows, maybe my boobs look like yours and this post helps you out?

Tentatively super excited about my results

The procedure went well! I recovered fairly quickly but then backtracked a little when I got a mild stomach virus and developed some *seriously awful terrible seriously the worst* nerve pain from nerve damage that occurred during the surgery. That was a few really awful days and I met briefly with my PS about solutions. He recommended Neurontin/gabapentin for nerve pain. He was going to write me a prescription but I already had some prescribed for a different reason. That stuff works really well for nerve pain. I still have lingering stabby, searing pains every once in awhile but at least now I can sleep.

Until I made the before/after collages for this update, I was convinced my surgeon made a mistake with my creases - one boob is higher than the other :( ...but then I saw my before pics and realized that's just how my boobs are, so... C'est la vie ¯\_(?)_/¯

I uploaded some photos - initially there was a significant dent in the side of one breast and a smaller dimple in the other. That seems to be resolving over time (I am, after all, only 2.5 weeks post).

I have full sensation in one breast and nipple, some numbness and tingling in the other (the one with the nerve damage).
Seattle Plastic Surgeon

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