Breast Revision/Lift through Areola with 505ccUHP Sientra Implants 10/27 - New York, NY

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I had my original breast augmentation done in...

I had my original breast augmentation done in 10/2003. They looked and felt very real and soft. In fact my ex couldn't believe it when I told him they weren't real after a few months of dating.

Since the augmention I had two kids, both were breast fed. My breasts held up pretty well considering, very soft and you still couldn't feel the implant.

After a car accident in 9/2009 my right breast started to get capsular contraction. I put off surgery until this year when I realized the right breast was becoming misshapen because of the hardened implant and it actually shifted position closer to the armpit. It was also becoming increasingly painful because it was completely hard like a rubber ball and it was tugging on nerves.

I researched and found a surgeon who has performed capsulectomies and who I trusted to correct any damage done in the breast.

After it was ruled out that there was no rupture we decided to use Sientra implants, HP instead of the medium round ones I had because we felt that I would need some fullness in the upper pole region since I opted out of getting a Breast lift and there was a little bit sag to my breast. Also bc of the smaller width of the HP implant we increased the size from 285 to 375 to help with creating more fullness to the breast. My original implants were periareola and over the muscle and I wanted them placed the same as before. I worried that if the new ones were placed under the muscle my real breast would have the 'double bubble' look bc of the decision not to have a life (I didnt like the vertical scar)

July 17,2014
I had the surgery and everything seemed great. The left breast seemed more swollen than the right, both were very sore and painful. The doctor told me that the surgery was a success. The right breast had a significant amount of scar tissue that was successful removed. He didn't remove any breast tissue he rearranged and stitched up the tissue and told me I needed to take it very easy because I had a lot of stitches to correct the placement of the implant. The left implant had no scar tissue or capsular contracture but was removed and replaced with a new implant.

I was in a lot of pain for a couple of weeks after surgery and couldn't lift my arms without feeling pain, I figured that was due to all the stitches that were put inside to correct the placement. My left breast was bigger than the left from the first day but I didn't worry right away since each breast reacts differently to surgery. Although I found it strange that the right one that had the extensive scarring that needed to be removed was reacting better than the left that had no issues pre op.

I continued to take my Singulaire for two months post op to minimize chance of capsular contracture. I wore my surgical bra and approved sportsbra 24/7. I felt the left breast soften up and start to drop but the left continued to stay hard, it actually got harder up top on the upper pole region and towards the cleavage area. Now three months later and the right is completely drooped, much lower than preop and almost tubular in shape. Toward the outer breast close to the areola I continue to have pain and every so often I see what looks like a welt but its actually something pushing outward from inside my breast - possible the seam of the implant that has moved out of place??

Im so upset and depressed because of this bc even covered completely its very noticeable difference in size and shape even with clothes on. The left looks at least a whole cup size larger than the left one.

I went to see my surgeon and he sent me for an MRI to rule out implant leakage since that is what it looked like even though it seemed unlikely. MRI came back fine no leakage.

There is no doubt something is definitely going on with the right droopy breast but until he can operate he wont know for sure. The left looks high but since there seems to be capsular contracture its hard to tell if that placement is too high. After discussion we agreed surgery is definitely needed! (pretty obvious, right?)

He want to go in and release the capsular contraction from the left side and he is going to reposition the right implant and put stitches to hold it in place. I will meet with him once more after I schedule the surgery for the end of the month.

Im trying to stay optimistic but I just feel hideous and deformed in the time being :(

CORRECTIONS: (With two little kids fighting for my attention I mixed up my right and left!!!) lol

** My left breast was bigger than the RIGHT BREAST from the first day but I didn't worry right away since each breast reacts differently to surgery.

** I felt the RIGHT BREAST soften up and start to drop but the left continued to stay hard, it actually got harder up top on the upper pole region and towards the cleavage area.

Surgery Completed 10/28/2014

I had my revision surgery yesterday. Feeling pretty good today. Been resting since I got home after surgery.

Even though its only one day I notice they are even and perky ! Yaay! I hope they keep getting better looking as they heal and drop! So excited!

I havent taken pictures yet but I will upload them as soon as I do.

11/5 Very Depressed My right nipple is black and flat

I havent been posting bc I have been taking it very easy after surgery. Havent lifted anything at all and been mainly laying down and sleeping with the pain meds.

I had my post op on Thursday 10/30 three days after my surgery. When the doctor took the bandages covering my areola off I was immediately alarmed in seeing my right one what I thought was black. THe Dr said it was just alot of bruising and didnt seem worried. The left is pink and looks good. I went home and that night I noticed that the right one bled enough to go through and spot my sweater. Again I had just seen the dr that day and the gauze he removed was spotted and he said that was normal. I put some gauze so it would go through my shirt.
Friday it looked like Thursday. Saturday I thought it felt a little hard but I thught that maybe it was some blood scabbing over it. I went out to dinner that night and it was so cold my nipples hurt but I though that was good sign bc that meant they were 'working' getting hard.
Sunday I was alarmed and couldnt wait to call the office the next day. Monday it was all flat and black. The attendee called me back and said nothing to worry about it all seemed normal as long as there was no yellow discarge or foul odor. I had my next post op Wed 10am she said they would look at it then.
Tuesday I dared to lift the edge of one of the thin strips of bandage that were covering the stitches around the areola and my heart stopped. I was sick to my stomach with dread. It looks like the areola is separating from the breast and the dark black hard area seems to be peeling off the rest of the areola underneath. I Called the Dr office and was crying on the phone, they had the doctor call me after he finished his surgery I sent him a photo and he said it didnt look good. He was talking options over the phone worst case scenarios and mentioned he though he might have to reconstruct the nipple areola area. I am in panic and so depressed. I DONT WANT TO LOSE MY NIPPLE. I havent slept or eaten since yesterday, Im just so anxious and nausceous. I have been putting bacitracin on it since I spoke with him on the phone like he told me to.

I went into this revision to correct a capsular contracture on the right side that was hurting me. Then I had to have a revision of the revision bc the right breast didnt stay in position it sagged way down and the left got a capsular contracure. I feel like if something could go wrong it does for me.

Im attaching photos if it might help someone else. If I was told this was a risk I would DEFINITELY not have done the lift part and lived with whatever little sagging I might have had after the second revision. The photos might be disturbing I apologize.

If any other doctors read this please give me some advice how to proceed. Im just a crying depressed mess right now.

Update: 11/6/2014

I went for my second post op yesterday. My doctor said it wasnt as bad as he originally thought from just the cell phone picture I sent him the night before. It was hard and black but there was that one section that was lifting off and there was soft nipple tissue under that area (not raw tissue more like delicate skin you are left with if you take a scab off if that makes sense?)

He poked the areola and nipple with a sterile needle, I didnt feel a thing but good news was that it bled all around on the areola part, the nipple was very hard and bled just a tiny bit. He said that it wasnt as bad as he thought, some blood was circulating since it was bleeding but it wasnt good situation either. He is hoping it is just epidermal lysis(sp?) Unfortunately it will take a few weeks to know for sure and how it is healing. In the meantime he wants me to go in everyday for oxygen therapy, he never tried this before but its supposed to promote healing. Its a flexible face shaped mask that is put over my right breast and pure oxygen flows around the breast. Yesterday we did that for 15 minutes. Then I am instructed to cover the area with Silverdene cream twice a day and cover with gauze.

Last night when I went to put the cream on again the hard part of the areola and nipple peeled off when I removed the gauze. The area underneath looked greyish but was soft and supple, even the slightest bit plump. Remember it was a flat hard circle that morning, the texture was much better I thought.

Today when the nurse cleaned the area to get it ready for oxygen therapy I felt it, it was almost like that slightly annoying feeling when you chafe your nipple. I nearly cried bc I had that slightest feeling in that area. We did the oxygen for over an hour today, I could see a reddish pink in side of the nipples. I pray that it is getting better and that its just going to be a slower healing process on the right side.

I asked if there were any vitamins or supplements I could take that might help and I was given two types of supplements by the nutritionist there. I will add the names on my next update.

Update January 29, 2015

Hi everyone. I have been really depressed, to say the least, since this major complication on this last revision surgery. Last time I left off I was very hopeful and starting Oxygen therapy. I did that for about an hour a day for a couple of weeks. Everyday I would travel to my surgeons office and they would clean my wound -the areola was a thick black scab- and administer the oxygen therapy. After that was done they would clean it with sterile water and hydrogen peroxide and then apply silvadene cream and cover it with gauze. I was able to get an oxygen machine in my home and do this myself everyday until I think Dec 23rd.

Towards the end of the oxygen therapy my surgeon surgically removed whatever was left of the thick scab and where my areola should have been was and indented red would with yellowish (protein) areas that was still healing. I was scheduled to get a skin graft on Dec 22nd but with my bad luck the machine that was delivered especially for my treatment was broken. I am usually a very positive person and hate to be pessimistic but it seems like if there is a slight chance something can go wrong it will for me. Anyway, I travelled into Manhattan the next day Dec 23rd and was able to have the skin graft.

The skin graft wasnt anything like I expected. A small machine the size of a small brick was placed on my inner thigh and it was being held in place by a little suction. There was a glass plate with rows of tiny holes that was pressed directly on my inner thigh skin. Once the machine was turned on it slowly heated up to the preset temperature and the suction action continued. I wish I had taken a photo of it. I think it stayed in place for 30 minutes. In the little circles I could see what appeared to be little bubbles, which was really my skin and its cells that were being heated and sucked into the plate. When the machine was removed there was a sharp pain but it passed quickly. My surgeon placed an adhesive strip on the 'bubble cells' that were removed then he put the adhesive with the cells on the open wound on my right breast.

This skin grafting really helped speed the healing process quickly. After a week that adhesive was removed and I just had to keep washing gently with Dial soap daily and then place a medicated gauze strip called Xeroform on until it was all healed in.

As of today 1/29/2015 the wound is healed or closed up at least. There is still much healing to happen. It looks like a dark pink scarred area. I am wearing a thin elastic non support bra and if I run my hand over my breast I had feel a hard thickened flat area. Im hoping with time that it will soften up and the texture will look better. Compared to the awful black scab and then the open wound, the breast looks better. Im not happy whatsoever. I feel pretty depressed and grotesque. After a few months or so, my surgeon is going to revise the areola and give me a nipple and make it look more natural - I hope.

Now that the wound is healed we can concentrate on the shape of the breasts which is another issue. The shapes do not look natural. It looks like I have two mishappened donuts in the breast area. Does that make sense? The areola section is flat no projection and around it, mainly the bottom cleavage area and the upper part by the armpit are very full but not the rest of the breast. Almost like there is a band flattening certain areas. It is noticeable even with clothes. It almost gives you the impression that I am wearing a bra that is too small and gives me a flattened front and pushing the breast upward. Not sure if Im explaining this good. I will add photos later. Also the fold of my left breast is lower than the right and gives them both two different looks, bigger size and different shape. I really wanted them to have a more sloped and natural look. I have to admit that I am rather surprised that they look so flat when the implants are ultra high profiles. I was so worried that they would be projecting too much instead they are flat!

Another issue I am dealing with is the rippling from the incision on the left areola. It was very pronounced before and it is getting less but still there. Even if it finally flattens out I think there is going to be a 'star burst' stretchmark look to that entire areola. Its not flattering at all. I have been applying TNS serum to the circle stitched area on that areola to help with the healing. You will notice in the pictures I will be posting that there is a small indent where a knot of once of the stitches dug a little hole into the areola. Honestly who has more bad luck than me right?

I went to my last post op yesterday. The plan is to not rush into another surgery just yet. The asymmetry and shape concerns were addressed and valid and he plans on correcting them but he needs to come up with a gameplan so we can hopefully do everything in one surgery.

In the meantime he wants to wait proactively and I will hopefully be starting an ultrasound on each breast for an hour once a week for three weeks. He is hoping this will release the slight capsular contracture around each breast and allow them to drop and look more full in the areas that look like there is a band around them.

If you are reading this and are considering an areola lift, I would think long and hard about all that can go wrong. If I could go back in time I would not have had any lift at all, I would have just has the revision surgery I had planned on to release the capsular contracture on one breast and adjust the placement of the implant on the other. To me it wasnt worth the trauma and depression and everything that I have gone through, am going through, and will continue to be going through.

GRAPHIC PHOTOS: Chronological Photos of Necrotic Areola after Areola Lift and BA


Its hard for me to post these photos. Ive been MIA from here for over a month bc I just couldnt talk about what Im going through. I loved my original breasts I thought they looked natural and beautiful. I just wanted the capsular contracture on the right breast released and since the implants were 10yrs old decided to exchange them for new ones. Simple or so I thought.
I developed a capsular contracture on the left breast that previously had no issues and the right the implant sagged horribly it looked flat or tubular definitely something happened with the placement. See previous posts for photos illustrating this.
I had a revision surgery and was convinced that a lift was the only way to correct the sagged right breast. It took over an hour to convince me and even then I felt nausceous at the idea of a lift, I never wanted to have a lift for numerous reasons the extra scars is a big factor. I was told that the areola lift would be good for me and I exchanged the implants again for larger 505 UHP. I was so nervous they would look too big and a lot of projection- am shocked at the flatness I have now.
I have more complications. The most concerning was the necrotic right areola and I am posting chronological photos that illustrate my depressing and traumatic journey up until today.

Feb 4th 2015 - Exchange UHP Implants for Teardrop shaped ones?

I forgot that my surgeon asked me to think about exchanging my UHP implants (yet again!) for tear drop shaped ones. He suggested this option only bc I dont like how I feel I have a lot of fullness (maybe too much) on the upper pole of my breasts but only on the outer top area closest to the armpit. I told him I would like them to look natural with a slope and then projection in the nipple area (Its completely flat) and fullness underneath. Am I the only woman to think that is the most natural look? I've always said this to him, he focused on giving me a lot of upper pole (think about when you wear a push up bra) and fullness in the cleavage area. The other areas are not balanced though, a nurse there agreed she said it looked as if there was a band on my breast from the top near the cleavage across the nipple to the bottom outside breast-fold. Anyway I am not too keen on getting the teardrop implant. I feel that with my luck they will move position at some point and give me more complications. Besides all implants become 'teardrop' shaped once they are vertical, gravity pulls most of the volume downwards. I was hoping there is a way to correct it without having to switch to yet another type of implant. I dont want to feel like a guinea pig with all this trial and error. What do you girls think?

Went to 7 month post op (7 month from last surgery)

I've been pretty depressed since this whole ordeal. Wish I never did the original surgery. I rather have lived with the capsular contracture on the right breast than have to go all through this spend $$$$ and look like the bride of Frankenstein.....
Ok, that said....

My PS really wants me to do a vertical lift to 'fix' assymetrical issues but I cant even bear to look at my breast now with all the scarring from the last surgery and the huge ugly deformed scarred areola area on my right breast... He said that vertical lift would help minimize the flattened appearance. I told him that what I am most upset over is that he rearranged all my breast tissue to the center (cleavage area) and I have no fullness on the sides. Also the breasts arent round they are flat in the center. Imagine if you have two donuts in front of you and you squish down the sides. Thats what they look like. I just feel like they need more breast tissue in that area but I am so leery of putting my breast through another traumatic surgery.

His suggestion was that he could liposuction some fat from my abdomen and then use my own fat to give me that volume back on the sides of my breast and in the center to give me projection behind the areola areas. Has anyone had this done? I have it tentatively scheduled to be done on June 24 but I am still researching and looking into it.

There is a little good news. I have very slight sensation on the right side right were the nipple would be and a tiny bit of nipple tissue must have survived bc it reacts. I mean its just the tiniest bit but we thought I would have no sensation whatsoever. The first thought was to recreate a nipple with a nipple flap but since there is my own little bit of nipple there we are going to wait to see how much more will declare itself. I wonder if there is something to do to extend the nipple to make it longer and match the other side?

June 26, 2015 - Update - Had lipo of abdomen and fat injections to make breasts more symmetrical

My doctor did lipo on my abdomen region and removed fat from that area so that he could inject it into the flattened areas of my breast. The center where the areola was very flat (see above after pictures) and the sides of the breasts (bilateral on both breasts) He needed to put more in my right breast that had the necrotic issue bc not only did the areola die but I lost some breast tissue as well. It also had less fullness bc the original surgery in July of 2014 was to correct a capsular constracture on that right breast and there was severe scarring that had to be removed and breast tissue rearranged.

I went in very nervous on the 24th. I wanted to cancel so many times bc I kept thinking 'am I going to look worse?' and maybe it was better to just live with the Frankenstein breasts I already had. Its too early to make any 100% positive statement but I did get a little emotional when the doctor took the curtain away from my face s I could look down at my breast.... guys!!! They werent flat!! They were rounded! Projection!! and he injected a little more fat under the tiny bit of nipple that miraculously survived the necrosis and it looks a little more raised!

I know its only almost 48 hours and too soon to know how they will look but I am hopeful.

The proceedure was done under local anesthesia. I was given valium and percocet and then he injected the areas where the lip was to be performed and the fat injected with epinephrin. That did sting and hurt in places but tolerable. The lipo was the same, some areas hurt more than others but mostly I just felt a pressure almost like someone giving a massage. Im wearing my original post op bra from my augmentations and a body compression garment.

I remember the whole procedure as if I was in some sort of dream fog.... I was having conversations with the doctor and nurses present through the whole thing.

Please keep me in your thoughts and prayers that this is a big step in making me look feminine and normal again!

I dont want to take anything off yet so I will add pictures after my monday post op. I might take with the bra on bc you can already see a round fullness where before it was so flat!

June 24 - Before Pictures - Fat Transfer to Breasts

Im finally posting the photos I promised. These pictures I took in the bathroom of my PS right before I got prepped for the Abdominal lipo and then fat transfer to my breasts. FYI: I was not interested in any lipo other than for the purpose of reshaping my breasts.


June 27 photos - AFTER PHOTOS -Fat Transfer to Breasts

I took these photos in my home three days after the fat transfer. The surgeon said that up to 40% might get reabsorbed. I was happy that they did not look AS flat as before the transfer but feel he could/should have added more. They looked like they had some more projection didnt they? Or was it just my hopefully imagination?

Photo Update: 3 months post fat transfer 9/12/2015

I think most of the fat has been reabsorbed by my body. They arent as flat as before but they arent natural or pointed in other words still flat. Im not sure that the fat grafting is a satisfactory procedure as I did not get the results I wanted. I was hoping, expecting really , that the fat grafting would give my areola area the projection they were lacking and also make my right nipple elongated to match the left one.
Then the only thing left was to have one more surgery to remove the scarring around the areolas (and raise the right one-this scares me bc its the one that became necrotic after blood circulation was poor) and make them have a round rather than the jagged look and lower the breast crease on the right breast.

I personally think that the left breast crease needs to be lifted a bit and create more of a 'curve' as I think it looks like it has a point under there when I lift my arms. I can totally live with that if I dont need to have any more invasive surgery on that breast.

My surgeon asked me which breast I think looks best to me so he can figure out how to make them look more symmetrical. Which do you girls think? he thinks we should try to match the left one (with the good areola).

To note: I was reading my review from the beginning and I was reminded that after the first 7/2014 surgery I did question why I kept seeing dark veins on my right breasts every so often and almost looked like a bruise on the side. My PS told me that it was normal and that my breast was just healing. Given that the following surgery caused my areola to become necrotic due to lack of blood circulation I wonder if he missed a warning sign of a possible risk. Mind you I was never told that what occurred to me was a possibility. When I asked what were the risks I was just told that possible loss of nipple sensitivity but he was very good at what he does and it was less than 20% of that happening. Necrosis was NEVER mentioned, believe me if it had I would never have had the lift especially since I was opposed to having one from the beginning.

Im going back next week for my 3 month fat transfer post op - its also 1 year since I had the last breast lift/revision that left me scarred for life. I am also going to get antoher plastic surgeons advice and opinions to see how I should proceed. I am having so many doubts and am scared to have my original PS do any more to me as I feel its a never ending guessing game. Im pretty distraught over this whole ordeal and its affecting my dad to day life. I feel monstrous when I look at myself naked.
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