Breast Implant Revision Question

Unfortunately, sometimes plastic surgery procedures go awry and don’t deliver the results the patient expected. Our ACA Question of the Week comes in from a Facebook viewer who ran into this problem. She asks, “I have 375cc Mentor implants, high profile and under the muscle. They have progressively got[ten] worse aesthetically. I had them done in December 2014. I was a tuberous A cup. Their shape, size, and the asymmetry is really disappointing. How do you think they could overall be improved? I am seeing a consultant from Spire Hospital tomorrow. I originally went with MYA. This photo was taken during slight muscle contraction to emphasize the “flat” surface in my right [breast]. I appreciate your words.” Our founder and Chief Medical Officer, Dr. Thomas Pane, selected this question because this is a situation that, while not common, can and does happen, and it’s important to understand that it can be corrected.

Dr. Pane explains that a tuberous breast profile differs from the traditional breast aesthetic because instead of a smooth curve down to the aureole and nipple area, there is the curve from the shoulder and upper chest and then a swelling at the aureole. While this doesn’t mean there’s anything wrong with the breast per se, some people consider it unsightly. Breasts come in a range of shapes, sizes and profiles, ranging from very mild to quite pronounced, even when a breast profile is described as “tuberous.”

In this case, Dr. Pane says that after reviewing the pictures the patient provided, what most likely happened was that the patient’s breasts were mildly tuberous to begin with, but the implant used for the patient was larger than the breast itself. The result was that the breast’s natural shape ended up “stacking” on top of the implant’s shape and profile, exacerbating a situation that wasn’t all that bad to begin with and giving an irregular curve to the underside of the breast.

The main concern in this case is that the implant hasn’t been in very long as implants go, and that revision is already on the table as an option. Unfortunately, while this is not typical, it does occasionally happen. When it does, every surgeon will likely express a slightly different opinion as to how best to correct it, because there are a number of approaches to fixing a problem like this and each surgeon has their own unique preferences. These preferences and approaches are based largely on each surgeon’s education, training and background, but there’s no universally agreed-upon “right” way to correct a breast revision. If that were the case, Dr. Pane points out that every cosmetic surgeon would basically give the same answer.

Dr. Pane says in his experience, the best solution would probably be to completely redo the implant procedure using a smaller implant. Once the new implant is in position, the next step would be a tightening procedure to secure the area around the aureole. A second stage in which the lower curvature of the breast is addressed through fat grafting may be an option as well, but this is one case where photographs alone don’t tell the whole story. For this reason, Dr. Pane says an in-person clinical evaluation is essential to determine the correct sequence of procedures and determine whether the lower curvature will self-correct or if it needs to be addressed as part of the procedure.

Dr. Pane also stressed that in cases like this, it is a good idea to get several different opinions and go with the surgeon who is telling you what you are comfortable with and sounds closest to achieving the results you’re looking for. Some surgeons will decline to get involved with a case like this because revision surgeries do have a higher risk of complications or for other reasons. Dr. Pane notes that he is perfectly willing to evaluate patients in this situation and offer possible corrective solutions.

Whether you’re just considering plastic surgery for the first time or you’ve had a procedure go awry, Atlantic Coast Aesthetics welcomes questions about anything related to cosmetic surgery. You can follow us on Facebook and Twitter, email us at https://acplasticsurg.com or call us at (561) 422-4116 with your question. You might even find that your question is ACA’s next Question of the Week, answered live and in person by Dr. Pane during an upcoming Google Hangout. We believe the only bad question is the one you don’t ask, because you can’t get the answers you need if we don’t know what you want to learn!