Q: Dr. Eppley,I am looking to get a breast lift revision. I had breast implants and a periareolar breast lift performed over one year ago . Since then I’ve had three nipple revisions due to inconsistent shape and size. I am unsatisfied with the result and I am in need of new approach to hopefully fix what I have left. To deal further, I had the initial procedure done 18 months ago. I’ve had two revisions on my nipples since then. My left nipple continued to be more oval and larger then my right. My right I was very pleased with. The most recent revision was done to correct my left nipple as well as lift the breasts, as my original inframammary fold was showing upon any flexion. Both nipples were revised and I developed on infection on my right side. A tip of nylon suture had migrated to the skin surface and caused the infection. There is also a dark spot on my left nipple were I can only assume is nylon as well. Please see if there can be a revision done to restore my feelings of happiness in having this done. I feel very much like Frankenstein and embarrassed with my bra off. Although if more time is needed to pass and I just need patience for them to heal? I don’t have a good feeling that they will. I’ve attached photos of my recent outcome. Thank you so much.
A: Thank you for sending your pictures and detailing your history. It appears that you have had an original periareolar mastopexy (donut lift) with your implants and have been battling areolar asymmetry and hypertrophic scars since. I am not a fan of the periareolar mastopexy as I have seen too many patients go down the road you are traveling. But despite the revisions maybe it is still worth it to avoid the scars from a vertical breast lift. (although they have a much lower risk of these problems than the periareolar mastopexy) The reason is that all the tension of the lift and the implants is placed on the areolar closure. Inevitably they widen and have hypertrophic problems frequently.
But that is water over the dam so to speak now. The question is whether a third areolar revision (breast lift revision) would be beneficial. Despite having two ‘failures’ at them I would still remain an optimist. But you would ned to wait at least 4 to 6 months if not longer to let the scars mature first. Redoing the areolar scars too soon is just a set up for recurrent hypertrophic scar formation as the scar tissue is still inflamed and highly reactive.
Dr. Barry Eppley