What Is The Best Method To Revise My Breast Implant and Lift Result?

Q:  Dr. Eppley, I had breast implants with a lift over one year ago. While they do look better than before they are very asymmetric. I had 375cc silicone gel implants and vertical breast lifts. The left breast is considerably larger than the right and the implant sits lower and more towards the side of my chest. My plastic surgeon wants to redo the lift on the left and tighten the pocket. Rather than place a bigger implant in my right breast, he wants to take more breast tissue on the left to make them more even. This doesn’t make sense to me and I think it would be better to place a bigger implant on the right to make them look more even. I think he is wrong with his plan but he won’t do it the way I think it should be done. What do you suggest I do?

A:  One of the most difficult body contouring procedures to do and get a symmetric outcome is breast reshaping. The combination procedure of lifting sagging breasts and adding volume (an augmentation-mastopexy or breast implants-lift) is challenging and the need for secondary revisions is remarkably high. (25% to 50%) When planning a revision of this operation, there can be multiple options to manipulate including more of a lift or tightening the breast skin, increasing the size of one or both implants, or even removing some breast tissue. Any or all of these may be needed and there are advantages and disadvantages to any of them. While you would prefer to exchange an implant for a bigger size, your plastic surgeon has recommended otherwise. I would make the assumption that he has a lot more experience in doing this surgery and has a good reason for making this recommendation. I would suggest you sit down with your plastic surgeon and discuss your differences. Unless the final result is perfect, and it is likely that it won’t be (better but not perfect),  you will never be happy with any outcome unless you understand and agree with the revisional plan. 

Dr. Barry Eppley

Indianapolis, Indiana