Why Doesn’t My Breast Implant Revision Look Right?

Q: Dr. Eppley, I have had a breast enlargement in September under the muscle. Three weeks ago I had to have revision surgery as my right breast dropped and now my breast still does not look right as he has tucked it up so tight the breast looks square. I would really appreciate if I can send you the photos and you can give me some advice and tell me what your thoughts are. Many thanks.

A: Unfortunately breast asymmetry after augmentation surgery is not rare. While one implant can be too high or too low, the more challenging revision is when the implant is lower than desired. It is always easier and more predictable to drop an implant down than it is to raise it. This is because the new lower breast fold is held together with sutures and it is not always known how stable the new fold position will be with time. Ideally I prefer to position the new breast fold in the desired position and use enough permanent sutures that it does not drop or settle later. Other plastic surgeons prefer to overcorrect with their experience that some dropping of the implant will occur as it heals.

Based on your present description of a square-shaped implant, that would suggest that the new breast fold is higher than the other side. Given that it is only three weeks after your breast implant revision, it is too early to say what will happen in the next few months. You need to give this revision time to heal and settle for at least 3 months if not longer. Any attempt at further revision now would be ill-advised.

Dr. Barry Eppley