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Q: Upper pain on right breast when using muscle, 2 months post op is it normal?

Submitted by Q-A from clee on Mon, 09/05/2016 - 21:05

The top of my right breast is painful whenever I use my right arm. Ive had BA 2 months ago, under the muscles. My breast seem to Have dropped nicely but I can feel a hard spot on my muscle/ top of my breast. Whenever I lift something, open soirs etc its painful. Should I worry? Ive only started to sleep on my side few days ago. Also I Have upper pole fulness, can it still Go down after 2 months?

A: Your are still very early with spontaneous improvements still expected

Thank you for your photos and questions. The symptoms you describe are very common 2 months after submuscular breast augmentation. The breasts will continue to soften and the upper pole fullness improve. Be patient as these final changes may take another 4-6 months. Keep your surgeon posted on your concerns.

Q: Uneven Nipples After Breast Augmentation

Submitted by Q-A from clee on Fri, 05/13/2011 - 14:38

I had a breast aug 3 days ago. I was previously a 34B and got 300cc smooth under the muscle Mentor silicone. Based on what I've read I understand that it takes a while for them to drop. However, the implant on my right breast has dropped and the left one is a very weird shape and extremely high up. Due to this, my nipples are completely uneven (they were fine pre-op). I just want to make sure that this is normal and that my breasts aren't gonna stay uneven forever. About how long will it take?

A: 3 days after surgery is early

Asymmetry early after surgery is often accentuated by the swelling and tight submuscular pocket. The tight pocket often drives the implant superiorly. As swelling subsides and your tissues relax the implant will often descend into a better position. You can help it along with specialized garments to push the breast inferiorly. This is worthwhile doing consistently in the first 6 weeks before the pocket fully forms and seals the implant to its final position.

Q: Asymmetry After 300cc Mentor High Profile Silicone Under the Muscle Breast Augmentation?

Submitted by Q-A from clee on Fri, 05/13/2011 - 12:38

I got 300cc Mentor high profile silicone under the muscle implants n am 17 days post-op.been wearing the surgical bra w/band 24/7,massaging them,n yet they are completely asymmetrical and the left one is super high up.

Ive asked my doctor countless times but she says nothing is wrong and it'll take another couple months til they look "normal". I had NO asymmetry pre-op. I have no pain (a bit sore still). Am I being paranoid or is she wrong? How long will it take for it to drop? What can I do?

 

A: Be patient

Young patients have tight tissues that may compress the implant superior. This is often made worse by the early surgical swelling. This should improve progressively with a plateau 3-6 months later. If residuals exist, then revision can be contemplated. You will be amazed at how things evolve. Avoid uplift support bras for a full 6 weeks.

Q: Will my Implant Drop Into the Pocket?

Submitted by Q-A from clee on Fri, 05/13/2011 - 10:36

I am 3 weeks post op from having a breast augmentation. I was a small B and they were low and very loose. I am 5'9 and went with saline under the muscle, I had a crescent lift on the right breast which was my larger breast.

I had 550cc in the right breast and 600cc in the left breast. My concern is that the right breast is very RECTANGULAR, and the implant is obviously high, when I bend over my saggy small breast still dangles and my implant is in my chest wall. Will it drop into the pocket?

A: Submuscular implants with mastopexies can be problematic

Subpectoral augmentation with mastopexy tend to be problematic as then lax tissue mastopexy tends to slide over the top of the muscle over time leading to a double bubble type of deformity. The submuscular implant tends not to drop and may accentuate the deformity with descent of the breast.

You are still early after surgery and might respond to breast garment straps to externally push the implants inferior. At the lest it might prevent further migration superior.

Hopefully this will address your issue. However, if you have the misfortune of requiring a revision then discuss with your surgeon the possibility of having submammary repositining of implants with cohesive gel and mastopexy.

Q: Breasts Don't Look Right After Augmentation

Submitted by Q-A from clee on Fri, 05/13/2011 - 10:22

I had PS breast augumentation and lift in July 2010 with basically same results as pictured. Flew to PS in January 2011 b/c he said implants needed to be "dropped" in place. He opened me up, found tissues around nerves- oh! so, the intense pain I'd had WAS real, and also ended up re-doing the lift.

Now,PS sees results of recent (March 2011) photographs, and says I just need to come in and have the implants dropped! I think it's more complicated. SOMETHING IS NOT RIGHT!

A: Your subpectoral placement of implants has made the condition worse

A revision of the mastopexy alone will not be sufficient. At best it will temporarily help until this soon returns. More predictable in outcome wound be to exchange the implant into a submammary plane along with a redo of the mastopexy. This would be best managed with a silicone cohesive implant.

Q: 3 Months Post Breast Augmentation: Experiencing Pain

Submitted by Q-A from clee on Fri, 05/13/2011 - 07:03

It's been a week now that i feel localized pain on my left breast (the pain is like a bruise). I feel the pain on the sides of my left nipple toward my left arm. I also feel the pain on the incision site after I wear my none wire bra (like there's a feeling of heaviness), every time I bend over (this time on the side of the left nipple again but extending medially) & when sleeping on my left side. Is this something serious or it's just a sign of drop and fluff? Thank you for the replies docs.

A: Scar maturation with more time will likely improve your symptoms.

If all else is normal and unchanged, then it is highly likely that your symptoms are a result of an immature scar.  The normal progress is for these symptoms to become progressively better with lower frequency and amplitude of discomfort.  Usually all symptoms resolve by 6 months.  If your discomfort deviates beyond these parameters, you should return to see your plastic surgeon.  He will be able to examine your breast to rule out other possible issues as well as provide you with insight on how to manage the discomforts during this period of scar maturation.

Q: My right breast never dropped and now my PS is telling me that he has to re-operate

Submitted by Q-A from clee on Thu, 05/12/2011 - 08:14

BA performed 1 month ago. The next day my bandages were removed, and my right breast was significantly higher than my left. The doctor assured me that it would drop after the muscle relaxed. I'm 5 weeks PO and it's in same exact place. Stitches were removed 10 days PO and he showed me on how to do my daily massaging, which I did religiously. I also wore the strap 24/7. I had a checkup last Friday & he says that he has to re-operate. I don't think that he made the pocket big enough. Opinions welcomed!

A: It can be a challenge to make a diagnosis by photo

You did a great job posting photos demonstrating the asymmetry following your surgery. Unfortunately, there are many potential causes for this problem. The incomplete list of problems include acute fluid collection (seroma, hematoma), asymmetry before surgery, technical aspects such as inadequate pocket dissection, malrotation of shaped implants, etc... Your definitive diagnosis will necessitate at least one other examination by an experienced plastic surgeon. Within my stated partial list of problems, only the acute collection of fluid necessitates early semi-urgent attention. Otherwise you will have the luxury of time to clarify the cause and decide on the best treatment plan for your situation. So do not rush into a plan of action. Best of luck.

Q: Right breast deformed post op, why did it happen and how can this be corrected?

Submitted by Q-A from clee on Thu, 05/12/2011 - 01:24

I had a breast augmentation one year ago (round silicone mod+ 275 ml placed  partially under the muscle). I had aalso a Benelli breast lift 7 weeks ago. My right will not drop and there is a ridge on lower pole. Is it my muscle creating this deformed line? Its like the implant is hung up on something and my tissues won't cover the bottom half of implant or allow it to relax and drop fully. Basically, my right lower pole is completely deformed. My creases were not lowered and the right is sitting higher than original fold.

A: Benelli mastopexies can cause wrinkles that take time to settle but this looks more than expected

Benelli mastopexies have the advantage of confining the scar to around the areola but problems with early wrinkling of the scar and flattening of the breast from circumferential pressure. In your photos, the deep visible banding exceeds what I would expect from the wrinkling of a Benelli. Instead, it is possible that the increased pressure from the recent mastopexy may have brought out some latent problems with your 1 year old implants. There may have been some underlying degree of capsular contracture that became visible with the breast tightening from your mastopexy. This can be easily confirmed with a physical exam. If a firm underlying band is present, then a capsulotomy with implant exchange may be necessary to correct the underlying problem.