Q&A: CAPSULAR CONTRACTION, BIG GAP BETWEEN THE BREASTS, AND MAYBE BOTTOMING OUT...

"I am 5’8 and 56 kg, before surgery, one year ago, I was 32b, I got 450 cc hp profile, silicone, under the muscle. In my left breast I have capsular contraction, and I suspect that I have bottoming out on the right side, my breast looks low,wide and to the sides, and nipple pointed up and to the right:( I really want to get a nice cleavage and to get an upper full,round look. What procedures do I need? I decided to go with bigger implant, can’t decide which one I need for that 500cc HP or 600cc?"

 

DR. POUSTI: Thank you for the question and pictures. Unfortunately, online consultants will not be able to provide you with specific enough advice to be truly helpful. It is possible, however, that you will benefit from revisionary breast surgery that will likely include maneuvers such as adjustment of the breast implant capsules (capsulorraphy), the use of acellular dermal matrix if capsular contracture is present, and/or adjustment of the breast implant size/profiles. Generally speaking, the best online advice I can give to ladies who are considering revisionary breast augmentation surgery (regarding breast implant size/profile selection) is:

1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work.

2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals.

In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or “C or D cup” etc means different things to different people and therefore prove unhelpful.

Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate.

3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery (after the use of temporary sizers assessed with you in the upright position).

I hope this (and the attached link, devoted to revisionary breast surgery) helps.

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