This patient underwent bilateral capsulorrhaphies with implant exchange from submuscular saline implants to larger submuscular silicone implants to correct bottoming out that occurred with previous surgery at another facility.
Implant asymmetry is when one implant is higher than the other or located too far medially or laterally with respect to the other implant. The more concerning asymmetries may require a secondary revision surgery. This type of secondary plastic surgery requires a significant amount of experience with diagnosis and implant surgery revisions. The doctors of Ennis Plastic Surgery have significant experience with breast augmentation revision surgery.
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Asymmetry Problems Following Breast Augmentation
After breast augmentation, breast asymmetry can be caused by problems with surgical placement or implant position. These are some common asymmetries:
- Bottoming out occurs when the implant rides too low in the breast tissue, causing the nipple to point upwards. It occurs more frequently with implants that are placed above the muscle (subglandular).
- Synmastia (sometimes called "uniboob") refers to the breasts being too close to each other. When an implant selected is too wide for the chest in an attempt to create better cleavage, it creates an unnatural appearance.
- Implants that remain too high postoperatively (and do not "drop" or "settle" into the correct position).
- Implants that are too widely spaced apart, lacking desirable cleavage.
- Deflation with saline implants is usually quite obvious because the augmentation effect is rapidly lost. With cohesive gel silicone implants, rupture may be less obvious and may require an MRI to confirm. Most implants today have a full replacement warranty that will provide you with replacement implant(s) at no cost to you. You may also be eligible for financial assistance towards the operating room costs as well from the manufacturer.
- Capsular contracture or breast hardening is when your body forms a thick scar around the breast implant. This may occur on one or both sides and may cause a shape change, discomfort, and make the breast to feel more firm.
- Double bubble is a postsurgical complication that occurs when one or both breast implants drop down below the inframammary crease (the fold where the breast meets the chest), creating a line across the lower part of the breast. This "4-breast effect" may correct on its own; if not, revision breast augmentation surgery can be performed.
This patient had a double bubble (left photo) which was corrected at Ennis Plastic Surgery with an implant exchange (right photo).
- Problems with patient's tissue characteristics such as tuberous breasts and preexisting natural asymmetry that was not properly corrected with implant selection.
Correcting Breast Augmentation Asymmetry
There are several ways to correct breast augmentation asymmetry including the following:
- Implant exchange: replacing your present implants with new implants that may be smaller or larger, repositioning implants under the muscle from over the muscle, changing the present shape of your implants to a new shape such as high profile or moderate profile, or switching from saline to silicone
- Capsulectomy: removing the entire scar tissue capsule surrounding the implant to allow it to fall into proper position
- Capsulotomy: making incisions in the capsules surrounding the implants to change their position
- Breast lift (mastopexy): raising the lower breast or both breasts
Natural breast asymmetry can be surgically corrected, as well. Your surgeon may perform breast augmentation using implants of different sizes or shapes, and may also adjust the inframammary crease on one or both breasts.