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In June, 2010, I had a breast augmentation/lift. Before the surgery I was a size...

Q:

In June, 2010, I had a breast augmentation/lift. Before the surgery I was a size 34A. How do I know if I really did get what I paid for? I went with 425cc's that brought my breast size up to a 36D. The incisions that were performed were around the nipples and under the breasts. My breasts before surgery were very saggy as a result of having three children. It has been four months since surgery and I find that my breasts have dropped significantly and are becoming saggy again. I have consulted my surgeon about this issue and she mentioned to me that my skin has alot of elasticity and therefore the breasts will drop. She also mentioned to me that even if I wanted them to be perky, it would be impossible because of my skin type. Is this true? Should I have gone with a larger size? I am still wearing the surgical bra at night and a regular supportive bra with no underwire during the day for support. However, I don't find either of them helping. I paid alot of money for this surgery and I am unhappy with the results. I did mention to the doctor that i did not want the breasts to look like basketballs on my chest but I was also not expecting them to be saggy as they were before. The point of me getting the breast augmentation/lift was to correct the saggy issue from the start. If a patient is unhappy with her results, will the surgeon re-do the procedure or correct it? I hope you can help clarify some of this for me.

Thank you.

A:

 From the phrasing of your question, your initial result of surgery did achieve the lift you desired, but the droop/sagging has recurred since that time.  If this is true, the problem you describe is a very unusual problem. Because your problems can be very patient specific (assessment of skin elasticity, etc), I don't believe your question can be satisfactorily answered for you in this forum.

I believe your best answers can be achieved by two means:  1) Address your problems with your surgeon;  2) Get a second opinion from another experienced Board Certified Plastic Surgeon.

A:

Hello

You have asked for clarification of your situation.  The best person to clarify things for you is your surgeon, and what you have agreed to have done by your surgeon.

You also ask the question if  "you got what you paid for?"  It depends on what you agreed to and signed for with your surgeon.

It sounds like you had a breast augmentation through an inframammary incision, and you had a periareolar mastopexy.  Is that what you wanted and signed for with your surgeon?

Now you have droopy breasts.  You need to understand tht periareolar mastopexy is effective for small lifts only.  You also need to understand that an implant is not a substitute for a lift, even a large implant.

It now sounds that your skin elasticity is lost and you need a formal "anchor" type of breast lift to maintain the shape of the breast for any reasonable peroid of time.

Discuss the issue with your surgeon. I think you are still responsible for the cost of the surgery, but your surgeon may give you some consideration.

The breast lift you need now is extensive and carries a certain risk of skin loss, nipple areola loss, along with other complication that you need to understand before surgery.  In the case of needing more surgery discuss with your surgeon ahead of time your responsibility for the cost.  What, where, when, who?  All of these question should be discussed and understood before surgery.

A:

Recurrent sagging is always an issue if you had loose tissues, and the desire to go with a large implant size.  Loose tissues and laxity of the breast skin, as a result of breast feeding, weight fluctuation and pregnancy, does not support weight well.  Gravitational factors are out of the surgeon's control.  Going larger would be a mistake and would aggravate your problem.  Your surgeon's revision policy should have been discussed ahead of time.  I'm sure your surgeon wants a satisfactory result for you.  However, your situation is somewhat predictable, and I hope you had realistic expectations. Revisionary surgery often requires financial obligation, typically for outside costs we can't control such as anesthesia, OR fees, etc.  Desires to maintain a large implant size, will potentially lead to recurrent sagging over time.  I would follow your doctor's advice, and maintain an open, honest relationship to get the most out of your investment.

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