Breast augmentation is a complex surgery, and if not performed by a highly skilled surgeon, can result in an undesired outcome.
Asymmetry, where the breasts are uneven in appearance in terms of size, shape or breast level, is a common issue. Or perhaps you simply feel your breasts don’t look natural enough?
Whatever it is, if you don’t like the look of your breasts following surgery, you will no doubt be very distressed. Breast surgery is a significant investment – one which you might have saved several years for.
This is why it is vital to research your surgeon in advance and not be lured in by ‘bargain boob job’ offers – it is undoubtedly a false economy, as you may well have to undergo additional surgery.
However, if you do have implants you’re unhappy with, there’s no need to despair. Here at Ocean Clinic Marbella we have much experience in correctional and reconstructive breast implant surgery, helping give women breasts they can be proud of.
Common breast implant appearance issues (and how we can correct them for you)
Breasts are misshapen
One cause of misshapen breasts is implant malrotation. This happens when a teardrop implant (which is fuller at the bottom than it is at the top) rotates. It can turn sideways, or even rotate upside down, making the breast look misshapen. It sometimes occurs when the surgeon has created too large an implant pocket in the breast, allowing the implant space to move around.
It can be corrected by replacing the teardrop implants with round shaped ones – if they rotate within the breast it does not cause a problem. However, corrective surgery should be sought as soon as possible because if the breast tissue has stretched to fit the new position of the rotated implant it will be harder to put right.
Misshapen breasts can also be caused by loss of breast tissue or the formation of scar tissue around the implants. Capsular contracture (tightening of the breast tissue) can also cause distortion in one or both breasts. Releasing the tissue by making incisions, or completely removing scar tissue, can correct the problem.
Breasts are uneven
One breast may appear to sit higher or lower than the other on the chest. This can be caused by the surgeon making pockets to place the implants that don’t match or are in slightly different positions.
Using an incision in the armpit to place the implant may result in an increased risk of asymmetry. This is because the implant must be placed without direct access to the breast.
The position of the breast creases can also cause asymmetry. If they are at different positions it will cause the implants to sit differently on the chest. The problem can be corrected by repositioning the implant and/or reconstructing the fold underneath the affected breast.
Breasts have unnatural fullness at the top
Excessive upper pole fullness in one or both breasts can occur when implants fail to descend properly, or rise up after placement.
This can be treated by lowering or releasing the tissue that is holding up the implant so it can rest in its new lowered position.
Breasts sit too low
This issue is known as ‘bottoming out’ and happens when the breast implant is placed too low or descends too much over time. This may occur due to excessive weight of the implant, poor breast tissue elasticity, or from the implant pocket being made too low. It occurs more often when the implants are placed above the muscle instead of below it.
Depending on what contributed to bottoming out, you may need to consider a different implant size, but the issue can usually be corrected by reconstructing the inframammary fold under the breast so that it is better able to support the implant in the desired position on the chest.
Nipples are uneven
Asymmetry of the nipple (and areola) on the breast mound can happen for a number of reasons.
One cause is choosing an implant that is too large. If the implant doesn’t fit the dimensions of the patient’s chest wall it may place the nipple areolar complex in an unnatural position. Here, correction is made by changing to a more appropriate size.
Incorrect implant placement can also cause nipples to look odd. Placing implants too high can make the nipples point downward, place them too low and nipples may point upwards. The same can occur if the implants are placed too far to the middle or the side; the nipples point to the side or middle. This can be corrected by repositioning the implants.
Breasts are too far apart
A wide gap between breasts may be caused by a patient’s natural anatomy (i.e. they have a bowed breast bone and their breasts sit wide on their chest), however this issue is accentuated by large implants. The appearance can often be improved by replacing them with a smaller implant. A common mistake is to go for larger implants to achieve a better cleavage, but this will only serve to make the gap look even bigger.
In some cases, the surgeon has made too wide a pocket and the implants have migrated to the side, or the implants are too heavy and have stretched the tissue (stretching can happen when a person lies down and their breasts go out to the sides). This displacement can be corrected by moving the implants back together and reinforcing the sides (a smaller implant may also be recommended).
Breasts look ‘fake’
Choosing an implant that is too large for your frame, a shape/type that doesn’t suit you or the wrong placement method can result in an unnatural appearance.
For example, if you opt for subgandular implants (implants placed underneath breast tissue, but above the chest muscles) when you don’t have enough existing breast tissue it is possible you’ll be able to see and feel the implants in the breast.
These issues can be solved by either using a smaller size or different shape/type of implant and/or by placing them subpectorially (under the muscle). This method creates more cushion between the implant and the skin, so you’re less likely to feel the edges or see rippling. It also offers a beautiful, natural breast shape and reduced risk of capsular contracture.