Breast revision surgery
I had a vertical breast reduction 1 month ago. I have lower pole fullness and look droopy with high nipples. I had a medial pedicle. 500 g was removed from each breast. Breasts now end at the crease of my elbow not my belly button but I feel they are to big and my surgeon agrees but what's the safest procedure to fix this? Is a revision surgery risky?
First of all, the best thing to do is to wait for at least 6 months to see what will be nearly your final result. . If your breasts look Bottomed Out now (ie: long distance from your nipple to crease), you will definitely need to have a revision surgery. But, it's best to allow for more settling before you proceed with correction! I have to admit, I'm not at all a fan of the Vertical Reduction or Lift Technique, ie: the Lolly Pop Scar!. I have seen way too many patients who have had this procedure that come to me afterwards to have a revision to correct bottoming out. I'm just not a fan! The crease scar adds a totally different vector of tightening and lifting that you don't get from the vertical lift technique.
When you have "high Nipples", It may not be that your nipples are really too high. they may just appear too high because there is too much volume inferiorly. The best way to correct this is to push all that breast tissue up, giving you a more full, perky breast and making it so that your nipples will fit into your bra and Bikini again!
At this point in your recovery it is important to stay in close contact with your plastic surgeon. They have the ability to examine you and follow the changes you describe. It will take weeks to months before you see the final results of your surgery. In terms of revision, without a picture or exam it is difficult to counsel you on the best approach should revision be necessary.
Dr. Edwards
It is early in your healing process. I would allow more time for settling maybe 3-6 months. If at that time you still have the same concerns there are surgical options. Your surgeon will review them at that point. Options include: adding a horizontal incision this will centralize the nipple over the breast mound elevating the breast tissue and shortening the verical dimension or redoing the surgery and removing more tissue. Without photos and measurements it is not possible to provide more specific recommendations.
Revision surgery after vertical breast reduction should be fairly straightforward. I would definitely wait at least 6 months if not longer to allow your tissues to heal if you are going to have a secondary breast reduction. Small lower pole scar revisions can be done sooner. Without a revision, you will see continued changes in your breast for months and even up to one year after vertical breast reduction so be patient.
25% of all plastic surgery needs revisions, if your Plastic Surgeon suggests one that is the best way to go. Stick with your original Plastic Surgeon because she knows where the previous pedicle was designed, which is important to avoid complications.
First of alll, you should know that it is always somewhat difficult to give clear advice without actually seeing the patient. There are some general rules that should be followed if a patient is unhappy with their surgical results. If you still trust your surgeon, then sticking with your original surgeon is advised because that person will know your post surgical anatomy the best and there may be some nuances that a new surgeon wouldn't know about. It is also best advised to wait a minimum of 6 months from your original surgery before passing judgement on the results and closer to one year postop before having revision surgery. It may be that all you need is some additional breast tissue removed horizontally along the bottom of the breast. This would lower the nipple and reduce you even further..
Thank you for your question. In my opinion, I would advise you to wait at least 2-3 months before proceeding with a revision. This gives the tissues time to soften. It sounds like you may need some support to your internal tissues (breast tissue) in form of products like SERI. This will lessen the appearance of a "bottomed out" breast. Of course there are inherent risks of reoperation and the use of internal support. Best wishes.
At times vertical breast reductions, may need to be converted to an anchor, Wise pattern, inverted "T" to minimize high nipples and bottoming out. This would allow for additional reducing the breasts too. Usually one waits 6 months for a revision but there may be exceptions to the rule.