Q: Hi, I had breast augmentation but I don’t feel satisfied. I include the after and before picture. You can see that my before picture my nipples were center and the shape of my breast was round. I don’t know if it’s because of the dual plane technique that I feel my breasts are lower and saggy, and if because they try to reduce the gap in the middle, the nipples are more to the side. I want to know if it’s there a way to fix it because I’m considering that or either taking them out with a reconstructive surgeon.

A: Hi Marie. Thanks for your question.

It looks like your reconstructed breasts are somewhat larger than your original breasts were, and I think this is at least partially what has produced the appearance with the nipples “off center” that you don’t like.

We don’t do implant reconstruction under the muscle or “dual plane” any more, we pretty much always use a completely Alloderm-wrapped implant placed entirely in front of the muscle (which is where the normal breast is), which usually produces a very natural appearance. I suspect that if your implants were reduced in size and placed in front of the muscle you would have an appearance much more closely approximating what you looked like originally. I would be happy to discuss your situation with you further by phone or in person, if you wish.

Thanks again for your question.

--Richard M Kline Jr MD.