Do you think this is a failed or successful breast lift (pix)?

My breast lift markup and 7-mod post op

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I am despondent. Comments from surgeons have come back to me about my breast lift from the RealSelf site. The plastic surgeons said I needed my breast lift redone (http://www.realself.com/question/36dd-32-38-158-pounds-after-massive-weight-loss-57-tall-50yo-create-big). Here are a few of the comments that were particularly painful:
"Appears to be a very, very, conservative lift."
"You need a GOOD breast lift."

Worse, comments have come back from plastic surgeons in the community, and these are the comments that have driven me to tears. I was speechless when I heard the following:
"Her breasts looked better before the lift."

That is by far the worst breast lift I have ever seen."

"If I did not see the scars I never would have known she'd had a lift."

Other comments were too crude for me to reprint.

I spoke with my surgeon, Dr. Joseph F. Capella, and he said he thinks they look fine and that he doesn't know how much more he can raise the NAC. And although I have had a long relationship with him, the other plastic surgeons' comments were very compelling. I have never liked my breast lift and so many patients told me it was a beautiful breast lift that I began to mistrust my own observation. But these surgeons are confirming what I have always felt, that this was a failed breast lift. I just don't know who to believe anymore. 

I've posted my photos and welcome all opinions and advice.

I don't think it's failed and I don't see what more can be done. Reposition the nipple a little higher, maybe?  

You didn't get implants, did you?  The problem is that the lift alone only really improves the bottom of the breast , repositions the nipple, and takes off excess skin. It doesn't help with the upper pole at all. If you were expecting more fullness, you'd need the implant. What is it exactly that you don't like about them?

Thank you for writing. Yes, these surgeons who have seen my photos believe there is still ptosis and that it doesn't even look like I have had a breast lift aside from the scars. As for me, I always did expect the NAC to be higher than this as well as my breast shape being corrected with the lift. They are oddly-shaped and always have been.

I understand that implants make a dramatic difference. I was scheduled as a 2-stage lift and implant. My surgeon told me he would raise the NAC higher after he added the implants. He also said he would open the breast pocket to shape them better. But now I am scared to do this because, if as all these other surgeons are saying (and I am talking mor then 2 dozen plastic surgeons who have seen my pix) that this was a failed breast lift, then we basically would be doing a primary lift and implant as a single stage. And that would cause so many problems in the near future such as the tissue falling off the breast, bottoming out, etc. as well, one surgeon said that adding a large implant and doing a breast lift revision at the same time can cause serious issues with blood supply to the NAC. Another surgeon said that my surgeon would not be able to lift me that much with a large implant and asked if I would accept a breast that sits lower on the chest.

None of these doctors have seen me in person, nor have I had a conversation with any of them. When I get back home (I am traveling until Memorial Day), I will get one or more opinions of a female plastic surgeon who sees me in person. I am just wondering if the photo that these surgeons have seen did not clearly show my lift. This is the photo they saw (3rd pic in) http://www.realself.com/question/36dd-32-38-158-pounds-after-massive-weight-loss-57-tall-50yo-create-big. I am unable to copy and paste from my iPad.

 

Seeing a PS in person for an exam and opinion is a good idea.  Pictures only take you so far.

I looked at the realself posting and the answers from the docs.  A few said that it was a conservative lift, but most of them were more focused on the issues of getting the size that you want.  I was never interested in implants, so I don't know a lot about how they work, but my surgeon said the same thing that some of the realself docs said - overstretched skin and implants are iffy at best.

Capella must have a plan.  He knew you were coming back for implants and may have done the lift with that in mind.  I assume some extra room is needed to get the implants placed, particularly for the size that you want. But I know it's frustrating when you're not seeing what you expected to see.  Hang in until you have a one on one with the other surgeon. 

The thing is I was absolutely fine with my breast left even though I didn't have the ultimate look I wanted. I knew I would look very different after I had the implants. My question to the doctors was specifically about implants but some of them basically said I had a bad breast lift. Then there were other surgeons in the community not on real self that said does very harsh things about my breast lift. So it was very alarming to me to have so many surgeons say such convincing things about my breast lift not being at all good. I have to wonder why so many surgeons would all say such negative things and it's very concerning to me. 

It seems that either a very good breast lifts and or Alloderm are the safest approach when doing large implants on a massive weight loss person. The aloferm is very expensive. 

Dr. Capella planned to list my NAC higher when he did the implants because I told him I did not like their position. But I think this is like doing a single stage lift and implants because the breasts are already too saggy after the lift. 

So I am considering not doing implants now and doing them a few months after the revision. And even though Dr. Capella does not charge for revisions I do have to pick up the hospital fees. And I'm not sure if I can afford this for two more surgeries. 

Aren't you getting implants at a later date? My opinion is that surgeons treat us 2 stagers a little differently with the future implants in mind. Perhaps they do not pull us as high as lifts only because they know the implants need room and that will even everything out. I hope that makes sense.

I am a two-stager who has had the lift but not the implants. I am happy with my lift, but can visualize that they will look phenomenal with the implants. I need to start saving my pennies  

Thanks, Laura. Yes, I am a two-stage lift and implant. If you have pix of your lift in your albums, may I have the password to see them?

Dr. Capella does a tailor tack approach with the breast lift (whatever that means). He said this preserves projection and most women like it. 

Looking at the 3rd pic in here http://www.realself.com/question/36dd-32-38-158-pounds-after-massive-weight-loss-57-tall-50yo-create-big do you think there is a difference between that photo and the one in my post? That is the after photo that all these doctors saw. I may post another question on realself with my photo above and hear what they have to say about my breast lift.

when I was in his office in March, Dr. Capella was able to pinch more Brest tissue/skin and tell me that was what they would look like once he moved the excess. There seems to be quite a bit there, like the same amount that he pinched off in my first breast lift markup.

You had the lift and not augmentation so no roundness.
I learned going in to my plastics after resuming these boards and Dr.S to expect improvement and not perfection. I'm not looking to have "headlights or grapefruits" AND I'm only able to get what my HMO will cover so I have to convince myself to be happy with whatever I got and live with it. I have half avocados and not much bounce so I can go out w/o a bra- and a bra is very hard to find for a 38" but B-C cup that an over the head "sports" bra or nothing works better for me in my limited opinion.
You are putting out good hard-earned money and you deserve to feel good in your body and with your body...but there is also the reality if you have had done the best that can be given the excess skin removal and elasticity. You have done your research yet you have to live with the end results.
Will doing more work on what was done cause not only more scarring but tissue damage? Will you be satisfied or give yourself an ultimatum to...?
Can you look back at pics of who and what you looked like to compare how far you've come to see if that gels you decide?
Mikimi in Israel

Hi Mikimi - The breast shape can be changed during a lift by opening up the pocket as far as I know. But it is not the lack of roundness that I am concerned about because he is addressing that during the augmentation, but rather that the excess skin was not removed and so the NAC sits too low on the breast. There should be more breast seen under the NAC.

Dr. Capella told me a long time ago that he revise me and would lift the NAC higher during my augmentation because I told him I hated my breast lift. But my concern for a long time now is that will be more like a primary lift and augmentation. And now with all of these surgeons saying my breast lift was a failure, it just confirms my fears of having a primary lift and augmentation.

Getting a single step is not successful, which is why Dr. Capella does a two-stage. So I told him that I was not comfortable with doing a single surgery and we discussed doing the revisions we had planned without the implants and then getting those 3-mod down the road. My concern with that is cost. While he is not charging me any surgery fee for my revisions, and that is very generous of him because my results are very good, there still are the expensive hospital fees. I believe as an established client he also holds his prices, which is a very nice thing to do as he has had two price increases. Anyway, I am hoping that when I get the revised price quote that it does not cost any more by breaking the surgeries into two shorter versus one longer. 

At the end of the day, what really upset me was all of these surgeons saying I had a really bad lift. It knocked me off my feet because it came so unexpectedly. I was unaware there was a problem with my breast lift. I was speechless at first and then in tears!

Dr. Capella says my lift looks fine, but he has seen other parts of my body that he said need a little skin removal. So I don't know why he would say the lift looked good if he did not believe it, because he has been honest to say I needed a little skin removal on my right thigh. My greatest concern was that he was not being honest with me about the lift. I have put so much trust in him. 

Talking through this with everyone has helped.

Boy will I be glad when my plastic surgery is over! The emotional aspect is so much harder than the physical recovery.

If I read your original post correctly, you will be consulting a female PS so after that you will have all your confirmation or doubts more readily resolved as to what and how you will do further plastics.
Some of your medical terminology I am not familiar with; but I do not need to understand every aspect.
I've read your journey as well as knowing mine.
You want validation that your body was not mistreated. Seeing a PS with new eyes and up close and personal should give you the perspective you need.
Mikimi