Ask the Doctor

breast implants

Posted Question:

I had breast reconstruction with under-muscle implant in 2003. The implant was replaced in 2017 but the result has left me very uneven.

I feel that my prior surgeon didn’t take into account the proper shape and size of the breast to match the other breast. He simply measured across the breast, so I have an implant that lays beyond the center of the chest wall and is too flat. It doesn’t fill my bra cup so I have to wear a prosthesis. I trusted him and didn’t look for information about under muscle prosthesis.

Many women have asked my advice about implant procedures. I am extremely unhappy with this result but, at 68 years old, I will have to live with it for the rest of my life. I hate my result and want to be able to help others get more information in order to make sure their doctor is using proper forms/prostheses.

What can be done for a better result? Did I just make a mistake by not seeing multiple surgeons? He was my original surgeon and I was fine with the first implant. It became constricted so we did the replacement. Had I known I would have had this result, I would have just started wearing a prosthesis and skipped the misery of another surgery.

– Pat


Hi Pat,

I’m sorry to hear you are disappointed with your newest implant. I’m not sure I understand what was different from the previous implant. If the first was constricted and the second one was to replace the first after releasing the contracture, can you tell me what was done differently? If you liked the first one, I’m sure there is a chance to correct your problem. I think you should find out if the two implants are the same size and type. If the same surgeon did both surgeries, then he/she should have that information. If they don’t match, perhaps you need to replace the new implant with one that is a closer match to your first one.

Thanks for your question let me know if you have more information. 

-Dr. Craigie


  1. Hello! I’m currently seeking a surgeon for phase 2 diep. My plastic surgeon here did a great job for phase 1 but doesn’t seem interested in correcting what I think is a problem for phase 2. My breast size is currently a DD and I do not like the size. Heavy and my back hurts by the end of the day. I’m seeking a c cup. Also, my abdomen is hard and bloated from under the boobs until past my bellybutton. Making it hard to breathe. Is this something you have seen and something you could fix?

    • Hi Karen,

      For some reason, we fairly commonly run into patients who have had phase 1 DIEP elsewhere, but end up coming to us for the “finishing” work. Of course, we are delighted to help, no matter who has operated on you, and no matter what condition you are in. Breast size can certainly be reduced, symmetry can often be improved, and the donor site can often be optimized. It is important to remember that for the optimal result, several procedures are often necessary, although they typically decrease in size and complexity as the process progresses. A typical scenario would be stage 2 would include open revisions of the breast mounds and donor site, and stage 3 would involve free fat grafting to further refine the shape of the breast mounds and lower body. While the initial flap transfer is obviously the “big procedure,” we believe that the subsequent procedures are absolutely essential to getting the result that most patients want.

      Richard M. Kline, Jr., MD
      East Cooper Plastic Surgery –
      The Center for Natural Breast Reconstruction
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