Bottoming out or capsular contracture after revision?

Thanks for posting photos so we can TRY to give you a diagnosis and treatment options. First you must realize an in person examination is much better than an internet examine with photos.
Now I feel the right breast is capsuled and an inferior capsulotomy is a choice. If the right implant is a 500 cc than that is all I would do for this side. Of course I would drain this side.
For the left side, it appears as a bottoming out, kinda of. A side view would help, but with the frontal the view is not to unacceptable. If you like the left than either leave it alone or I could recommend repair the bottoming out via internal sutures or a combination of the mesh (Strattice).
Finally, I would inform you of the risks involved and may need more than one operation. Hope I have given you at least a game plan.
From MIAMI Dr. B

Hello! Thank you for your question! Physical examination will determine if you have capsular contracture. The look and feel of hardness surrounding your implant is seen and/or felt. At its worst, you experience pain. It may also cause distortion of your breast. What has caused it will be in question.  Given your photos and description, it may be a recurrent capsular contracture. Your surgeon will likely recommend implant massage and may add the medication Singulair. If these fail, surgical correction may be suggested. It is a matter of surgeon preference as well as what is seen during your procedure that will determine whether or not a complete capsulectomy is performed. If significant capsule formation is seen intraoperatively, a full capule removal may be warranted with a drain in order to completely remove all of the tissue and allow better adherence of your breast back to its normal anatomic position down on your chest wall. Irrigating with certain medications may also be if benefit. If minimal contracture is seen, it may be possible to leave the capsule, or place cuts within the capsule to allow better adherence. It truly is dependent on what is seen with your capsule and the issues that may be causing you to have such a procedure (e.g., contracture from rutptured implant vs pain vs simple pocket adjustment, etc). Without knowing your issues and without an examination, it is difficult to tell you what may be the best thing for you. I tend to favor performing capsulectomies in order to create a fresh pocket, reshape the pocket, allow better shape and adherence of the overlying breast. I would discuss your issues with your plastic surgeon who will assist you in determining the right modality for you. Hope that this helps! Best wishes!

?Thank you for your question. Obviously it is important that you see your plastic surgeon so that you may be examined and a proper diagnosis made.My guess looking at your photograph would be that the right breast is forming a capsule which is constricting the breast and making at higher than your left breast. You should be able to determine if this is a capsule by simply feeling the breast and feels harder on the right than the left and you likely are getting a capsule. Again be sure and see your plastic surgeon for an accurate diagnosis