Breast lift with implants? How much will it cost? (photo)
Doctor Answers 5
Breast Implant Bottoming Out Needs Internal Support Strattice Or Alloderm
Thank you for your question.Your breast implants have bottomed out following your multiple surgeries which have included breast lifting.
Your skin and breast tissue will need more support to hold the implant in a proper position, especially if you're considering larger implants.
A dermal substitute such as Strattice or AlloDermcan be used as a sling to support the implant and hopefully prevent recurrence of your bottoming out.
Breast lift redo
Yes, it looks like your implants have bottomed out and you will most likely need a correcting the pocket and performing a mastopexy. Going larger with implant may not be such a good idea, because the implants you have now already caused a bottoming out. Strattice is potentially another option to support the lower pole
Internal bra for implant support with breast lift revision
The pictures show what is sometimes called a stretch deformity, meaning that the bottom of the breast has expanded. This means that your skin and tissues are not strong enough to support the weight of the implants, and if you go larger this will become worse. The solution is to add support and coverage with an internal bra procedure, using Strattice, SERI scaffold, or similar. No version of a lift alone will do the job when the first one has stretched out especially when going larger. A Strattice donut around the areola will prevent widening of the areola (the link below is an article that describes the procedure).
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Revision Augmentation Mastopexy
There are two issues at hand that need to be addressed. The first is the position of your current implants. They have dropped out due to pocket enlargement and have filled the lower pole of your breasts. This has caused a significant expansion of the skin of your breasts in that area, as well as near complete loss of upper pole fullness. Correction is done by closing down the lower part of this pocket by sewing the walls of the capsule to the floor, known as 'capsulorrhaphy'. This supports the implants into a higher position on the chest wall, increasing upper pole fullness significantly, and decreasing lower pole dropout.
The second may be a solely a manifestation of the first, or be an issue on its own, which is the breast gland has dropped out, and there is an excess of skin below the nipple-areolar complex. In addition, the nipple-areolar complex is subjectively a little high on the mound, once again, this could just be due to drop out and not truley be too high. Either way, this would be managed by a revision mastopexy which would eliminate more skin, mostly from the inframammary scar region. Although your inframammary scar would be removed, and a fresh incision would replace it, it is likely that all scars would be revised too in order to reshape the breast mound and areola.
Your photograph depicts a fairly full, but dropped out breast. Increasing your implant size by almost 200 cc will of course put you at risk for recurrent dropout in either the near or distant future. Similarly, using saline filled implants will also raise the risk of early or late dropout too. If your reason for larger implants was due to loss of upper pole fullness, then let it be known that capsulorraphy will be sufficient to restore your fullness without an implant volume increase.
You have had three surgeries, and you are still not where you want to be. My recommendation is not to shop for the lowest price surgeon to fix you. In the end, that could be the most expensive way of doing things, possibly leading to a problem that is unfixable. You need to find someone with an excellent reputation for complex revision breast surgery. Of course, board certification by the ABPS and membership with ASAPS is a baseline requirement. But just as important, this person should be a seasoned expert who does this as his specialty all the time. Anyone with a sympathetic heart and a love of his craft will, of course, give you a discount to make it all possible.
Best of luck!
Breast implant and lift revision
After reviewing your photo, I dont think that you will get the results you want with a lollipop lift, your nipple areola is high on your breast mound, and to get this proportionally back to the correct placement, you will need a formal Weiss pattern (keyhole) mastopexy. Without an exam, I cannot say whether you are a good candidate to go to a larger size implant unless you are willing to get a dermal matrix for support, as your implants sit too low now, and they are a small size. I recommend that you consult with a couple of Board Certified Plastic Surgeons who are experts in revisional breast surgery before making any decisions. Good luck!
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.