Bottoming out after breast revision - what would be my best options to treat this?

Hello and thank you for your question! I understand it can be frustrating to go through revision procedures, whether they be for implant exchange, capsular contracture, or implant malposition - or sometimes all 3. Every patient is different and the best recommendation for you would come from an in person consultation with a board certified plastic surgeon, which it sounds you have done. Sometimes going to different surgeons will result in slightly different answers, as you have experienced. This means that there is no one 'right' answer and each surgeon has different preferences and experiences with the different techniques. What the techniques you have mentioned have in common is some form of skin excision/lift revision as well as strengthening of the internal breast tissues/reinforcement of the implant position. Those are all viable answers and without doing an in-person exam or seeing photos, etc. it will be hard to say one option is better than the others. Our practice does have good experience with Galaflex/the internal bra technique, which is commonly recommend in revision/capsular contracture/implant malposition cases. Good luck on your journey!