Lower pole laxity following capsulectomy - would a simple capsulorrhaphy be a solution to my current ptosis? (Photo)

An examination is needed to see if mesh would be helpful. Sometimes the excess lower skin needs to be removed with an inferior incision. Your surgeon can let you know what is best.

You don't really appear any more bottomed out on the left than you do on the right. It just seems like the implant is too small. Strattice is an excellent, if not overly expensive, supporting material that can do what any other absorbable mesh can do. When I look at you, you started out before implants with significant soft tissue asymmetry, and the placement of implants alone and the subsequent capsular contracture didn't help. I would consider surgery on both breasts to achieve the best symmetry possible. Preparation would include measuring distances like nipple to fold, nipple to sternal notch, overall breast tissue volume, and areolar diameter. Based on those measurements, you would have a complex surgery that would both modify the internal implant pockets and the soft tissue envelopes as well, the later executed through breast lifting (breast lifts don't just lift a saggy breast, they control skin surface area as well). This may come as a shock and perhaps going a little overboard, but this is what's required. In the end your scars would be barely visible and your breast shape would be optimized.

I recommend explantation and mini lift. Using a circumareola incision, the implants are removed, your breast tissue is reshaped, elevated higher on the chest wall and more medial to increase your cleavage. At the same time, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.