What can I do about having too much upper pole four years after breast implants? (photo)

Thanks for your question and for your pictures.  Indeed it appears that the upper portion of the implant is high and the distance between your nipple and the fold of your breast is short. Fortunately, lowering implants is relatively easy (raising them is harder).Based upon your photos you may have had a tight or constricted breast prior to your initial surgery. If so this kind of breast can require a more aggressive release of the lower breast at the time of surgery.Check with a board certified plastic surgeon in your area. Options are likely to include releasing the lower pole of the breast and dropping the fold and may include the possibility of a shorter hight or shaped implant.Hope this helps.  

Your implants are too high and you need the
pocket extended inferiorly. I would
recommend a circumareola approach to reshape your breast tissue, elevate them
higher on the chest wall and more medial.
If you are dissatisfied with your size and want to be larger, a slightly
larger implant can be placed. I always
recommend small round textured silicone gel implants placed retro-pectoral
since they look and feel more natural, are more stable, less likely to ripple or
have complications needing revision. This
technique avoids the ugly vertical scars of the lollipop incision, maintains
nipple sensation and the ability to breast feed.Best Wishes,Gary Horndeski, M.D.

     If the implants have always been high, then the likely solution is to lower the pocket.  If the implants have migrated upwards and the breasts feel hard, then capsular contracture treatment may need to be pursued.  An exam will help make this determination.  Kenneth Hughes, MDLos Angeles, CA