Revision surgery needed? (Photo)

I am just about 2 years post op of having a breast lift and augmentation. I have saline 400cc implants currently. I want to achieve fullness in the upper portion of my breasts and reduce the size of my areola. I had a consultation last week and he said he can go back in and "close the pocket" so the implants don't slide into my armpits like they do but I'm not sure that will be enough.. Attached is a collection of pictures of myself since my surgery, as well as a wish pic of what I would like..

Doctor Answers 8

Revision Surgery Needed?

I am sorry to read of your disappointment. The #sagging or #flattening of current implants can occur for many reasons.  Some include the #size of the breast and implant,  #weight of the breast and implant, #gravity, #age and/or aging, #weight loss and weight gain.  #Tissue integrity (i.e. some women are more prone to experience sagging due to weakness of their skin and breast #tissue at the fold). 

In regards to implants alone, this is usually said to be mistake by patients reflecting back at the decision. Most breasts will look larger and more droopy with solely implants. They will sag more and sooner, due to the sudden and excess weight. At times it's possible for a “Snoopy” breast or double bubble to develop as a result. There are a variety of techniques for a #BreastLift. I prefer to use the short scar technique, “#lollipop scar” or “#donut lift” rather than the majority of surgeons in the United States that use an anchor pattern lift which involve more significant scarring.

Please be advised that each patient is unique and previous results are not a guarantee for individual outcomes. As with all cosmetic surgery, results will be rewarding if expectations are realistic. With any surgical procedure, there are some risks which your doctor will discuss with you during your consultation.
It is imperative you select a plastic surgeon who is #board-certified and has a great deal of experience with breast #augmentation and the incision type, #implant placement, and implant type. Aside from checking board-certification, it is suggested that you look at before and after photos of the surgeons actual patients, and read patient reviews.

Orange County Plastic Surgeon
4.9 out of 5 stars 110 reviews

Revision breast implants

 From your photographs, in my opinion, you will need to exchange the implants for a high profile smaller  implant, redo the mastopexy, and close the space that's extra both below the implant and to the side that we call a capsulorraphy. Your plastic surgeon  and you at consultation to discuss all of these options. Good luck with your revision.

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 54 reviews

Breast implant exchange and revision lift

Thank you for the question and posting excellent pictures. He seem to be a good candidate for Implant exchange using textured silicone implants as well as a revision breast lift.  You would need a consultation to discuss your options in detail.

Kevin Tehrani, MD, FACS
New York Plastic Surgeon
4.8 out of 5 stars 95 reviews


This is what happens with time for some individuals.  A revisoin may improve the overall appearance. Best of luck.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews


To achieve your wish picture, a revision of the pockets, possible change in implants and revision mastopexy would be indicated.

An exam and consultation with a plastic surgeon is recommended to discuss your options and expectations. 

Harry T. Haramis, MD, FACS
Montclair Plastic Surgeon
3.7 out of 5 stars 19 reviews

Implant Revision

It appears your skin and lower pole has stretched out over time.  I agree that a capsule tightening will be needed but I would also consider skin tightening through a secondary mastopexy.  You already have the pre-existing scar so addressing on both the skin and capsule level will help.  I would talk to your PS about this aspect of the revision.  Best wishes.

John Y.S. Kim, MD, FACS
Chicago Plastic Surgeon
5.0 out of 5 stars 69 reviews

Revision surgery needed?

Thank you for your question.  Implant position can be adjusted by manipulating the capsule; this is certainly an option.  Sometimes a mastopexy is also required to address the excess skin, correct the ptosis and reduce the areola size.  Be sure to have a clear communication about your goals and expectations with your plastic surgeon.  Good luck.

Zachary Farris, MD, FACS
Dallas Plastic Surgeon
5.0 out of 5 stars 19 reviews

Revision surgery needed after breast augmentation/lifting surgery?

Thank you for the question and pictures. What you are describing and  experiencing is not that unusual, unfortunately.  It is somewhat challenging to maintain upper pole fullness/volume when patients undergo breast augmentation/lifting combination surgery.  In other words, it is not unusual that patients who wish to achieve your desired outcome, require a second stage procedure as described by your plastic surgeon consultant.  This procedure is called capsulorraphy and involves closing off the breast implant pocket preventing breast implant displacement.  Sometimes additional skin removal and/or use of a larger breast implant may also be helpful.
 Communicate your goals carefully with your plastic surgeon. Working together you will come up with the best plan to achieve an outcome that you will be happier with. Best wishes

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,499 reviews

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.