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