5’3”, 130lbs, 400ccs, Mentor, silicone, under muscle, can this be corrected? (Photos)

Like any other surgical repair, capsulorrhaphy with mesh isn't always 100% effective, and recidivism is a small but real possibility. It happens to me about 2-3% of the time when using mesh. Another consideration is whether the 'internal bra' was executed properly, and whether your surgeon's expertise in this type of revision surgery is sufficient. These are questions I can't answer, but a surgeon should have a reputation for revision implant surgery, which would usually indicate experience. Your drop out doesn't look severe or unfixable by any means.

Your breasts are widely separated and falling off to the sides. You need smaller implants with medial plication and the pockets dissected more medially with excess skin excised.

Best Wishes,

Gary Horndeski, M.D.

Your implants are a bit too large and heavy for your tissue. You can go smaller and have the inferior and lateral pockets tightened. You will still have the gap between the breasts because of your anatomy. However, fat can be added in that area to help minimize the gap.

The fact your implants are far apart may be related to the fact that the implants are under the muscle
Correction may need placement above the muscle

To make an assessment on the outcome of a plastic surgery procedure we always need to see proper before and after pictures. If you don’t have before, and after pictures and ask your surgeon to forward the pictures they took.
Don’t take pictures using a mirror. Use the timer on your camera or have someone else take the pictures for you.
Implant is it direct reflection of how the procedure was performed. Surgeons who end up with implants that bottom out should blame no one but themselves.
Treating bottomed out implants it’s not easy or straightforward and this is better done by someone who has a proven track record correcting this deformity.
Should you happen to be close to Southern California then consider checking out Tom Pousi , MD or other plastic surgeons, who had extensive breast augmentation backgrounds.
You appear to have a divergent breath, and this can most likely be seen on your before pictures. Women who have diverge in France are going to have the divergence be amplified from the projection of breast implants. This should be discussed during your consultation. Not everybody is an ideal candidate for implant augmentation and results vary based on three different variables. The variables that determine the outcome are the patient’s candidacy for the procedure, the choice of size and shape of implants and creating the implant pocket correctly.
If your breast bother you enough that you’re willing to have another operation, then I suggest either following up with your provider for scheduling second opinion in person consultation with other providers in your community.
To find the best provider I suggest patient start the process by scheduling multiple in person consultations with local plastic surgeons in your community who seem to have a good track record for the procedure you’re interested in.
During each consultation ask each provider to open up their portfolio and show you their entire collection of before, and after pictures of previous patient who had similar body characteristics to your own. And experienced plastic surgeon should have no difficulty showing you the before and after pictures of at least 50 previous patients. Highly experienced plastic surgeons should have hundreds or even thousands of before and after pictures to choose from for commonly performed procedures such as breast implant augmentation. Being shown a handful of preselected images, representing the best results of a providers career is insufficient to get a clear understanding of what average results look like in the hands of each provider. It’s also important that providers show you pictures of previous patient who is breast look very similar to your own. For example, women who have divergent breasts should be shown pictures of other patient who also had breast divergence, so they can have a clear understanding of what this looks like after augmentation.
Ask each provider what are most common revision cause is, what their revision rate is the revision policy is.
Providers who claim to have a few or no revisions are probably not leaving patients with the best outcomes so low revision rates does not necessarily mean somebody is good at the procedure, but May instead indicated that someone is reluctant to give people the best outcomes when improvements are possible. What’s more important is to understand if the provider has a history of having to lower implants or correct implants that bottomed out.
For revision work do you need to ask specifically how many previous cases they’ve had at treating that condition. Preferably as providers to show a specific examples of a long-term outcomes have been corrected whatever condition you are concerned about.
. There’s no correct number of consultations needed to find the best provider. The more consultations your schedule, the more likely you are to find the best provider for your needs. Having only one consultation leave patient with virtually zero choice between providers the biggest mistake Patients typically make is not scheduling enough consultations and not taking responsibility for vetting providers properly.
Your outcome seems fairly typical. It is unfortunate when providers open the inferior pocket aggressively causing implants to bottom out. It is always a balancing act between implants riding high versus implants bottoming out with time.
Leaving just enough pectoralis muscle to support the implanted against gravity over many years is the quintessential hallmark of quality work.
When the condition bothers you enough that you’re willing to have a third operation is probably the right time to move forward. In the meantime, I suggest working diligently ti finding the best provider for your needs whether that is your current provider or someone new.Best,
Mats Hagstrom, MD