Breast augmentation; need the best doctor? Time to be redone (Photos)

I'm looking to get theses saline implants out had them since 2007 want more perky breast I've had them inserted behind the muscle but the dr put 460cc on one side and 455 cc on other to try and offset the lift that was needed was worried cause of keloid issue now think I need a lift as well as perky breast

Doctor Answers 10

Breast augmentation; need the best doctor?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Thank you for the question and pictures.

As you know, careful selection of plastic surgeon will be the most important decision patients make when they decide to  undergo surgery to achieve a specific outcome. Besides appropriate training and experience (and certification by the American Board of plastic surgery), looking at before/after photographs (and  preferably talking to previous patients) can be very helpful in this selection process.

 Basically, patients should look at the overall "quality" of the outcomes achieved;  in other words, it will be important that patients see lots of examples of outcomes that they would be pleased with.  In doing so patients will be able to get an idea of each  plastic surgeon's "aesthetic sensibilities". Of course, careful evaluation of the photographs (including factors such as time out of surgery and initial anatomic starting point) will be important as patients evaluate before/after photographs.

  Best wishes.  

Saline implant redo

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Thanks for the photos. Based on the photos, I agree that you will benefit from a breast lift and implant exchange to silicone. Make sure to select a board certified Plastic Surgeon who has experience dealing with keloid scars. Good luck

Implants, some advices:

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Thank you very much for enquire.

The only type of breast implant that can be re-filled with a syringe are the saline implants (if the valve can be located) but the consistency is that of a bladder filled with water, therefore i recommend you change them for Cohesive Gel - Silicón Breast Implants with textured cover ("gummy bear implants".
They are quite safe and aesthetically best as they give a firmer consistency, better projection and most natural appearance than Saline implants.
Dr. Emmanuel Mallol Cotes.-

Emmanuel Mallol Cotes, MD
Dominican Republic Plastic Surgeon
4.7 out of 5 stars 307 reviews

Breast lift and change of implants?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

The best advice you could receive would be based on a face-to-face examination.  Your photograph suggests to me however that you would benefit from a full mastopexy and change to cohesive gel silicone implants of a smaller size.  Your scars do not seem to be particularly hypertrophic suggesting that your mastopexy scars would be reasonably acceptable.  Avoiding an uplift would be a significant mistake despite the risk of the quality of your incision healing from the mastopexy.


Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery
Member, American Society for Aesthetic Plastic Surgery (ASAPS)
ABC-TV Extreme Makeover Surgeon
Beverly Hills, California

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 31 reviews


{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Yes, I agree with you. I  think that you need a lift as well. Best of luck with your decision to move forward.

Lift and implant exchange to smaller implants or fat

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

The pictures are very helpful. The options are to do the implant exchange and fat grafting for symmetry if you are ok with your nipple position. If would like higher nipple and smaller breast, I would suggest smaller implants , fat grafting and lift. 

Breast Lift

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

It appears that a breast lift will be necessary to give you the perky appearance you desire. Scars will be necessary around the nipple-areola and vertically fom the areola towards the fold ("lollipop lift"). 

Keloid or hypertrophic scars are possible with any surgery. However, most people scar favorably. 

Whether or not to keep and/or exchange the implant depends on your desired cup size. This should be discussed with your plastic surgeon to help you make this/these decision(s). 

Make sure your plastic surgeon is experienced in re-do procedures which can be somewhat "tricky" to get right. 


Aug or aug+lift

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

You appear to be a good candidate for a BA with a lift to achieve your desired "perky" goals. From your pictures you healed very well from your initial surgery, so there shouldn't be any real concern that you won't be able to heal nicely again. 


{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

For perky breasts, I would recommend removing the implants and capsules if they are hard, and undergoing a vertical lift.  You may consider a small implant for volume but you would probably not need it.  Best wishes, Dr. T. 

Replace implants?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

It appears that the implants are still intact, so there is nothing forcing you to replace them. But if you want a "perky" breast then you would likely need replacement of the implants and a mastopexy (breast lift). Best to see a board certified plastic surgeon who routinely does this operation.  You should also be able to look at several before/after pictures of patients who have a similar body type.  I think you are a good candidate for a revision.  Good luck.

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.