How can I encourage more drop/underboob for my revision? (Photo)

Dear CLM25,
breast revision surgery is the most difficult plastic surgery procedure performed. Botched breast surgery alters normal tissue planes and laxity, the ability of breasts to heal properly, and leaves scar tissue that dramatically affects the level of difficulty of the corrective surgery.Many patients come in to correct poor outcomes from their initial surgeries. The most common problems are due to implant malposition, bottoming out of the implant, poor scarring, and incorrect implant size.While the type of revision required will depend on the result of the previous surgery and the desired result of the patient, some revisions involve extensive pocket repair that may or may not need specialized external bras.If you are considering breast surgery revision, you should speak with a board certified plastic surgeon and have yourself properly assessed. Only after a thorough examination you will get more information and recommendations. Also, you have to make sure that your surgeon understands your breast augmentation goals.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

The real issue isn't that the lower pole of your breasts haven't filled, it's that your reference point of where the lower pole begins (your nipple areolar complex, NAC) is too low. This is because you started off with a constricted breast and a short nipple to fold distance. Fortunately, your surgeon didn't do the wrong thing at your first surgery, which is done all too often, and lower your fold; you would be contending with double bubble and severe dynamic breast deformity. Instead, imagine if your NAC were higher, and you could see more breast skin below them, like in your wish pic! So, the surgery you need is removal of current implants, targeted scar capsule removal or incisions, replacement with new, larger implants (all via an inframammary incision), and a vertical breast lift (lollypop scar).

At this time, I recommend a mini lift. Using a circumareola incision, your breast tissue is reshaped creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage. At the same time, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

The pocket can be lowered or made larger laterally for the tighter side. The nipple could be raised on the opposite side.

Why are you having revision surgery?
Breast augmentation outcomes are based on three variables.
The first is patient candidacy. The second is implant selection. The third is the surgeons ability to place the implant in the correct anatomic location.
There’s nothing you can do to change your candidacy for the procedure
While your original implant selection was slightly conservative working with larger implants increases undesirable side effects, complications and increases revision rates.
Bigger implants will also emphasize the variables that make you less than ideal candidate for breast augmentation.
You have some breast divergence and your breast sit wide on your chest wall.
The bigger implants select the more these variables are going to be put on display.
There’s nothing wrong with with your current outcome.
It looks like the implants were put in the correct position.
You can choose bigger implants, but I don’t think it’s going to deliver what you’re looking for.
Your last picture which I assume is your Wish Picture is not possible because your candidacy for the procedure is different than that person.
Honestly, I don’t see why you’re having revision surgery.
Quality surgery outcomes always start with having a clear understanding of what the problem is.
In your case I don’t think you have a clear understanding of why your outcome looks the way it does.
I think you’re asking for a procedure that isn’t going to deliver what you’re looking for.
Bigger implants are going to give you a bigger version of what you have now.
If you don’t like the outcome, then why are you going to be happy with a bigger version of it?
Lowering the implant pocket is going to create implants that bottom out.
Implants that “bottom out” is a highly undesirable outcome.The enemy of good is better and the enemy of better is best.
Perhaps you should get a couple of second opinions before moving forward.
Best,
Mats Hagstrom MD