Breast implant, lift, scarring. Second revision advice? (Photo)

I highly recommend significantly downsizing the implants, placing an internal bra scaffold (Galaflex) for support, and performing an anchor-type scar pattern breast lift. I would find a surgeon certified by the American Board of Plastic Surgery; ideally, one with an aesthetic fellowship accredited by The Aesthetic Society. I would also review before/after photos, Google reviews, and talk to the surgeon directly if possible.

Yes, a revision would be indicated if you so desire. The vertical scar is widened and the breasts have bottomed out. With large implants, they add extra weight which will increase the chances the breasts will bottom out. I would suggest smaller implants, a gala flex mesh, and a redo anchor mastopexy.

620 cc implants weigh more than 1 lb each and are too heavy for your frame to hold. The only thing holding up your implants is the skin envelope and as you can see you are bottoming out. At this time, you need the areolas reduced, the vertical scars revised and explantation with breast lift. The fact that you have had several previous breast surgeries puts you at a higher risk for complications. Mesh is a passive device which will not be able to hold up the implants you have.

Best Wishes,

Gary Horndeski, M.D.

Thank you for your question. A large portion of my practice is dedicated to breast surgery and revision breast surgery. I have been in practice for over 28 years. In your case, you would benefit from an internal bra procedure - capsulorrhaphy and a revision of your breast lift. I wrote the very first paper on capsulorrhaphy over 20 years ago. If you are on top of the muscle, then I would reposition the implants under the muscle. I wrote that paper too. I find that many surgeons are not skilled at these procedures and have high rate of recurrence. You should be able to have an excellent result. Best wishes to you

Dear Resourceful845473,
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

You need to go smaller and lift again. With such heavy implants that are too large for your frame, they will not stay where you want them. You may also need mesh for better support.

In my opinion your implants are way too large.
I would recommend replacement with smaller implants ,pocket tightening ,and possible mesh support
At the same time the scars would be revised .

I’ve read your posting and reviewed your posted photos which were nicely done. My initial thought is do you really want that size breast? If you do, then my suggestion would be to exchange implants to a very slightly lower cc in the 550 to 575 range With or without mesh and scar revision. If you desire the same size implants and look, this is the only option at this point. If you do not mind going down a cup size, I would reduce the implant volume to under 500 or even to 450 cc with scar revision re-lifting and small Inferior meshing. Expect fees to be in the $20,000 ranges best to virtual consult with good luck.

Quality breast, augmentation outcomes are generally based on three variables.
These are the patients candidacy for the procedure, the choice of implants in regards to size shape, and type, and the surgeons ability to place the implant in the correct anatomic position, the new paragraph when choosing accessibly large implants patients are at significantly increased risk for having undesirable secondary side effects, increased risk for revision surgery, and Increased risk for complication, including implant failure.
With the size of your implants, the natural tissue that should be supporting the weight of the implants are probably gone or stretched out, and no longer sufficient to support the weight of the implant.
This put you at increased risk for bottoming out, having consistent problems and need for revision surgery.
Once the tissues are stretched out, it’s difficult to go back.
At this point, it is likely you will continue to have problems with your breast and implants based on previous decisions and previous surgical procedures.
Follow up with your provider or scheduling person second opinion consultations with other plastic surgeons in your community to get a better assessment and better understanding of treatment options.
Mats Hagstrom MD