Breast revision. How do I know what the right answer is? (Photo)

Question

I am 45, 5’0 and 129 lbs. Currently have 18 yr old saline implants under the muscle. After a pregnancy and full hysterectomy my implants have moved a bit and I am looking to have them replaced with silicone. After 2 consults I have been told by both surgeons I do not need a lift. One recommends to repair the pockets and replace the implants with silicone back under the muscle. The other recommends to repair the pocket and place over the muscle. How do I know what the right answer is?

Daniel Barrett, MD · Answer

Dear myahd9876,
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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Gary M. Horndeski, MD · Answer

Your breasts are low on the chest wall.  You will need a lift and the technique I recommend is explantation and The Bellesoma Method.  The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage.  Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained if not injured during your previous surgery.  Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Connie Hiers, MD, FACS · Answer

Your pockets have stretched and let the implant sag and they do need to be tightened. I prefer the implants behind the muscle to avoid seeing the edge of the implant and better upper chest fullness. Your breasts do sit somewhat low on your chest and the breast bases cannot be changed.  Please avoid going bigger since the increased weight may weaken and stretch the pocket repair.

Richard P. Rand, MD, FACS (retired) · Answer

There is no one right answer, but I believe most would agree that because your nipples are not low, a breast lift is not needed. That is what a lift is for. Not for upper pole fullness as some now say on the internet. Second, a pocket revision and staying under the muscle should move the implants up and in for better positioning. There are many ways to do this so be sure to see MANY photos of exactly this kind of revision done by each interviewed surgeon.

Breast revision. How do I know what the right answer is? (Photo)

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Answer: Breast revision

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Breast revision. How do I know what the right answer is? (Photo)

Answers (4)

Answer: Breast revision

Answer: Breast revision

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Recommended reading

Everything you need to know about Breast Implant Revision

Our mission is to create a world where every investment in modern beauty is Worth It.