286cc, silicone, can I put new implants in & fix the nipple/scar issues I am having? (Photos)

My suggestion would be implant removal then wait six months then secondary mastopexy with an experienced surgeon.

I would recommend a breast revisionary surgery that includes new implants, internal pocket work, possible Galaflex (internal bra), and another breast lift. This may require use of free nipple grafts depending on the original technique that was performed. I recommend seeing a board-certified plastic surgeon (American Board of Plastic Surgery). Ideally, this surgeon has also completed an accredited aesthetic fellowship (The Aesthetic Society).

Dear SweetEmmers,
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

A high nipple areolar complex is a difficult problem to correct. Based on the photographs provided, you have excess breast volume below both of your nipple areolar complexes. This may represent a combination of your own breast tissue (what we call glandular ptosis) and bottoming out of the implant. This can be addressed by a removing the excess breast tissue and repositioning the implant more superiorly, possibly with an absorbable mesh to provide additional support. This will help with repositioning the nipple areolar complexes by providing more superior volume on both sides. However, even with repositioning the implant unfortunately the right nipple areolar complex may need to be moved inferiorly, which will leave a visible vertical scar above it. The brown discoloration along the vertical scar may represent residual areola pigment from your prior breast reduction. This would be removed with the revision. Your case is very complex so make sure you see a plastic surgeon certified by the American Board of Plastic Surgery who specializes in breast revision surgery.

This is a challenging problem that probably requires 2 steps to correct. First then distance between the areola and infra mammary fold needs to be shortened a great deal which means removing the implant temporarily and removing some breast tissue inferiority. That will lower the nipple significantly and the.lm as a second step an implant of the desired size can be placed. A smaller contraction can probably be done as a one step operation but that Woukd depend on an in person examination.

Your tissue is not supporting the weight of the implants, which is common in women who were stretched out initially with large heavy breasts. Your best long-term results will be to remove the implants and do another lift. If you want to keep the implants, consider going down in size and using mesh for better support.

Dear Sweet,
Wow! You've been through alot there. A breast lift revision is definitely in order to correct the pseudoptosis (bottoming out of breast tissue), scars, and improve the high riding nipple asymmetry. High profile breast implants might not be the best option because they to raise the nipples even a little bit higher. Seek consultation with an American Board of Plastic Surgery board certified plastic surgeon for an examination and discussion of your options. Good luck!

My previously responded to one of your questions. The same response is a full revision with decreasing the nipple on the higher side and using a full thickness, skin graph for the donor site of the old nipple against symmetry, revision of all breast scars and insertion of high profile implants. Expect to be from $10,000 plus. Best to virtual consult with.

I suggest you schedule in person consultation with plastic surgeons in your community.
You basically need to tighten skin envelope. Lowering nipple is very difficult and you may not like what that looks like.
I think continuing to post here isn’t really going to help you much.
Work on finding the best providers in your area.
See who does most of the breast cancer reconstruction in your area and consider those surgeons. Plastic surgeons who do a lot of breast reconstruction tend to be good at breast surgery.
Best,
Mats Hagström MD