2 years post-op & super unhappy with how breasts look, now what? (Photo)

I'll be brief and straight forward:
1. You've been born with tubular breast deformity (aka constricted breasts, etc), featured by a conical or cylindrical shape, high submammary creas and large areolas, among other features); they were not treated, as a consequence you have waterfall deformity and double breast deformity
2. The placement of the implants is partially submuscular (dual plane), however the surgeon failed to separate the lower edge of the muscle from the breast skin, a mandatory step; failing to do so creates the animation deformity seen in the pictures and well described by you.

Solution:
-find a good and experienced revision mammoplasty and tuberous breast surgeon
-change implants, use anatomical shaped ones in a good position, wider given your chest needs it
-treat the tuberous deformity: glandular plasties, lower the submammary fold, reduce areolas
-release the muscle from the skin

I'm sorry to hear you're not happy with your breast augmentation results.
A full exam might be necessary to determine the exact issues going on. Based on the single photo it looks like there might be a double bubble on the right side creating that crease. Not sure if you're animating in the photo or not.
If the implants are under the muscle there is going to be some degree of animation deformity. If that's really bothering you, you could considering moving to a subfascial implant pocket. That might increase the risk of implant visibility - depending on implant size and your anatomy.
I would recommend a full consultation to determine what the best plan might be. Make sure to seek out board certified plastic surgeons. I would expect a revision like this to cost somewhere between 10-15k depending on variables - pocket change, new implants, internal bra mesh, mastopexy.

I hear you and what you’re dealing with is unfortunately pretty common (though that doesn’t make it less frustrating), and there are options to help. I’ll walk you through what might be happening, what to expect in a revision, so you can go into consultations knowing what questions to ask and what outcomes are realistic. From what you describe, a few issues seem plausible:
Capsular contracture on the left side: the scar tissue around the implant has tightened, causing visible distortion, hardness, asymmetry. Implant malposition or pocket issues: one or both implants may be sitting awkwardly because the pocket wasn’t ideal (shape, size, tension). Shape asymmetry (between sides) exacerbated by the contracture, possibly different healing, different implant settling, or even anatomical differences. Possibly rippling/thin tissue coverage so the implant edges show, especially noticeable when flexing or tensing the chest muscles. These are all issues that plastic surgeons do revisions for, but how they approach them depends a lot on your anatomy (skin thickness, chest wall shape, muscle coverage), the type of implants you have, how long they’ve been in, and your goals (do you want similar look to now but better shape? Or do you want a substantial change?).

Here are things surgeons often do in revision cases like yours. Remove the old implants. Perform a capsulectomy (removing the scar/tissue capsule around one or both implants) or at least a capsulectomy on the affected side. Possibly change the implant type, size, or profile (shape, gel firmness, smooth vs textured, etc.) Adjust the implant pocket – reshaping, repositioning, reinforcing (sometimes with mesh or acellular dermal matrix) If there’s sagging or skin looseness, a breast lift (“mastopexy”) might be added to get better shape and symmetry. Possibly add additional soft tissue coverage (fat grafting) to hide the implant edges/rippling. Recovery tends to be similar to primary surgery but sometimes a bit more involved, depending on how much scar tissue is removed, how extensive the changes are. You’ll have swelling, some pain, and limitations on lifting / exercise for some weeks. I hope this helps to understand a little more. Wish you the best of luck!

You likely had some element of tuberous breast preoperatively. In some instances implants alone significantly improve this and have acceptable results and avoids mastopexy scarring. Unfortunately when that is not the case, you see outcomes similar to the breast depicted on the left side of the photo. The double bubble deformity is related to your native inframammary fold being disrupted by the implant. You may or may not have some element of the same deformity on the other side. With that significance of a double bubble, my recommendation would be mastopexy with or without implant removal or exchange. Simply removing the implants and doing a mastopexy first will give you the most reliable longterm outcome. It will also give you the opportunity to determine if you really want implants once the breasts have been lifted and reshaped. Seek a consultation with a board certified plastic surgeon to develop a personalized care plan.

hello ,
Thank you for your question.
Based on your description and the visual evidence provided, it appears you are experiencing significant breast asymmetry, likely due to capsular contracture on the left side, implant malposition, and visible implant edges—particularly when flexing—which may indicate inadequate soft tissue coverage or implant displacement. These are not uncommon complications following breast augmentation, particularly several years post-op. Revision surgery would typically involve capsulectomy to remove the contracted capsule, potential implant exchange, and pocket correction or reinforcement to restore symmetry and achieve a more natural contour. In some cases, fat grafting or a breast lift may also be recommended to improve tissue quality and overall appearance. The next step is a consultation with a board-certified plastic surgeon experienced in revision breast surgery, who can perform a thorough examination and develop an individualized surgical plan.

Thank you for sharing your experience. Based on your description and the photos provided, it appears you may be experiencing capsular contracture and possibly implant malposition, which are both common reasons for a breast augmentation revision. These concerns not only affect the aesthetics such as asymmetry and visible implant edges but may also signal internal complications that require correction.
A breast revision surgery is typically recommended in cases like yours to restore a more natural shape, improve symmetry, and address any underlying issues such as hardened scar tissue or improper implant placement. The procedure may involve removing or replacing the implants, performing a capsulectomy (removal of scar tissue), and reshaping the breast pocket.
In terms of cost, a breast revision usually ranges between $4,500 to $5,500 USD, depending on the complexity of the case, the techniques required, and whether new implants are chosen.
Early intervention can help you avoid further discomfort and achieve the results you originally envisioned.

(Based off your single photo) - It seems as if one side has developed a double bubble deformity. If this is a flexing picture, likely you want to discuss with your surgeon about revising the pocket (can be because more release of the muscle is needed +/- mastopexy (lift) or changing it from submuscular to above muscle +/- mastopexy). Essentially you need a lift as well to properly replace your breast tissue onto the implant in the correct position and fix animation if it bothers you. I would suggest discussing all this with your surgeon and study the mastopexy scar to prepare yourself for possible outcomes and what the scar looks like. (I do this quite often with my patients - if they aren't ready for the scar, then hold off.)

Reviewing your photo. The right breast shows a double bubble deformity. This happens when the implant falls below the anatomic borders of your natural breast. From your description of your left breast, you have what's called an animation deformity, where the muscle pushes the implant out and to the side with contractions of the muscle. Both of these can be corrected with revision surgery using various techniques. The asymmetry of your breast would probably be best addressed with a breast lift but if you are trying to avoid that then discussing expectations with your surgeon will be very important. Don't lose hope, just know everything has a solution, but yes it will require a second surgery.

Thank you for your ?. Based on the photo provided and looking straight on at it it appears the left breast has a contour irregularity with the lower origin of the pec muscle having been divided and now retracting upwards. This will also allow the skin to stretch out. There may be scar tissue present which i cannot tell by the picture. The right breast appears to have some droop at this time. I would highly recommend consulting with a BC PS with experience in breast revision surgery. I believe all your breast issues can be corrected.

Thank you for your question. You've got a challenging combination of issues that will not be easy to fix, but a skilled surgeon should be able to give you significant improvement. It would be helpful to see a "before " pic for comparison, but I can tell kind of where you started. On your right, you have a significant "double bubble" deformity, which is when you can see the old inframammary fold sitting on top of the implant. This occurs because an implant is placed below the old inframammary fold without properly obliteraing or wakening the fold. You likely had a small, tight breast with a high-riding fold on that side to start. The left side doesn't have that problem, indicating that you probably had a significantly larger breast on the left and that the implant is sitting on the fold instead of below it. You talk about a cabsular contracture on the left, but you are actualy describing an animation deformity, which is a totally different issue. Capsular contracture is a tightening of the scar tissue that forms around the implant. It creates a firm, distorted and sometimes painful breast. Animation deformity is when a subpectoral implant is affected by the overlying muscle, leading to a temporary distortion of the implant/breast when flexing or using the upper body, and that's what I think you have. (You can have both!)
So what might improve your situation? Firstly, you need to find a talented, experienced plastic surgeon well versed in revisionary surgery. I would probably change your implants to a subfascial plane to get a fresh start and remove the potential for animation deformity. Your photo indicates that you have adequate soft tissue coverage to hide the implants. I would strongly recommend Motiva implants for this, due to their excellent performance above the muscle, with no increase in capsular contracture when used in that plane. They are newly approved in the U.S. and are a game changer.
Smaller implants would help. Your right breast needs to have the fold repaired, possibly with mesh to support it and the implant long term. You definitely need a breast lift to reshape the gland, reduce your areolas, and even out your uneven breasts. On the left, you need a more straightforward breast lift with implant exchange and site change to above the muscle. I'm sorry to say that this is not going to be inexpensive, certainly far more than your original augmentation. You're going to have to pay for experience, new implants, and a more involved surgery. Best of luck moving forward!