Will internal bra with a fat transfer or Horndeski method will help? (Photos)

The technique I recommend is The Bellesoma Method (previously Horndeski Method). This will reshape your breast tissue creating upper pole fullness without implants, elevate them 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. At the same time or later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

You are understandably mistaken if you think that you can get upper pole fullness without an implant. Although fat grafts or 'auto-augmentation' are helpful, ultimately their results are not the same as an implant. You would absolutely do well with a revision lift to not only improve scarring and areolar shape and size, but also relift the breast. The use of resorbable mesh may have a benefit in resisting recurrent ptosis.

Dear flirtythirty22,
my preferred lift is a lollipop lift when a periareolar won't do (ie greater than 2cm lift required). The lollipop technique was created by a Canadian plastic surgeon named Elizabeth Hall-Findley and treats the breast as a three dimensional structure instead of two dimensions (anchor - lift). Most importantly it does not require the horizontal component scars that the anchor-lift requires and breasts appear much more natural, lifted, and less boxy. Lastly, the lift lasts longer because the lollipop doesn't rely on the skin to hold the breast up, its actually breast tissue thats being brought together to support the breast and hence improves longevity. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

I think another lift would work better because you are sill sagging. Measurements are needed to be sure, but your nipple placement may be fine.

I think you have a good volume when you have a revision breast-lift in a proper way. Your nipple is not high, actually it is a bit down. The reason it looks so is the bottom-out of your breasts. When the volume is lifted up with internal static sutures, the nipples will still need 2-3 cm relocation upwards. A reverse-T scar mastopexy will provide breasts with upper pole fullness and a beautiful cleavage and decollate.

I feel that you absolutely need a revision lift (same type performed before just with better nipple placement and rounder areolas). The fat transfer to the breasts augments them minimally (even in the best circumstances). You may have fat transferred, just do not expect to gain more than 1/2 to 1 size larger (at best).
Best wishes.
Dr. Taranow

Hi and welcome to our forum!
From your photos, I note an increased distance from the top of the breast bone to the nipples. The areolae demonstrate irregular margins, your breasts demonstrate moderate sag, and you demonstrate significant stretch marks.
Stretch marks indicate the presence of permanently damaged overstretched skin usually occurring during pregnancy or significant weight fluctuation where when pregnant or overweight, the skin's dermal elastic fibers rupture, resulting in the loss of elasticity and the development of streaks on the skin surface. The skin will thin and stretch over a greater surface area and will predispose to further sagging.
During the procedure of breast lift, only skin and underlying fat is removed. No significant amount of breast tissue is removed during the surgery. Apparent breast size reduction following surgery is due to the change in shape.
You appear to be a candidate for revisional mastopexy, perhaps with a soft tissue mesh to prevent recurrence of this phenomenon. This can be accomplished with either a traditional mastopexy or Bellasoma technique.
15% of cosmetic surgeries can be improved with a touch up procedure.
Revisit your plastic surgeon.
Best wishes...