What deformity has caused this issue with my breast and how do I fix?

The vertical scar of your lift resulted in lifting the nipple-areola complex too high. The mechanical strength of your skin envelope is too weak to hold up your implants and your implants have bottomed out. You have skyward gazing nipples and bottomed out implants. At this time, I recommend explantation and inferior repair of the inframammary fold. I would wait 6 months and consider reaugmentation totally submuscular.

Best Wishes,

Gary Horndeski, M.D.

First and foremost, I do not recommend traveling long distances for elective surgical procedures.
The number of patients who have issues after surgery, need revision surgery or end up with complications is very real.
There are three variables that determine the outcome of breast augmentation surgery.
The first is the patient’s candidacy for the procedure.
The second is implant selection.
The third and most important variable is provider selection.
As a general statement, anytime, excessively large implants are used the chance of undesirable side effects, complications, and the need for revision surgery will go up.
Likewise, if a lift is done in conjunction with breast augmentation the chance of needing revision surgery or having problems after close-up significantly.
To make a quality assessment, we need quality information.
This should add a minimum include a complete set of proper before and after pictures for each of your previous operations.
If you don’t have before and after pictures, then ask your surgeon to forward the pictures they took.
Anytime there are issues after breast documentation we can almost always trace them back to one or more of the three variables mentioned above.
And your case I think number one is implant selection. I don’t know what the sites of your breast was before surgery, but I’m guessing the diameter of your implant is significantly wider than the natural diameter of your breast.
And I also think the procedure was done in a way where your pectoralis muscle is not able to hold the weight of the implant, and because of that gravity is pushing the implant down and stretching out your skin envelope. Different plastic surgeons have different ways of inserting implants and Often part of the pectoralis muscle is transfected to allow placement of the implant.
If the surgeon is able to leave enough pectoralis muscle that the muscle can hold up to weight of the implant, and this problem doesn’t happen.
Without transacting the pectoralis muscle the implant has a chance of sitting to high so it’s a technical balancing act between the two.
I don’t want to get too technical, but the procedure is done. This Basically determines if this problem happens or not.
The condition you have is often referred to as implants having bottomed out.
It’s not an easy or straightforward condition to correct
It can be done using internal permanent sutures with or without mash or cadaver dermal products like AlloDerm.
Before considering revision surgery, you should focus your efforts on finding a plastic surgeon who has extensive experience correcting this condition.
That means having multiple in person consultations, asking providers to open up their portfolio and show you lots of before, and after pictures of previous patients who had the same problem with good long-term outcomes.
The chance of this recurring is if it’s not done correctly and each time you have another procedure things get more complicated.
Your best and most important decision at this point is provider selection.
In the hands of the right plastic surgeon, you should be able to restore this to a quality long-term outcome.
if you don’t find the right provider, then you’ll be having trouble again and again and the condition will only worsen.
I did not recommend you travel to have revision surgery.
Traveling may be indicated if there’re simply isn’t local talent.
From my experience, most people in Europe, who go to Turkey for cosmetic surgery do so to save money.
The savings and of being a poor choice if expensive revision surgery becomes indicated.
I’ve seen this too many times to count and I continue to encourage peopleto stay local and always have in person consultations before selecting a provider.
Look for plastic surgeons in your community who have extensive breast surgery experience.
If you don’t know who to go to then start by finding the plastic surgeons who do most of the breast cancer reconstruction in your community.
Plastic surgeons who are good at breast cancer reconstruction are usually good at all aspects of breast surgery.
Schedule several consultations with several different surgeons and insist that they show you their entire collection of before and after pictures of previous patients who had the same condition.
Ask them specifically what the long-term outcome is and what the chances of this recurring.
Ask each provider what their revision policy is.
Best,
Mats Hagstrom MD