Suggestions for misshapen, high areola 13 years after lift & implants? (Photo)

Hello,
And thank you for the question and the photos.
Following removal of breast implants without replacement, a patient may choose one of two options: do nothing and see how much the skin retracts and then decide about fat grafting or breast lift at a later point, or undergo a breast lift and fat grafting at the same time.
If the breast capsules are soft without any issues or evidence of capsular contracture, it is safe to just remove the implants without performing capsulectomy.
Full mastopexy (breast lift) which will put your nipples into the correct position, make the areola smaller and allow excess skin to be taken away, giving you a more youthful and lifted breast appearance. Some people are a little apprehensive to the full breast lift due to the scars (lollipop or anchor), but typically they do very well and scars fade over time.
Fat grafting can also add additional volume to the breasts, sometimes more than 1 session is necessary.
I suggest that you seek an in person consultation with a Board-Certified Plastic Surgeon specializing in Breast surgeries to further discuss your options, specific techniques, concerns and expectations. Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.
I hope this helps.
Best, Dr. Karanetz
Dr. Irena KaranetzBreast Fellowship-TrainedBoard Certified Plastic Surgeon

Hello, thank you for your question @L_Brown_7 a very effective procedure is a breast implant removal with mammary reconstruction with a series of steps and techniques that allows to restore the appearance of the mammas with the patient own tissue and incision in L shape for minimal and smaller scars. The best course of action is to consult one or several board certified plastic surgeon for more information and options tailored specifically to your needs. Best wishes! Alan Gonzalez MD FACS

The technique I recommend is explantation and lift using 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.

Dear L_Brown_7,
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

From your photo it appears you may need to consider a breast lift when you have your implants removed. This will address the size and shape of the areola as well as remove excess skin. Depending on the amount of breast tissue you have, a small implant may be advised for shaping. See a board certified plastic surgeon near you to learn more.

A lift done at the same time as the removal would be ideal if you have enough breast tissue to support the blood circulation to your nipples. Otherwise, the lift could be done at a later time. You could also consider going smaller and a lift.

I agree that removing the implants and lifting the tissue can be a very good start for you. As far as replacing volume without implants, there is the option of fat grafting for many people. The final shape and position of the areolae is best discussed with a Board Certified Plastic Surgeon and would involve tissue analysis, measurements, etc.