Should my breasts look like this after a lift and implant exchange or will I need a revision? (Photos)

Question

40F, 135lbs. I lost 75 lbs and had an abdominoplasty with muscle repair and breast lift with implant exchange in 11/2024. I am very happy with my tummy tuck but my breasts have bothered me for some time. I feel like they are not lifted appropriately/sufficiently. My surgeon has suggested a lift revision where she would remove more of my own tissue. The surgeon does not use internal mesh bras which I feel like I need since my skin laxity is very poor. The question is though, are my expectations about what they should look like after a lift unrealistic? The surgeon also used a much larger implant than I wanted which is another issue.

Alejandro Nogueira, MD · Answer

Synthetic mesh is a popular aesthetic surgery practice in the US to "hold implants", not in the rest of the world and it is for a reason. In the us market you don't have available bio-velcro implants coated with polyurethane, which stick to the chest and prevent bottoming out, this on top of the use and abuse of smooth breast implants (another peculiarity of the US-based surgeons), which nave close to null adhesion to the ribcage. However, it is a biologically very unwise idea to set together and in contact a non-living prosthesis (breast implant) with another non-living prosthesis (the mesh), the rate of calamitous complications is, evidently, high.

However, you don't seem to suffer from bottoming out (in need of "holding" your prostheses), but a low set planning for the breast lift you have received, poor planning affecting also to the shape of the breasts.

Note how the upper polo of the breast is hollow, this is because you have round shaped implantes; no hesitation to get new anatomical shaped implants that are designed to competely and naturally fill up the cleavage.

Seek the advice of a solid and reliable revision mammoplasty surgeon.

Daniel Barrett, MD · Answer

Dear mallory2585,

I understand your concern. However, without a proper assessment, it would be difficult to determine what is wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Gary M. Horndeski, MD · Answer

I recommend 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.

Best Wishes,

Gary Horndeski, M.D.

Camille Cash, MD · Answer

From the submitted photo it appears you could expect improvement with a revision.  There is volume and nipple asymmetry which could be addressed.  It would also be an opportunity to exchange implants so they are more in line with your desired look.  Overall a revision would improve shape and correct other concerns.

Should my breasts look like this after a lift and implant exchange or will I need a revision? (Photos)

Answers (4)

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