Do I need to have my breast implants removed ? (photo)

From your pictures the degree of symmastia or tenting does not seem very significant. There is bilateral breast bottoming out. A full examination would be necessary for the best recommendations, but from your description you would likely benefit from placing the implants in a new pocket under the muscle and reinforcing with a Seri scaffold mesh.

Removal of breast implants, intact or ruptured, may have positive implications if patients are symptomatic. A constellation of symptoms associated with breast implant illness, and autoimmune disease are considered when treating patients who have breast implants and are concerned about foreign body reaction. In our office, we begin this journey with a consideration of symptoms and exclusion of obvious autoimmune problems. In many of our patients, en bloc removal of breast implants with capsulectomy is important and beneficial. Further clinical evidence about breast implant illness is evolving and will continue to guide treatment. I would suggest removal if there is a possibility of foreign body reaction.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Per your photographs, it is difficult to make suggestions online. Symmastia is a condition which can occur when the implants are too close together. Patients often refer to this as a “uniboob.” Occasionally, the space or pocket for the breast implant is created towards the center, or the tissue stretches, forcing  the implants to fall too much towards the center of the breasts. Therefore, it is best to consult with your plastic surgeon to better confirm and determine how it can be addressed if necessary.
Correction of this problem may involve using different implants such as textured, a smaller size, or a smaller base and placing the implants in a new pocket. On occasion, this may require surgery in more than one stage to allow the tissues to heal and then place the implants. If the implants have been placed above the muscle, converting them under the muscle frequently will help and, again, the use of a dermal substitute may be required for additional support if the tissues are thin. The techniques of capsulorrhaphy and neopectoral pockets may apply here as well. 
 Additional elective cosmetic #surgery is a personal choice. Your procedures should always be performed by a #PlasticSurgeon who is board-certified and has a great deal of experience specializing in cosmetic #surgery. You will then greatly improve your chances of getting the result you desire, and, without the need for a revision surgery. It is suggested that you look at before and after photos of the surgeons actual patients, and read patient reviews. Gathering all of this information will help you make a well-informed decision.

Thank you for your
question and picturesIt appears that the symmastia is mild.  This may or may not get worse.  You have large implants for your body frame. Yes, implant removal will solve the tenting problem.  Also, going with a smaller implant and changing pocket location might be helpful.

To be sure, see
two or more board-certified plastic surgeons in your area for a full and
complete evaluation to make sure you are a good candidate and that it is safe
for you to have surgery.

I hope this helps.

Your symmastia or closeness appears mild, however your implants are large for your frame. If you are content, leave them alone.  If not, consider reducing the size of your implants.  This will also decrease the appearance of the symmastia.  I would suggest discussing this with your plastic surgeon.

Good planning of breast augmentation and choosing the right size implant is paramount for avoiding complications of breast augmentation. Implant displacement is common, how ever correction of implant displacement, medial lateral or inferion can be a difficult task. It is important to repair that with one revision procedure although it might be a major surgery. Repeated attempts to correct implant displacement can result in more difficult problems. The pictures show medial and inferior displacement and way too bog of an implant for your chest size.This can be corrected using much smaller implant. Repairing the pocket, even changing the pocket into a new pocket, and some times may have to use acellular matrix to correct the implant pocket. Explantation is another option.

You have to decide which way you want to go with this and, to help you, you should see several board-certified plastic surgeons in your area and get their opinions.The simplest approach is to leave them alone.  While they are a little large for your frame (that's an aesthetic decision, and not everyone necessarily would agree with that) and a little close together, if you're okay with the way you look, and the mild symmastia/tenting is not getting worse, then there's no reason why you have to do anything.But if, for whatever reason, you want the symmastia/tenting corrected, you'll need another procedure, in which you'll need smaller implants put in, the pockets sewn off medially, the skin resecured to the sternum and, possibly, the addition of an acellular dermal matrix (ADM) like Strattice or Alloderm to prevent recurrence.Removing the implants without doing anything else will improve the symmastia/tenting, particularly if the skin is resutured centrally, but that may be too big of a change for you to tolerate at this time.Hopefully a few opinions will help you decide what your next step should be, if any.I hope that this helps and good luck,Dr. Alan EnglerMember of RealSelf100

Removal of your breast implants certainly should help the tenting of that you have between the implants.  Whether or not the skin above your breast bone needs to be resutured to the periosteum of your breast bone will depend on your examination and want your surgeon findings during surgery.Much smaller implants and a revision of the cleavage area might also be of help if you want to continue to have implants.

Your implants are dramatically large for your chest dimensions. Raising or widening their separation is not possible without using much smaller implants.