Excess skin in cleavage. How can this be remedied? (Photo)

Good afternoon!
I perform well over 500 breast implant surgeries a year, many of them revisions, and I can tell you without a doubt this is one of the most difficult issues and one of the most difficult areas of the breasts to work on. The area is the most visible in public and the least forgiving. There is no standard "textbook" answer that fits every patient- it could involve skin lifting or removal, it could involve implant or pocket work, or some combination of all of these. I always goodheartedly make fun of other surgeons on this website who try to increase their exposure by posting BS answers to every single question "you should see a board certified plastic surgeon for a physical examination" and offer nothing more useful. I apologize if this seems like one of those answers because it really isn't- this is an actual situation that does require an in person consultation with a revision expert to figure out the proper steps forward.