How would this be fixed? I currently have 415 cc Sientra under the muscle.

At this time, I recommend explantation and lift then wait six months and place totally submuscular implants.

Best Wishes,

Gary Horndeski, M.D.

Good afternoon,
You have quite a few things going on that need revised- you have double bubbles, bottoming out, very long lower poles, and what appears to be some encapsulation. I would use a combination of Internal Bra, capsulectomy, and implant exchange as well as place some Strattice mesh in each lower pole. This is a big revision- come see me or email me directly if you wish to discuss further.

Dear Goldendogs,
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