To lift or not to lift? And what about scar tissue? (Photo)

You will need a formal mastopexy to reposition your nipple areolar complexes into a pleasing position, eliminate that periareolar tethering of skin to the old implant capsule, and lift the lower pole of the breast mound. Additionally, you would benefit from lateral chest liposuction to define that lateral breast border and deflate the lateral chest.

Dear Affectionate421606,
determining whether you need simply a breast augmentation versus a breast lift can be somewhat complicated. It depends on a number of factors including skin laxity and current nipple position. Generally speaking, if the nipples are lower than the inframammary line the patient will most likely need a breast lift. If the nipples are at or above the inframammary line we can generally get by with just a breast augmentation depending on the size of the implant the patient wants. I often still using implant when I perform a breast lift because it provides more upper breast fullness after the lift. To be sure a consultation with a board-certified plastic surgeon will help determine what the patient actually needs.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery