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

First of all, you will have better results after losing your weight. Based on your photos, your areolae are being pulled in by your retained capsule. I would recommend a capsulectomy which will release the tethered areolar scar, perhaps placing acellular matrix underneath the incision to help prevent it from reoccurring. Furthermore, I believe you would benefit from either a Benelli mastopexy(around the nipple) or a vertical lift. I hope this helps. Good luck.

The technique I recommend The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them 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. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

You would need to have the scar released and revised in the affected areola. During the augmentation, a release of the inframammary fold medially on both breasts would help improve your lower pole constriction. I do not think you need your areolas lifted further.

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

Just based on your photos, you will need a lift, especially if you lose more volume with weight loss. Once implants are replaced and you are lifted, if you have any indentations, fat grafting can be done later.

Nicely posted photos. All full lift have potential scars including circum areolar. Doing a full lift with small implant and internal residual capsule removal is the operation to consider. Fee $10,000-$12,000. Best to virtual consult with...

You’re a great candidate for a breast augmentation combined with a periareolar (around the nipple) lift.
I feel you must do the lift to get the round youthful appearance and fix the denting.

I would recommend a Vertical lift .This will correct the scar tissue and improve the shape of the breast
This could be done with or with or without implants

Dear Affectionate,
The good news is that you do not appear to need a breast lift. The scar contractions around your areolae may, or may not be improved with augmentation and scar revision at the time of re-augmentation and may need a fat transfer procedure some time in the future. You should anticipate that. Good luck!