Breast implant revision? Bottoming out/asymmetry. (photo)

Hello and thank you for your question.
While it is difficult to provide a specific recommendation without a physical examination, based on your photographs, you do appear to have bottoming out on both sides. The left breast is also slightly larger than the right, with a lower and more poorly defined inframammary fold.
It can be very difficult to achieve optimal breast symmetry without placing implants on both sides. I would recommend a revision mastopexy on the right with placement of an implant to provide more upper pole fullness. This would also help correct the position of the nipple areolar complex.
The left side would also benefit from a mastopexy with an implant exchange and pocket modification with a capsular repair. Given the implant malposition on the left, you may also benefit from placement of absorbable mesh to provide more long-term stability. You should consult with a surgeon certified by the American Board of Plastic Surgery who has extensive experience with breast surgery revisions. Good luck. I hope this helps.

Thank you for your question. I have been in practice for over 30 years, and breast revision surgery is a large portion of my practice. I invented a surgery that is a particularly suited for your issues with significant breast asymmetry and published this in 2017. It is called reductive augmentation. I tried to remove more tissue from the larger breast so I can place the same size implants in both breasts and perform a lift and removal of inferior pole breast tissue. You are an excellent candidate for this. You should be able have an excellent result. Best wishes to you.

I agree that both nipples are too high and pointing upward. You would benefit from a circumareola approach that will reposition the nipple-areola complex. You may also benefit from fat transfer to the upper poles to give more upper pole fullness. You may also benefit from a curvilinear incision near the inframammary fold to take out excess skin, tighten you inferiorly and correct the bottoming out appearance of both breasts.

Best Wishes,

Gary Horndeski, M.D.