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

Dear Pioneering959646,


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

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.

Yes you could go with bigger implants. Your areolas can be reduced by having a circumareolar mastopexy/NAC reduction. The appearance of your breast will also be improved with a lift over all. It would not be a traditional lift, but an inferior mastopexy.
I feel that with the proper surgeon/surgery you could have a very nice outcome.

Hope that helps.

Based on the nicely posted photos, you do need revision surgery may be one stage or two stages. Best of virtual concert with. I would increase the volume of the implant on the lifted side with a minor lift on the non-lifted side and a smaller implant in the sitting position to adjust for sizing, I expect the Smaller previously lifted side would need a 350 to 400 cc implant while the non-lifted side that needs a small donut lift of the Ariola area would need a 150 C implant. Again best of virtual console with expect fees to range from $10,000-$20,000.