Good evening! I perform lots of revisions and it appears you would most benefit from a mastopexy to tighten your skin, the Internal Bra to tighten and lift your implant pockets, and a switch to 700cc High Profile sounds awesome! I have attached a link to my Breast Augmentation Revision photo gallery for your review- hope it helps!
You probably have good options/potential
It appears that you just have a large somewhat droopy breast (but better than average skin tone), but you would need a formal lift (mastopexy +/- reduction of tissue) to reshape the breast in general, and likely internal support sutures to tighten the pockets ("capsulorrhaphy") at minimum. (If your internal capsular tissues around the implants are too weak however - which may have led to this problem - you may need additional supportive layers placed, which can get a bit pricey . . . ) The first combination of procedures would probably be my approach, but staying in a similar implant range. Obviously you would technically be a bit smaller with new scars, but would have a nicer looking i.e. "perky" and proportionate breasts, generally a worthwhile trade-off. Be sure to see a plastic surgeon with good experience with a variety of breast lifts.
What surgery will I be looking at to achieve the look I want of perky, large breasts w/ no lateral movement of breasts?
I am sorry to hear about the problem you are experiencing. You demonstrate your concerns nicely. Although some “falling to these sides” of breast implants is quite normal when you lie down, if this occurs “excessively”, it may be a concern to patients. This phenomenon is called lateral displacement of the breast implant; it may be of concern from the visual and the discomfort standpoints. Surgical correction is an option.
Generally, the lateral breast implant displacement can be corrected using an internal suture technique, decreasing the size of the pockets and moving the implants toward the midline. In my practice, I use a 2 layered suture technique (capsulorraphy) to close off the space laterally (towards the axilla). The use of acellular dermal matrix is an option ( although not usually necessary) especially if significant implant rippling/palpability is present.
Based on your photographs, I agree that some type of breast lifting will also be necessary. Exactly what type of breast lifting would be required would be best determined during in-person evaluation.
I hope this (and the attached link) helps.
Larger implants make lateral movement worse without additional support
Several things to consider:
- Natural breasts move to the side when lying on your back
- Heavier breasts (larger implants) will tend to move more
- Your pictures show some sagging which would require a lift, even with larger implants
- An internal bra with Strattice, SERI, or Galaflex will be helpful to support the breasts and implants and minimize lateral movement.