20 years post-op - What would the revision process be? How much would it cost? (photo)

Unfortunately, over time your body makes scar tissue around the implants and post pregnancy changes can add to this.

A revision- not from the axillae, either under crease or areolae- to remove/open pockets and place new implants in better position would improve your breasts overall.

An exam and consultation with a plastic surgeon is recommended to discuss your options and expectations.

Your breasts are asymmetrical in volume, shape and position. Your implants are high on the chest wall and the breasts are low. At this time, I recommend explantation and breast lift using The Bellesoma Method. The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided and nipple sensation (in 95%) is maintained if not injured during your previous surgery. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Thank you for your question and photos. Based on these photos, you have bilateral contractures and other changes that happen with pregnancy and over time. You would need removal of your implants and tissue capsules around the implants, creating an adequate pocket to place new implants and most likely a breast lift. This surgery is more difficult than your initial augmentation was and cannot be done through the arm pit. You are looking at a cost of $15K+ to give you a natural and pleasing result. See a board certified plastic surgeon experienced in all aspects of breast surgery for an in person consultation/evaluation. Good luck.