350cc & 400cc, still left with no upper pole fullness & gap 1 year post-op, what can be done to correct? (Photos)

Dear User83.,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Hi, thanks for your question. I would consider exchanging your implant for one that is more projected and is an appropriate shape to provide you with upper pole fullness, in addition to tightening the lower pole. An alternative (or in combination) would be to perform some fat transfer to the cleavage area to enhance the fullness using your own tissue (this would have the added benefit of concealing the edge of the implant).

You have 2 options: fat transfers to the upper portion of the breasts or a repeat breast lift. The lift technique I recommend is 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 if not injured during your previous surgery.

Best Wishes,

Gary Horndeski, M.D.

With your anatomy, your breasts naturally sit somewhat low on your chest and you have a natural gap. The bases of your breasts cannot be moved. However, you can go with larger implants and a higher profile behind the muscle for more upper breast fullness. Please do not go too large for your tissue and frame. You cannot have round high breasts with implants. If you go too large, your implants will just bottom out and you will be left with not much upper fullness and sagging breasts.