Your current results are typical of the Wise
pattern.The breasts have bottomed out
and have unattractive scars.I recommend
a new technique called The Horndeski Method™.The breast tissue is reshaped creating upper pole fullness, elevated
higher on the chest wall and more medial to increase your cleavage.The weight of the breast is transferred to
the underlying muscle resulting in immediate pain relief and long term
stability.This technique avoids the
ugly vertical scars associated with traditional technique, maintains nipple
sensation and the ability to breast feed.Unfortunately, this technique is not covered by insurance.
Gary Horndeski, M.D.
From the look of your photos and history, I would recommend a redo of your mastopexy. Since I do not take health insurance I have no idea what the amounts of breast tissue that would be necessary to qualify under insurance guidelines. Most of your situation which we call bottoming out of in inferior pedicle reduction can be fixed with mostly taking out extra skin. I recommend you seek the counsel of a board-certified plastic surgeon in your area. Good luck.
...probably just a tightening of the breast envelope or "lift" would be best. Insurance companies would want a considerable amount of tissue removed that might not look proportionate to your body frame. All advice is from a couple pictures though, so best to see a board certified plastic surgeon that knows how to create beautiful breasts and does revision breast work regularly.
I breast reduction would decrease the volume to much ton your appearance as seen in the posted photos. In my over the internet opinion you need a breast lift without a reduction, NOT insurance covered...
What operation you should undergo, if any, will be a very personal decision that only you can make after careful consideration of your goals. Discuss your goals, preferably in front of a full length mirror, with your plastic surgeon may be very helpful when it comes to discussing goals/concerns/questions.
At the very minimum, I think breast lifting will certainly improve your breasts' position; consider breast reduction surgery if you feel that your breasts are too large for you. I hope this, and the attached link, helps. Best wishes with your decision-making and for an outcome that you will be pleased with long-term.
The right decision is really going to depend on your desired outcome. But given the fact that you are still experiencing back and neck pain and that you have significant breast volume, a breast reduction seems like your best bet. Schedule a consultation with a board certified plastic surgeon in your area (link below) to discuss your options. Best, Dr. Nazarian