What can be done to correct my stretched skin and tissue loss after breast augmentation? (photos)

Thank you for your question. You are an excellent candidate for breast revision. I have been in practice for almost 30 years and a large portion of my practice is dedicated to breast revision surgery. In your case, I would perform a reaugmentation to a slightly larger higher profile implant, a internal bra/capsulorrhaphy, and revision of your mastopexy. You should be able to have an excellent result. Best wishes to you.

Your situation is sufficiently complex that I recommend relying exclusively on in person second opinion consultations.
For second opinion, consultations come prepared to being with you a complete set of proper before and after pictures and copies of your previews operative report for each of your previous operations.
In a nutshell, I think your best option at this point is to tighten the skin envelope with another breast lift and consider adding a round of fat transfer.
Fat transfer by itself, isn’t going to do that much but add tissue between your skin and the implant.
Once implants have bottomed out, correcting this deformity becomes difficult and each previous operation adds to the complexity and overall decreases the chance of a long-term quality outcome.
By far, the most important variable is provider selection.
If you feel confident with your current provider, then continue working with him or her.
Finding the right provider is not at all easy or straightforward.
There are substantial differences in both skill and experience among board-certified plastic surgeons with years of experience and overall good reviews.
Look for plastic surgeons who practice is focused heavily or exclusively on breast surgery.
Consider plastic surgeons whose practice is heavily involved with breast cancer reconstruction.
Surgeons who are good at cancer reconstruction tend to have experience with more unusual cases and often difficult circumstances.
If you opt for finding a new provider, then insist on having in person consultations and avoid virtual consultations whenever possible.
As I mentioned earlier for second opinion, consultations, come prepared to bringing with you as much information about your previous procedures as possible.
During each consultation, take careful notes, especially regarding the quantity and quality of before and after picture the provider shows you.
It’s going to be difficult for providers to show you examples of previous patients who had the same type of deformity, but a sufficiently experienced provider should be able to show you an impressive collection of before, and after pictures of previous complex cases.
When in doubt slow down and schedule more consultations.
Look for surgeons who seem to be able to break down each component of the problems and describe a clear plan of action for each aspect. Complex problems may require a complex approach. Have a clear understanding of each of the primary and secondary problems is key to device a clear and competent plan of action.
The first step is deciding if you should change providers.
To find a new provider i suggest relying exclusively on in person consultations.
Best,
Mats Hagström MD