Lift revision or fat transfer? (Photo)

I am sorry you were swayed by a very old and very convincing group of activists who feel women should not have breast implants (now a major money-making industry). That's right, it was never about BII (now termed SSBI), it was about eliminating breast implants. Silicone materials were proven safe at the turn of the 20th century. A myriad number of things produced by these materials were rapidly developed for industrial, military, food, and medical uses by the 1930's. The first cosmetic use was in testicular implants in the 1940's, and since has expanded to facial and breast implants. There are many other implantable medical devices made of the same materials as well. That's why every person on the planet has silicone in their body, which is harmless. Anyway, the breast with the fold has inadequate skin resection. You could try to have it 're-lifted', which would help reposition the nipple areolar complex into a more symmetrical position, or you could get implants again, which would vastly improve shape, and give you more size. If my presumption is correct, you should know there are thousands of women who were gaslighted into thinking their implants were making them sick who are now happy after being re-implanted again. There are even support groups with women who've reimplanted.

First of all, comparing a lift with fat injection is not applicable in this case. From your photos, you seem to be suitable for a lift revision. I can make a final decision after a preoperative examination. Fat injection may be combined to provide a minimal volume. I can combine both procedures together if needed.

There are 2 possible lift revisions that can be done. One is using a circumareola approach. The excess skin will be excised in such a way to elevate your breast and nipple-areola complex higher on the chest wall and at the same time reposition the inframammary fold higher. Fat transfers can be done at the same time or later. The other alternative is to make a crescent shaped incision in the inframammary fold and below the areola several centimeters and use that block of tissue to pass underneath the nipple-areola complex and higher on the chest wall.

Best Wishes,

Gary Horndeski, M.D.

Dear curious gal NY,
I understand your concern. However, without a proper assessment, it would be difficult to determine what is wrong. You might benefit from fat transfer in case you want minor increase in size but fat transfer will not raise your breasts. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

I suspect you don’t want implants so fat transfer is the only option. Just keep your expectations with fat transfer very modest. You will not be able to attain the same size sac you had with implants

Your breasts are sagging below the nipples, but the nipples are probably in a good location. Measurements are needed to be certain. I would redo the lift first. Then, if you decide, you can add some volume with fat.

Nicely posted photos! I recommend stages of liposuction with breast fat transfer under ultrasound guided injections. I think 2 surgeries are needed. If after the fat grafting operations you may need revision of lift. Best to virtual consult with....

If you want, small perky implants, then, adding a small implant would be the way to do that.
You can benefit from a revision of the lift. Fat transfer will increase breast size by about 1/2 cup or about 50% total breast volume if done by a sufficiently experienced and talented provider.
Fat transfer does not give a significant amount of breast projection, and does not change the shape of the breast in any significant way.
Fat transfer is very subtle in compared to implants.
Fat transfer is never going to substitute the benefits of having an implant.
It’s important to understand what you’re hoping to achieve and what each procedure can accomplish. Projection is difficult to obtain without implants.
Mats Hagström MD