Having BA Revision With Lift, Is There a Way to Tighten the Bottom Without the Vertical Scar? (photo)

Opinions re: the TYPE of lift recommended? I have large HP implants bottomed out about year ago, the skin BELOW my areola is stretched at least 1-2 cup sizes, however I and my dr. also agrees, do NOT need a full lift with respect to the upper pole. I will be having smaller implants put in with a lift, but what TYPE of lift would be recommended for my situation where only the bottom tissue needs to be tightened up? I don't feel it will retract on it's own due to stretch marks/volume of extra tissue?

Doctor Answers 14

Breast implant revision

Thank you for the pictures, they are very helpful.  I would recommend downsizing to a smaller implant and closing the capsule from the inside along the inframammary fold to reverse the bottoming out appearance.  This repair would also bring your nipple position closer to where you started.  I hope this helps you.

Kindest regards,

Neil J. Zemmel

Richmond Plastic Surgeon
5.0 out of 5 stars 107 reviews

Bottoming out and a lift

A lift is completely unnecessary in your case.  The answer is to put in a smaller implant and tighten the breast pocket internally to elevate the implant into a normal position.  The skin will retract in the overwhelming majority of cases.

Robert Kearney, MD, FACS
La Jolla Plastic Surgeon
5.0 out of 5 stars 32 reviews

Breast augmentation revision

Thank you for you question as well as your pictures.  Based on the history is well as your pictures, do not have the typical droopiness that requires a lift with the associated scars.  Instead, you will benefit from an implant exchange with reshaping of the pocket to accommodate smaller implants using your excisting incisions.  I prefer the anatomical round base cohesive gel (gummy bear) implants made by Sientra.  Breast of luck. :)

Kevin Tehrani, MD, FACS
New York Plastic Surgeon
4.8 out of 5 stars 95 reviews

BA Revision With Lift,

What you photos show is "bottoming out" and not ptosis.

Using smaller implants is very sensible in terms of decreasing the likelihood of recurrence. If you need some skin resection it would only be necessary to remove skin through a breast fold incision. 

Something will need to be done to recreate a sturdy breast fold. Sometimes that can be done with your own tissue, (including the "excess" in the lower pole), and sometimes using Strattice, an acellular dermal matrix may be a better choice. 

Thanks for your question, and for the photos. Best wishes. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.6 out of 5 stars 45 reviews

Bottoming out, not ptosi

I agree with those who recommend restoring the inframammary arc, not trying to "lift" the breast. Smaller implants usually increase the reliability of the procedure. Acellular dermal matrices often help as well. Best of luck to you. 

Dr. Chappell

James E. Chappell, MD
Annapolis Plastic Surgeon
5.0 out of 5 stars 18 reviews

Bottoming Out after Breast Augmentation Treatment

Bottoming Out after Breast Augmentation Treatment
Although an exam would be required to offer a specific opinion in your case, it would appear the the main issue you face is bottoming out and not drooping (ptosis). Therefore the appropriate treatment would be to reconstruct you inframammary crease in its original position (for example using an internal Ryan procedure). That would not require a breast lift incision. Also helpful would be textured implants and placing them in a submuscular pocket to minimize re-bottoming out

Good luck

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 157 reviews

BA revison and lift?

Without an exam it is very difficult to say what you need. Most of the time if the implants have bottomed out, an internal procedure can be performed to raise the implants.  If the tissues are falling off and the skin is very loose, then more than likely a lift is required.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Having BA Revision With Lift, Is There a Way to Tighten the Bottom Without the Vertical Scar?

Thanks for the posted photos. In my opinion limited by no in person examination I would recommend a "full" lift or anchor type mastopexy. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 174 reviews

Having BA Revision With Lift, Is There a Way to Tighten the Bottom Without the Vertical Scar?


You do not need a breast lift

The lower pole can be elevated internally with ADM or mesh support

Hilton Becker, MD
Boca Raton Plastic Surgeon
4.6 out of 5 stars 15 reviews

Breast augmentation revision in Beverly Hills

from your pictures it seems that you don't need a lift to fix your breast implant descent. the appropirate treatment is to do an internal repair of the inframammary fold in order to raise your fold.

Sean Younai, MD, FACS
Beverly Hills Plastic Surgeon
4.4 out of 5 stars 49 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.