What are the odds of getting nipple necrosis a second time with revision surgery? (Photo)

I would go back to discuss your outcome with your original surgeon. They will know best what was done and why the outcome turned out this way. They will be the best potential individual to help revise your outcome.

Nipple necrosis is an extremely rare event. You did require a pretty substantial mastopexy(lift) and used larger than average implants, which may have contributed.
Developing nipple necrosis during your revision would be extremely unlikely. The general nipple position is much better so you likely wouldn't need to move them again.
It sounds like your main issues are implant displacement - the pocket has stretched too much. So most of the revision work would be internal - tightening the capsule to make the implant sit in the right spot.
It's unlikely you have capsular contracture if your implant is moving around this much. There is always risk of it with revision surgery but it's relatively low.
Discuss your concerns with your plastic surgeon and/or get a second opinion to see what your options might be. As always - make sure you're seeing a board certified plastic surgeon.

Dear Pinkcheeks95,
every revision surgery carries increased risk of complications and this is the case with breast revision surgery. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Thank you for your pictures and questions. Your pre-op photo is very helpful as it shows that your pre-op appearance makes a single-stage mastopexy and augmentation VERY difficult. You had severe (grade 3) breast ptosis (drooping) with a very enlarged areola and significant stretching of the skin envelope. It is actually pretty impressive that your surgeon (whoever he or she is) was able to achieve a reasonable result in one operation. Many surgeons might have told you they could only do your surgery in two stages (lift first, implant later). Your scars are very reasonable, the shape and symmetry may not be perfect, but is completely reasonable given the starting position. The nipple necrosis is unfortunate, but with a big lift and a large implant, you are putting a large amount of tension on those tissues and incisions, and you are lucky you did not have a more significant healing problem that lead to larger skin loss, deformity, and loss of the implant or exposure of the mesh.
Not saying that your outcome is perfect. Not saying that you will not want/need a revision in the future. But hopefully this gives you some perspective on things. I would advise waiting until one year postop before considering any surgical revisions.
Best of luck!
Dallas Buchanan, MD
VIVIFY plastic surgery
Tampa, FL

At this time, your nipples are at uneven heights. You will need a circumareola lift to correct the nipple positions. You would benefit from smaller implants with inferior and lateral plications.

Best Wishes,

Gary Horndeski, M.D.

I’m
Not exactly sure what would be done to improve your result. However as long as the nipple is not moved your chance if further nipple necrosis is small

Your implants were too large and compromised the blood flow to your nipple. New blood has grown back to the nipple, so revision surgery should be safer. Do not go larger, but consider going down in size for a better shape.