What is my best option for breast augmentation revision? I am 38 years old, 5'9" tall and 145lbs. (photos)

The best options are smaller implants with a simultaneous lift or explantation with lift and later fat transfers. The technique I recommend is The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained, if not injured during your previous surgery. Later, fat transfers can be performed if additional volume is desired.

Best Wishes.

Gary Horndeski, M.D.

Good afternoon,
My recommendation would be to go a little larger, with the XHPs- patients love them! At the same time a donut mastopexy to lift your nipple position and tighten your skin would be a great idea as well!

Hello and thank you for your question. Based on your photographs, you would benefit from a breast lift. This would lift and reshape your entire breast around the implants. Regarding the choice of implants, it is best that you discussed this with your surgeon as it is a complex process that involves several factors, including a physical examination. I wish you the best of luck. Vasileios Vasilakis, MD. Fellowship-trained plastic surgeon.

You’d do well to have a breast lift; it would utilize your own breast tissue to give more projection where you need it, not down under the implant.

Dear johnsonmama06,
breast revision surgery is the most difficult plastic surgery procedure performed. Botched breast surgery alters normal tissue planes and laxity, the ability of breasts to heal properly, and leaves scar tissue that dramatically affects the level of difficulty of the corrective surgery.Many patients come in to correct poor outcomes from their initial surgeries. The most common problems are due to implant malposition, bottoming out of the implant, poor scarring, and incorrect implant size.While the type of revision required will depend on the result of the previous surgery and the desired result of the patient, some revisions involve extensive pocket repair that may or may not need specialized external bras.If you are considering breast surgery revision, you should speak with a board certified plastic surgeon and have yourself properly assessed. Only after a thorough examination you will get more information and recommendations. Also, you have to make sure that your surgeon understands your breast augmentation goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

I would suggest going smaller with a size that better fits your frame and tissue and do a lift. With a smaller size, you will do much better over the long term. Bras are much cheaper than repeat surgeries.