I'm receiving a breast revision after a bad experience. What should be done during the procedure to achieve the goal? (Photo)

Dear BaddestB,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

The technique I recommend is explantation and lift using The Bellesoma Method. The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated 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.

Thank you for your question. A large portion of my practice is dedicated to breast revision surgery. I see the same mistake commonly occurring year after year in which surgeons will try to fill up the skin envelope by placing larger implants in the subglandular space. There are very few Nevers in my world, however this never works well. Ultimately, the skin will stretch and the implants will droop. In your case, you would benefit from placing the implants under the muscle and performing a breast lift. This will placed your implants in the correct location, lift here breast, and make your areolas much smaller. You are an excellent candidate for this procedure. In fact, I wrote the only paper on how to place the implants from on top to below the muscle without using a mesh. Best wishes to you.

Thank you for your question. Implant size will be determined on what you want your final size/result to be. You will likely need an anchor type incision pattern in order to lift the breasts appropriately. Your areola will also be resized during this procedure. Placing the implants under verse over the muscle will not significantly change a result either. What may benefit you the most is the addition of an internal bra, and without a doubt you need the pocket size changed if you decide to decrease the size of the implants. Good luck..

I agree with the plant of going smaller in size and doing the lift with either the vertical scar or anchor incisions. The areolae can be made smaller at the same time and your lateral pockets also may need to be tightened internally.

I would recommend replacement with smaller implants above the muscle ,subfascial and absorbable mesh, combined with a lollipop breast lift.