What can be done to reverse the stretched appearance of a botched crescent lift? What can be done with this Frankenstein-areola?

You
are an excellent candidate for a new technique called The Mini Ultimate Breast
LiftTM.Using only a
circumareola incision it is possible to reshape your breast tissue creating
upper pole fullness, elevate them higher on the chest wall and more medial to
increase your cleavage.Aligning the
areola, breast tissue and implant over the bony prominence of the chest wall
maximizes anterior projection.22% of
women who undergo breast augmentation alone require revision within 2 years
because they are dissatisfied with the result.Frequent causes of dissatisfaction are over implantation and not
performing a lift when needed.Best Wishes,Gary Horndeski, M.D.

Hello,Thank you for question, and attached image.Based on your the fullness and amount of residual ptosis (breast sag) I would suggest that after you have fully healed consider a revision of your breast lift.  Unfortunately, although the scarring is kept to a minimum with a crescent, or even a peri-areolar lift, they are not mechanically capable to lift breast tissue in most cases.  If used for this purpose many time the result is a recurrence of the ptosis, and elongation of the areolas.  In order to achieve a more aesthetic, and youthful shaped breast with "perky" nipple positioning an actual reshaping of the breast is necessary.  This would require a lollipop (vertical), or inverted T type lift. I hope this helps.Thank you,S.P. Maggi, MD, FACSdrmaggi.comAustin Plastic Surgery Center

   With the level of droop present and the larger size of the areola, you could try a circumareolar lift with a permanent pursestring suture.  However, I think that a vertical breast lift produces a much nicer and more predictable result without the chance of continued areolar widening.Kenneth Hughes, MDLos Angeles, CA

Thanks for your photos and pictures.To prevent bad scars following this type of breast lift, multiple layer suturing is needed. If a circumareolar breast lift is needed, a more permanent sutures and serial deep and intermediate suture will reduce the width of the scars. I would highly recommend following up with your surgeon and to give better answers a more detailed clinical examination is needed. Hope this was helpful. Best wishes, Dr Sajjadian

A permanent suture is often used in this procedure and if not then it stretches out. It looks like you may not have enough laxity to convert to a circumvertical lift after your two prior surgeries but that is usually the best procedure. Some laser treatments can fade the scar. Good luck

Thank you for your picture. Your solution is easy and my mind. You need another periareolar with a interlocking permanent suture. You may need to seek a second opinion. 

The best way to address this would be to perform either a circumareolar mastopexy or a circumvertical mastopexy. This will reduce the areola size and address the upper scar.  It can also lift the breast and lead to a more youthful result.  Granted this leads to more scarring but in many cases looks better than the crescent procedure outcome. 

Often permanant sutures are necessary to control the areola diameter and keep it from stretching.  The skin of the breast has more elasticity than does the areola tissue - so the breast skin will win a "tug-of-war" between the two and stretch the areola.

Thank you for your question. I would recommend the interlocking suture technique which works wonderfully because it controls the stretching of the NAC( nipple areola complex). It is done with a permanent suture. Good Luck.

Thank you for your question and photo.Based on the fact that you mentioned dissolving sutures in your question, it seems like you have done your homework, and already know one of the problems.I would recommend a revision, this time using a circumvertical incision and use a permanent (gortex) suture. I would also recommend you have the same procedure on the opposite breast to obtain maximum symmetry in height, projection, and scarring.A consultation with a board certified plastic surgeon in your area will help to discuss all of your particular concerns and options.Best Regards,Dr. Stutman