Do I Need A Revision with Another Surgeon? (Photos)

Question

I had a breast lift with a slight reduction about 8 years ago. The first round did not heal well (they looked awful) but the surgeon did a much better job the second time around. I’ve been paranoid about the results since though. When I saw this recent photo of me (black top) I was horrified. To be fair I’m leaning forward and not the best angle, but still! Do you think its just a bad photo / where breasts would naturally fall with thier size, or could I benefit from another augmentation (with a new surgeon this time)!

Daniel Barrett, MD · Answer

Dear HMM73,

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

Muge Sevindik, MD · Answer

Hello, thank you for your question. Yes, your upper pole fullness has decreased, and your own tissue has descended, your breasts still appear saggy. Therefore, we recommend a repeat of your Brest lift with an implant.

Guray Yesiladali, MD, FEBOPRAS · Answer

This appearance is commonly seen after breast reduction or lift procedures. There is no clear abnormality in your case. 
If your goal is a higher, fuller upper pole and a breast that sits more elevated on the chest, that would typically require:
• A secondary lift• Possibly further reshaping or reduction• Addition of an implant to enhance upper fullness and projection
The decision depends entirely on the aesthetic outcome you are hoping to achieve.
With proper planning, it is possible to achieve a more lifted and fuller contour if that is your preference. I wish you clarity in your decision and a result that restores your confidence comfortably and safely.
&mdash; Güray Yeşiladalı, MD

Jeffrey M. Darrow, MD · Answer

Thank you for your photos.  Overall your breast shape and contour is good.  Your nipple/areola appear symmetrical and are close to the same level.  Most of the volume of your breast is in the lower half of your breast because breast lifts/breast reductions do not produce reliable upper pole fullness in the breasts. If you are interested in having additional breast volume, increase breast projection, and upper pole fullness in your breasts, a breast augmentation would provide that.  Some additional revision of your breast lift could be done concurrently, to help with breast shaping, if you wish.  Have a detailed consultation with a plastic surgeon of your choice. Best wishes.

Gary M. Horndeski, MD · Answer

Your results are typical of the vertical scar technique. The skin envelope below the areola does not have the mechanical strength to keep the breast up high on the chest wall. At this time, you will need a revision and you may wants implants or fat transfers for more fullness.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Gerald Minniti, MD, FACS · Answer

Your breasts have a classic shape associated with large breast reduction. They are very wide, flat, have little upper pole fullness, and have dropout of the lower pole. It's difficult to say if your nipple areolar complex (NAC), is too high or it just appears that way because of glandular ptosis. To maximize shape, you would benefit from a revision lift with lower and lateral pole reduction, liposuction of the lateral chest, and placement of a breast implant.

Camille Cash, MD · Answer

From the submitted photos it does appear your results could be improved.  You have decreased upper pole fullness, with the majority of the volume on the lower portion of the breast.  A revision with an implant could improve shape.  You may be a candidate for autoaugmentation which uses your own tissue to provide upper pole shaping.  This is different than fat grafting.  I've included a video I hope you find helpful.

Do I Need A Revision with Another Surgeon? (Photos)

Answers (7)

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