Revision for Capsular Contraction, Scars, Nipples, Fullness, Etc? (photo)

Recommendations for 2nd BA? Have 375cc saline filled to 375. Have capsular constraction, ugly scars. I want to 1) treat cap contrac, 2) revise scars, 3) make areoli smaller/rounder, 4) improve breast direction (to point straight ahead instead of to 11 & 1 o'clock), 5) improve shape (half-spherical shape with better cleavage and fullness up top than current teardrop/anatomical shape, 6) increase size slightly, 7) replace saline with silicone. Full vs concentric lift? Pocket revision? Mod+ or HP?

Doctor Answers 9

The more complicated the problem, the more important it is that you find the right surgeon

Hi there-

I don't think that it would be responsible for me to try to advise you without the benefit of a careful review of your history and goals, and a careful examination.

I think that your goals are achievable, but the procedure and its details would probably vary with the surgeon you choose- and this is okay, as long as that surgeon can show you examples of his work that you find pleasing.

Your best bet if your goal is to be safe and happy is to not worry about the how and why, and research the "who". In the hands of a talented and experienced surgeon your chances of being happy will be high and those of needing another revision low.

Orlando Plastic Surgeon
4.8 out of 5 stars 157 reviews

Laundry List for Breast Augmentation Revision

Not sure that all request can be accomplished.  Your pictures are helpful but with all your request it is better that you see several board certified plastic surgeons.

Dr. ES

Breast asymmetry and ptosis

You have a very common condition,breast asymmetry and  ptosis  (sagging)

As you already have saline implants ,I would recommend  adjustable saline implants .This will enable you to do post operative adjustments to correct not only volume ,but also shape

A circum-areolar mastopexy may be sufficient . This will reposition your areolae and reduce the size

The adjustable gel implant would be ideal but unfortunately is still not FDA approved in the USA

Hilton Becker, MD
Boca Raton Plastic Surgeon
4.6 out of 5 stars 15 reviews

Breast implant revision can help with capsular contracture and overall aesthetic breast appearance

Over time, your breast implants can develop capsular contracture (scarring) and the areolae can widen as you have seen.  Your requests do seem reasonable enough, and I believe you can get a nice result doing almost exactly as you have suggested.  Depending on where your current scars are located, the scars can be revised and the new implants can be placed through the existing incisions.  Although, switching to silicone implants may require a slightly larger incision.  The areolae can be made smaller with a lift, but you'll most likely need a vertical or lollipop mastopexy (breast lift) to achieve more projection to your breasts.  High profile implants are fantastic (Natrelle style 45) to get great projection and improved cleavage.  In my experience, these are the implants to get and they give outstanding results!  Good luck!  Dr. Schreiber, Baltimore Plastic Surgeon

Breast lift with implants

I agree with the other doctors that given your history an exam is needed. You appear to have a scar all the way around your areola wich may be from a prior attemptted breast lift using a donut lift. I  would probably use moderate plus profile for your breast diameter. A lolipop lift should do the trick with scar release. Of course it would be nice to see your  original pre op pictures and read the operative report from your first surgery. Good luck and please see several board certified plastic surgeons for consultation.

Gregory T. Lynam, MD
Richmond Plastic Surgeon
4.9 out of 5 stars 59 reviews

Revisional breast surgery

You have proposed a lot of potential changes and I agree that it would have been beneficial to see a preop photo because we take the breasts as we find them. I think addressing the capsular contractors and implant swap are the first order; it is difficult to comment on the rest without a full examination and history.

Robert L. Kraft, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 40 reviews

Revision for Capsular Contraction, Scars, Nipples, Fullness, Etc?

Thanks for the very good series of posted photos. I would have liked to see a before photo to compare the results. In my view you are requesting quite a few changes and a hope of improvement. Think the capsule repair and external areolar revision make good sense. As for a full lift I would offer that as a second stage in the operative plan. But ONLY in person examination/consult will help, seek this please. Regards 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

Capsulectomy, pocket correction, implant exchange, and circumvertical (lollipop) breast lift


The changes that you will want to achieve require separate steps.  The capsule contracture would best be treated by capsule removal (capsulectomy), the implants chosen as needed, the scars will be corrected with the breast lift, the breast shaping procedure that would likely be best is a circumvertical breast lift (lollipop).  There is a good chance that you will also need pocket tightening at the lower portion of your breasts (capsulloraphy)  I have attached a link of a before and after photos from my website that had most of the above.

All the best,

Dr Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 162 reviews

Revision of breast augmentation

Revision of your breast augmentation sounds reasonable with a mastopexy to accomplish some of the goals that you requested. An in-office exam is key.  Good luck.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.