Do I need a revision? What's going on here? Why saggy? (photos)

Hello! Thank you for your question. I can’t see your before pictures but it seems that your breasts might be saggy before the surgery. In such case, only mild sagging could be fixed with implant augmentation only. If its little more severe, then mastopexy (breast lift) must be performed together for a beautiful shape. Even if you use bigger implants, it won’t solve your case. Mastopexy will be necessary, but the exact method – periareolar mastopexy or vertical mastopexy, must be judged and confirmed during an actual consultation. If the cleavage is not well formed, pocket dissection and fat graft on cleavage side will be helpful. If the capsule around the implant is too thick, capsulotomy or capsulectomy must be performed and implant position lowered a little. Wide lateral space should also be narrowed.

You needed a lift and underwent augmentation alone. At this time, I recommend 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 or small implants can be placed totally submuscular.

Best Wishes,

Gary Horndeski, M.D.

You needed the lift. Your implants are plenty close together, it's just that your soft tissue is hanging off of the implants (waterfall deformity). Go to a surgeon that won't lie and has a lot of experience with breast lifts.

Dear CosmicL,
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

Good morning,
It's hard to tell from the photos if you need a lift- I would need to measure your chest. It very well could just be a pocket problem- it appears your implants sit a little too high and too far apart- if I measure you and you don't need a lift then all we would have to do is fix your pockets. It's not a saline vs silicone problem, it's a pocket issue.

Your implants may still be sitting somewhat high, and you may need a lift. Your implants do appear to be somewhat large for your frame. I would go back to your surgeon and discuss your concerns.

Your implants are high on your chest and your breasts are hanging over the implants. Your implants should be adjusted lower, more medial (close to center) and a breast lift (raising the height of your nipple/areola).
Best wishes.
Dr. T

Your photos indicate that a full breast lift is warranted but that entails the scars which you would need to accept to elevate the nipples and tighten the skin. The implants aren't the issue here.