Breast lift revision - how can I fix lower pole laxity and nipple position? (Photos)

Question

I’m 33 years old I had a breast lift and breast implant exchange in nov 2025. my first implants were placed in 2016 I had 345 cc in left and 360 on my right. They were natrelle mod profile. In nov 2025 i got motiva 335cc full round profile. I wanted a tighter more youthful look. i feel like my breast lift wasonesoconservatively. Immediately After surgery i noticed my nipples were still low, there was a lot of lower pole laxity and my breasts felt oblong. After doing research, the imf fold should’ve been reinforced and placed higher. My Surgeon offered to do a revision to fix the lower pole laxity Im concerned with how he plans to fix the asymmetrical issues. One implant is sitting g higher. Can ang surgeons help and let me know if they have delt with something like this and how it was addressed ? Any recommendations on how to ensure this gets corrected? I feel dismissed by my surgeon

Frank Agullo, MD · Answer

You have breast asymmetry. The right breast is sitting higher. Your right nipple is also sitting higher. You also have a waterfall deformity. That is when the lower portion of the breast slips over the implant.

The best way to deal with this is a full mastopexy revision with excision of the lower pole breast tissue. You will end up being slightly smaller, so you should consider increasing implant size. The right implant needs to be lowered or the left needs to be raised. Pick the one you like more. Either way, I always recommend mesh reinforcement.

#StayBeautiful,

@RealDrWorldWide

Gary M. Horndeski, MD · Answer

Your implants seem to be high on the chest wall. You may benefit from smaller implants and have them placed lower on the chest wall to correct your abnormality. You also need a scar revision of the vertical scars.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Vasileios Vasilakis, MD, FACS · Answer

Hello,
Thank you for the question. From the photos, you require adjusting the pockets to improve the position of the implants, and another lift to achieve more tightening around the implants and to improve the position of the nipples. 
I wish you the best. 
Vasileios Vasilakis, MD, FACSDouble Board Certified Plastic SurgeonHouston, TX.

Daniel Barrett, MD · Answer

Dear Calm365523 ,

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

Mehmet Ozdemir, MD · Answer

It is completely understandable that you feel frustrated, as your photos clearly show a "bottoming out" effect where the implant has dropped relative to the nipple, leaving you with excess fullness in the lower pole and a nipple position that sits too high on the breast mound. This often happens when the inframammary fold (IMF) &mdash;the shelf that supports the implant&mdash;isn't sufficiently reinforced during a lift, allowing the weight of a full-round profile implant like the Motiva 335cc to stretch the lower skin. To fix this, a revision would require a formal IMF reconstruction (internal bra) using permanent sutures or surgical mesh to "reset" the crease higher, combined with a vertical or Wise-pattern skin tightening to reposition your nipple centrally on the mound. Since you feel dismissed by your current surgeon, it may be worth seeking a second opinion from a revision specialist who can walk you through a specific plan to stabilize those internal pockets, ensuring that this time, the "tight, youthful look" you wanted actually stays in place.

Kadir Berat Oyur, MD · Answer

It is very common to feel frustrated when you feel your concerns are being dismissed, but what you are describing lower pole laxity and nipple malposition after a lift is a recognized challenge that can definitely be addressed. When a lift feels too conservative or the breast takes on an "oblong" shape, it often indicates that the internal support of the inframammary fold (IMF) needs to be reinforced and physically elevated to better support the weight of the new implant. To correct the asymmetry where one implant sits higher, the surgeon can perform an internal capsulorrhaphy (precision suturing to tighten the pocket) on the higher side while simultaneously raising the fold on the lower side to ensure a level, symmetrical base. This "internal bra" technique, combined with a more robust skin tightening, is the standard way to secure the implants in a more youthful, elevated position and eliminate that heavy feeling in the lower part of the breast.

Semih Yildiz, MD, FEPOBRAS · Answer

At about six months after a breast lift with implant exchange, I would evaluate this as a pocket-and-skin-envelope issue rather than just a nipple-position problem. The photos show the general contour concern, but an exam is needed to judge implant position, fold stability, scar quality, and how much lower-pole skin stretch is present.
Revision can sometimes involve reinforcing or recreating the inframammary fold, adjusting the implant pocket, tightening lower-pole skin, and revising the lift pattern if the nipple position truly needs change. I would ask your surgeon for a very specific written plan and consider an in-person second opinion before another operation.

Darryl J. Blinski, MD · Answer

Great posted photos I recommend revision lower pole with internal mesh. Fee $12,000-$18,000. Best to virtual with

Breast lift revision - how can I fix lower pole laxity and nipple position? (Photos)

Answers (8)

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