Deciding on a Breast Lift with a Revision
The most common #breastprocedures include #mastopexy or #breastlift, #breastaugmentation, or #breastreduction.A #mastopexy or breast lift operation is designed to improve the shape and position of the breasts without reducing their size. It is the most suitable for #breasts which sag or droop (ptosis) as a result of development, aging, pregnancy, breast-feeding and weight loss . Some patients will experience better results to restore superior fullness if an #implant is used at the time of mastopexy; better known as #AugmentationMastopexy.
With both implant types there are choices when it comes to size, shape, and profile. The criteria best to suit you will be discussed in full detail at your breast augmentation consultation.
Altogether, the surgery will create an elevated, more youthful breast contour. Also, the nipple and areolae of the desired size and correct heightmay also be addressed. I prefer to use a #shortscar technique, #LollipopScar or #DonutLift” rather than the majority of surgeons in the United States that use an anchor pattern lift which involve more significant scarring.The best method and #technique for your #procedures will be discussed in greater length during your one-on-one consultation with a board-certified plastic surgeon.
What asymmetry are you wanting to 'fix'?
If you want your nipples more level, you will need a lift. If you're most concerned about the difference in size, a larger implant on the smaller side would probably improve this for you. But you do not need a lift due to nipple position. A larger augmentation should do well for you and the larger implant on the smaller size would help improve symmetry. But the hard thing is how much difference in size will make it perfect???
What degree of ptosis do I have? Do I need a breast lift? If so, which type? Will a breast lift correct the asymmetry?
From your photos, you do have moderate breast ptosis and would probably benefit from a breast lift. The type of lift which may be best suited for you would depend on several factors including how large of an implant you are considering and how much lift you would like to see compared to the length and number of scars associated with each type of lift (donut, lollipop, or anchor). The lift should be able to improve/correct the asymmetry. Ask your surgeon to see photos of patients similar to yourself who had breast lift or breast lift and augmentation procedures. Best wishes, Dr. Lepore.
Breast Lift Needed?
It appears that at least some of your asymmetry may be due to implant malposition. Your larger breast looks like the implant has dropped further causing the lower breast to look more full and rounded out. If the implant on the other side was lower you would look more symmetric. It is also possible that you would benefit from two different sized implants.
You also may not need a lift if you are OK with your breast being located lower on your chest wall and not feeling super "perky". Doing a lift along with upsizing to 500cc could be a challenge depending on how much skin laxity you have.
To answer your question best would entail looking at pictures of the look you wish you achieve after this surgery. You do have asymmetry yes and a lift with small reduction on the right side can help this. However if you wish to have large natural looking breasts you might just need two different sized implants with some pocket work to help even out asymmetry. I would see a Board Certified Plastic Surgeon who performs a lot of breast revision surgery. Best of luck to you!
Based on your pictures, I don't think the scars would be worth the improvement with a lift as far as your areolar size and position is concerned. As far as your volume asymmetry, I don't think 30 cc was enough difference to compensate. When you have new implants placed, the smaller side needs a larger size difference. Even with this, you may have to accept the fact that your breasts may never be perfectly even. Find an experience Board Certified surgeon for an evaluation.
Correcting breast asymmetry can be a very challenging and difficult problem. Your smaller breast has significantly less skin than your larger side and the only way to get closer symmetry is to perform a skin reduction on the larger side, This necessitates uplift type incision lines. If this is acceptable to you then your implants can be exchanged for somewhat larger ones (limited by distensability of your tissues on the smaller left side) but I would advise you to realize that perfect symmetry is probably not achievable. 9 years after placement of implants the good news is that your left side is probably more capable of expanding to accept a larger implant than was possible at the time of your initial surgery so further enlargement and improvement can be achieved.
I would strongly advise you to spend some time meeting with more than one board-certified plastic surgeon to review options and to help you formulate a plan.
Jon A Perlman M.D., F ACS
Certified, American Board of Plastic Surgery
Member American Society of Aesthetic Plastic Surgery
ABC-TV Extreme Makeover Plastic Surgeon
Beverly Hills, California
Your nipple is above or at the fold from what I see. I would recommend removal and replacement with Allergan Inspira moderate profile . A mastopexy may need to be done to remove some of the skin to help you get more symmetric. A consultation with a BCPS would be best.