Lollipop lift, utm, major pocket repair, swapped implants - bottoming out and flipping. What should I do next? (Photos)

Question

I’ve had a revision for the second time. This time around we did lollipop lift went utm major pocket repair swapped implants. From week 10 everything started going south. My ps refused mesh and now I believe I’ve bottomed out &has flipped 3x. I don’t know where to go from here. My right side seems to still be in place, the fold is higher than the left which may be why it’s higher. I have zero upper pole on the left. I have mentor boost hp. Any advice would be greatly appreciated thank you in advance.

Gary M. Horndeski, MD · Answer

Your breasts are wider than the chest wall and your implants are very large.  The only thing holding up your implants is the skin envelope.  You will need smaller implants and plicate the pockets.

Best Wishes,

Gary Horndeski, M.D.

Daniel Barrett, MD · Answer

Dear Birdie 16,

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

Dallas Buchanan, MD · Answer

Thank you for your pictures and questions. I think you need to revisit the concepts involved in the revision and rethink your goals. It appears to me that the muscle is causing problems, so I would get it out of the picture and transition to a pre-pectoral implant pocket. I would strongly recommend use of soft tissue support mesh (Galaflex) to prevent recurrent stretch and strengthen the soft tissue envelope as it is weakened from multiple revisions. In addition, I would recommend a revision of the lift for better symmetry as well as transitioning to a more cohesive gel device. Hope this helps!
Dallas Buchanan, MD
VIVIFY plastic surgery
Tampa, FL

Darryl J. Blinski, MD · Answer

Based on your series of nicely posted photos, and excellent explanation the real issue is whether to continue trying revisions or except the results as they are I might offer a virtual consultation, but most likely will require an in person consultation for better understanding that means traveling to see any boarded Plastic Surgeon to get opinions. I do agree that you need a mesh on the lower side and possibly Fat graphs or ALLOCLAEFDA approved fat injections to fill up the upper polls I might also do revision of the nipple area. Again, my real feeling is an in person consultation is needed. Expect fees to range from $10,000-$25,000.

Lollipop lift, utm, major pocket repair, swapped implants - bottoming out and flipping. What should I do next? (Photos)

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