Suggestions/advice for breast revision? (Photo)

I would recommend downsizing implants, correcting the implant pocket, placing an internal bra (Galaflex), and potentially performing a skin excision to help create more symmetry. An official recommendation is challenging without at least a telehealth digital evaluation; the ideal is an in person examination and possible breast ultrasound.

It appears the breast implants are in front of the muscle, they are close together almost forming symmastia and the implants or the base of the implants are too large for your frame. I recommend implant exchange with smaller implants and placed retro-pectoral. At that time, you will need a revision of the double bubble from the original inframammary fold.

Best Wishes,

Gary Horndeski, M.D.

You are thin and do not have much breast tissue. I would suggest going down a little in size, 200-225 cc's, and using mesh for internal support. These are just a little too large and heavy for your tissue.

Based on your nicely posted, postop photos, and stating was a year and a half of the dates are incorrect. It appears you have a one side, severe superior lateral capsule contracture, causing nipple, areola on that side to be superiorly laterally placed along with some capsule contraction on the other side, causing Tightness circumferentially of that breast. Always best to do in person or virtual consult. Plus posting before. Photos would be very helpful. My opinion is you will need 2 to 3 separate surgeries to achieve a more symmetrical result. Stage one would be removal implants for total capsulectomy Drains and possible relocation of that laterally superiorly placed nipple Ariola. Additionally implants might be placed in the dual plane position? Fee for stage one will range from $6000-$10,000, final fee quote, only after virtual or in person consultation in full examination. regards

To make an accurate assessment regarding the outcome of a plastic surgery procedure, we generally always need to see a complete set of proper before and after pictures.
If you don’t have before, and after pictures then ask your surgeon to forward, the pictures they took.
Without knowing what you look like before your procedure, we don’t know what your candidacy was for breast augmentation surgery.
Without understanding if you were a good candidate for the procedure, it’s difficult to make a quality assessment regarding the outcome.
I’m guessing you had somewhat of a tubular breast shape before the augmentation.
I’m guessing that your breast diameter was quite small.
Your current implants have created its own breast periphery that doesn’t match up with your normal anatomic breast, periphery, tissues, or landmarks.
It’s also important to recognize that when describing sidedness, we typically do it from the patient’s perspective.
It looks to me like it is your left breast implant that’s bottomed out not the right.
It may be on the right side of the picture but I believe it is on your left side of your body.
Correcting bottomed out implants is not always easy or straightforward.
This should generally be done by plastic surgeons who have a proven track record with correcting this complication.
The procedure can either be done using internal stitches with or without support from mesh or cadaver dermal products.
Interview plastic surgeons and asked them specifically how many cases of bottomed out implants they’ve treated and preferably ask them to show you numerous long-term follow-up pictures showing quality outcomes.
There are generally two variables that determine plastic surgery outcomes.
With breast implants there is a third variable.
The three variables that determine the quality of breast augmentation surgery are the patients candidacy for the procedure in the first place, the choice of implants and the technical ability for the surgeon to put the implant in the anatomically correct position.
Using excessively large implants, increases the rate of undesirable side effects, complications, and need for revision surgery. The bigger the implant the more likely these things are to happen.
The more the natural periphery of the breast is violated, using implants that are far larger than the natural breast diameter, the more likely these type of complications are to happen.
There isn’t all that much patients can do regarding their own candidacy.
Implant selection is best done with a provider.
Provider selection is the one single variable patients have the most control over and is where most of the effort should be focused when choosing to have this procedure.
Finding the right plastic surgeon, it turns out, is often far more difficult than most people realize.
Best,
Mats Hagstrom, MD