Suggestions and Solutions for Revision-long and Square-ish Breasts Covering a Large Area on Chest Wall?

I've had my original implants since 1987 and can't locate any information about them. I assume they are low profile and have a silicone outer bag with a saline inner bag. They are 325cc's placed under the muscle. I loved the fake round look for many years, but now they have taken on a longish bullet shape. I'm 5'5", 125 lbs, and have a swimmer's body: broad shoulders, small waist, slim hips. My rib cage measurement is 30". Before, my bra size was 34B, after 36D because of the breast width,

Doctor Answers 5

Revision Breast Augmentation

As other surgeons have mentioned, it is impossible to make specific recommendations without seeing what your breasts look like, however some general principles will likely apply.


First of all, revision surgery is usually more complex than a first time surgery because you are frequently dealing with old scar tissue, breast pockets that may be stretched out or oversized, possibly drooping breast skin, etc.  Expect to possibly have a longer and more involved surgery than the original surgery.


Many things can be done to revise and improve breasts.  The implants will generally be exchanged for newer, better quality implants (I generally recommend cohesive silicone gel for the best results).  You can use this opportunity to go larger or smaller if appropriate.  The breast pockets can also be adjusted, often with internal suturing to shift the implants into a better position on the chest.  Sometimes the soft tissues or internal repairs benefit from reinforcement using an acellular dermal matrix like Strattice, which acts almost like an internal bra.  Finally, many women seeking revision also need a mastopexy (breast lift) if the skin has become droopy over time.


The botttom line is that this is demanding surgery, so you should definitely find someone that performs breast augmentation revisions on a regular basis.  Check out their credentials as well as their before and after photos of revision cases.  Good luck!

Santa Monica Plastic Surgeon
5.0 out of 5 stars 53 reviews

Breast Surgery Revision after 25 years

Even before particulars are considered, breast surgery patients need to understand that there are very different options on the market for implant revision.  There are implants now that one can choose for just about every shape and size.  It is best to bring in a picture of what you'd like to look like and also tell the surgeon what you don't like about your current state.  After that, he/she will have a pretty good idea as to the type, shape, and size of implant to meet your cosmetic goals.  Typically, though, the fake round look is achieved with an implant that has an adequate diameter for your chest dimensions. 

Eric A. Marchant, MD, FACS
Philadelphia Plastic Surgeon
4.4 out of 5 stars 14 reviews

Suggestions and Solutions for Revision

Thanks for your question. There are many options available for revision surgery and we try to create an individual plan based around the patient's needs. However without any photows it is pretty impossible to assess what your needs may be. Please resubmit your question with medical quality front and side view pictures.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 27 reviews

Breast Implant Revision

Without seeing pictures or examining you in person, it is impossible to give you any advice.  In general, if you have already had a breast surgery, the same incisions can be used and a combination of chaining the implants, performing the lift, liposuction and possible fat grafting can all be used to help achieve the best breast shape.


Good Luck.

David Shafer, MD
New York Plastic Surgeon
4.9 out of 5 stars 75 reviews

Best Option for Revisionary Breast Surgery?

Without direct examination or viewing pictures it is not possible to give you good advice. I think it would be in your best interests to meet with well experienced board-certified plastic surgeons who can demonstrate significant experience with revisionary breast surgery. After examination and a full communication of your goals ( I prefer the use of goal pictures), precise recommendations can be provided to you.

Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,486 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.