What to Do After Third Revision Surgery for Breast Implants?

I am about 4 mos. post op full anchor lift and smaller implants. I had recreation of IMF at that time pocket revsions and the lift. Prior to that I had my orginal BA which led to bottoming out on my right side which I had a revision to that did not hold. This was my 3rd surgery. I am very disapointed with the extra skin in my cleavage area and the beginings of bottoming out and the lack of upperpole fullness. What can be done at this point to create a fuller perkier breast?

Doctor Answers 7

This is relatively easily fixed

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My only recommendation for correction of the extra skin as well as for the lack of superior pole fullness would be another revision. I believe in general you have a beautiful result, but if these issues bother you enough to have a 4th surgery, then I would remove the upper half of your capsule, extending the pocket superiorly so the implant could move up and give you some fullness superiorly. Then I would tighten the capsule across the lower half of your breast and tighten the skin along your crease as well. I have done this for many patients and it works well. This is relatively easily fixed and usually lasts for many years. 

Fat grafting will help

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You have a problem that is not unusual . The revision for the lift and implant is very high. You may leave them as they are and accept the result . The other option is fat grafting . I have done up to 50 patient with imlant removal and fat 10 patinets with fat grafting over the imlant. . This is a conteversial issue and you need to find a surgeon that has experince. Please check my web site at www.khoobehi.com for pictures and also you can check my on going study at www.clinicaltrial .gov and search for fat injection to the breast.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.7 out of 5 stars 153 reviews

Revision breasts

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I can see the extra skin fold along the lower pole, this may be easy to treat by jsut doing a small excison of the skin.  As for the upper pole fullness, that may require larger based implants, but it also may cause more problems.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

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PHOTO: What to Do After Third Revision Surgery for Breast Implants?

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What to Do After Third Revision Surgery for Breast Implants? Trying to achieve a perky result is generally not a realistic result and if accomplished, is likely ot be short lived. I would advise holding off on any more surgery for now.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Revision of Lift

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From your photograph, it appears that you could benefit from having your lift revised again.  This would eliminate excess skin, tighten the envelope, and help to raise your breasts, creating some more upper pole fullness.

Suggestions for breast lift and implants

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Bottoming out of breast implants with or without a lift is a common problem and sometimes can recur even after an operation designed to correct the problem. If adjustments of the pocket are not successful, then sometimes a product such as Alloderm or Flex HD can be used to reinforce the lower pocket, essentially creating a sling or hammock to support the implant.

These products are expensive, however. You will need to be careful about simply trying to raise the implants as this may make the nipples appear to be too low, and it may not be possible to change the nipple positions as skin has been excised with your lift procedure based on the selected locations for the nipples. It also appears that your right nipple is somewhat higher than your left nipple and this will make the adjustment more difficult.

One choice would be to place larger implants and this would increase your upper pole fullness. Obviously, this may not be to your liking as you just downsized your implant size.The areas of extra skin of the medial inframammary creases could be corrected by extending the inframammary incisions and excising the folds though care would need to be taken to make sure that the scars are still hidden as much as possible.

Fat grafting can be used to help shape the breasts and increase fullness in the upper aspects of the breasts. Fat is an excellent filler as it is your own tissue and can be permanent. However, usually more than one session is necessary as not all the fat will take. Having said all of the above, you may simply decide to leave things as they are, if you decide that you are not too unhappy with the result.

Michael D. Yates, MD
Huntsville Plastic Surgeon

Let everything heal, then consider alternatives

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Let everything heal.  The skin will contract more.  Skin that doesn't contract well enough can be filled out with fat graft.  I have written about this on by blog.

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.