Augmentation Revision- Need Pocket Revision? (photos)

Updated from Augmentation Revision- New Pocket?

So I had a BA 10 yrs ago with saline. Since then I had a son, and breast fed. I have totally lost upper pole fullness but also I think they've slid down my body. Do I need a pocket revision & bigger implants or just new implants? One dr wants to charge $12k for a revision with sutures for a revised pocket(no strattice) and another doc says I only need bigger implants and he believes sutures eventually give out anyway. Not sure which opinion is best. Thank you.

Doctor Answers 11

For breast augmentation revision, Strattice works well.


Pockets do need to be revised, and Strattice makes repair more secure (also reduces chance of capsular contracture).  Asymmetry needs to be corrected, too.  Don't think you will be happy just changing breast implants.

Manhattan Plastic Surgeon
4.8 out of 5 stars 9 reviews

Augmentation Revision- Need Pocket Revision?

     The purely technical answer is that suturing the pockets and supporting the implants in a higher position will improve the superior pole fullness.   You could consider dermal matrices, but this increases the cost significantly.  You could also add larger implants if you want larger breasts.  Find a plastic surgeon with ELITE credentials who performs hundreds of breast augmentations and breast augmentation revisions each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.  Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 496 reviews

Breast augmentation revision after 10 years

You have some asymmetry which is not unexpected after a pregnancy and 10 years post op.  The only real problem noted is the slight double bubble crease seen when your arms are raised. If you are just looking for upper pole fullness then an inferior capsulopexy may be considered using either your existing implants or switching out to a gel implant.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 19 reviews

Augmentation Revision- Need Pocket Revision?

Most likely ONLY new implantation. But in person examination is a MUST!!! Seek boarded PSs in your are/city. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 174 reviews

Augmentation Revision- Need Pocket Revision?

Your nipples are well above the fold as is almost all of your breast tissue. Do not let anyone talk you into a lift. You don't even need a pocket revision, but if you did Strattice is rarely necessary and sutures do hold well if accompanied by cautery scarrification of the capsule and the implants aren't too big. However, if more volume is your desired result then by all means consider larger implants. BTW, $12k sounds extremely high unless you live in NYC or some other very expensive area. Be sure to get several consults.

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

Augmentation revision?

Thanks for your photos but unless you're really wanting to be bigger OR have more fullness on top, your breasts look great.  My opinion comes from what I would think if I saw you on a topless beach... and you have a very natural look.  But if you want larger, then you could benefit from an implant.  If you want more fullness on top, then you will need either a lift or capsulorrhaphy, depending on what look you desire.  If you walked into my office, I would suggest you wait a little longer until issues become more obvious before pursuing more surgery.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Augmentation Revision- Need Pocket Revision?

Thank you for the question and pictures.  

Given your pictures and description, I think you will be best off undergoing internal suture “repair” of the breast implant pockets (capsulorraphy). Doing so will help avoid the “sliding” of the breastimplant phenomenon that you describe. The breast implants will be better positioned on your chest wall and help maintain more upper pole fullness. If your breast implants slide off to the side when you lie down, this procedure will help maintain volume in the cleavage area in the supine position as well.

 In regards to size/profile of breast implants to be used, it will be important for you to communicate your goals clearly with your plastic surgeon. In my practice, I find the use of goal pictures much more helpful than terminology such as “natural”, “fullness”, or a discussion of cup sizes which can vary from one bra manufacturer to another.

 I also think that postoperative management is very important in  achieving successful results after this type of surgery. I advise my patients to keep their elbows by their sides as much as possible for several months after the procedure is performed.  Avoidance of heavy lifting/exercise will be important for an “extended” period of time.  Keep in mind that recurrence of breast implant displacement is a potential problem.
 You may find the attached link helpful to you as you do your “homework”.

 Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,499 reviews

Revision Might Not be Necessary

First of all, your breasts still look good.  You have a very natural result. The irregularity beneath your breasts when you raise your arms is most likely where your breast tissue ends. In your case, raising the inframammary crease would help that as well as give you more upper fullness. Normally when I replace implants, I place sutures laterally as well to get rid of that outer laxity. It really depends upon what you want to achieve and how large you would like to be.

William H. Huffaker, MD
Saint Louis Plastic Surgeon
4.9 out of 5 stars 49 reviews

Downsize and Lift

Thank you for your pictures.  I would recommend you downsize your implants and have lift to improve shape and fullness.  A larger implant will only stretch out your skin more over time. 

Dr. ES

Breast Augmentation Revision

Thank you for your question. It appears that the distance from the nipple to IMF ( the junction between the inferior chest wall and breast ) has increased and this is common after pregnancy and breast feeding. If you are happy with your size, then exchange your implants. If you want to be bigger, put in larger implants. Surgeons will often place suture along that IMF to raise it therefore positioning the implant higher on your chest. If the quality of the tissue is poor or weak then the sutures may pull through and the sutures will need to be reinforced with strattice. Good luck

Lisa M. DiFrancesco, MD
Atlanta Plastic Surgeon
4.8 out of 5 stars 34 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.