I need a revision to fix a bad breast lift, what are my options? (Photos)

Good morning!
You do have some bottoming out on both sides. In terms of correction, this is the most common repair I perform, 5-6 times a week. I use the Internal Bra, my strong permanent internal suturing technique which corrects your bottoming out and double bubble and provides excellent long term support for your implants.

Dear Angie2193Thank you for your question and photos!  I am sorry that you are unhappy.  An in person consult would be best to assess what can be done .  Your photos prior to this last surgery , the details of the implant and the implant position.With Warm RegardsTrevor M Born MD

Your results are typical of the traditional anchor lift and your implant has bottomed out.  The technique I recommend is explantation using The Bellesoma Method.  The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage.  Vertical scars are avoided, nipple sensation and the ability to breast feed are maintained, if not injured during your previous surgery.  At the same time or later, fat transfers can be performed if additional volume is desired.  Implants are not lifetime devices and half are removed by 9.5 years.  Fat transfers are permanent and incorporated into the body.Best Wishes,Gary Horndeski, M.D.

What I noticed right away are that your implants appear quite large.  I would want to know what size they are.  I would also have to take specific measurements on the nipple location to determine if they need to be relocated.  Hopefully they don’t.  The lower portion of he breasts appear to need tightening which works easier with a smaller implant.  It’s a complex case so I recommend you go to someone in your area who specializes in revision breast surgery.  Best of luck.

Dear Angie2193,
based on your photos, it looks like your implants are bottoming out. Bottoming out occurs when the implant falls below the current breast crease or inframammary line. It's more likely to happen with inframammary incisions, which is why I try not to use the inframammary approach to any breast surgery.
Bottoming out can also occur if an implant is too large for the breast pocket. That is why it is important to choose an implant size that's correct for your body. I perform numerous measurements in the office to determine optimal implant size for my patient's bodies.
My preferred lift is a lollipop lift when a periareolar won't do (ie greater than 2cm lift required). The lollipop technique was created by a Canadian plastic surgeon named Elizabeth Hall-Findley and treats the breast as a three dimensional structure instead of two dimensions (anchor - lift). Most importantly it does not require the horizontal component scars that the anchor-lift requires and breasts appear much more natural, lifted, and less boxy. Lastly, the lift lasts longer because the lollipop doesn't rely on the skin to hold the breast up, its actually breast tissue thats being brought together to support the breast and hence improves longevity. 
If you are considering a revision surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD

Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

The biggest problem I see is the bottoming out of your implants creating an overly high nipple position. To improve your result you will need revision and possible smaller implants. Please see a well respected plastic surgeon for consultation. Good Luck!

A revision of the internal pocket with additional support form a mesh or allograft may help. I would also reduce the weight and size of the implants.  I usually wait till the scat tissue has formed 3 or 4 months after the initial surgery.  This is a difficult problem to fix, good luck.

Based on limited views of your photos, your implants seem to have bottomed out and you nipple position seems too high.  The best person to determine this and fix the problem is your initial surgeon.  If you have somehow lost trust in this surgeon, I would also get a second opinion to help you determine your path forward.

I am sorry to hear about/see the problems you are having after breast surgery. I think your concerns are appropriate; your breast implants do seem to sit quite low on your chest wall, consistent with breast implant displacement ("bottoming out”). Consistent with the breast implant positioning problem, the nipple areola complexes seem to be sitting relatively high, because the breast implants have settled too low. 
Generally, signs of breast implant bottoming out include: 
1. Breast implant "sits" too low on the chest wall.
2.  Excessive palpability or visibility of the breast implant along the lower breast pole.
3.  Nipple/areola complex seems to be sitting relatively high, because the breast implants have settled too low. 
4. Discomfort along the lower breast pole (secondary to pressure from the underlying implant).
5. Relative paucity of upper pole breast implant volume compared to lower pole volume.
6. Increased visibility of a infra mammary fold scar (higher on the breast mound).
I think you will benefit from revisionary breast surgery which will likely involve capsulorraphy ( internal suture repair). Sometimes, depending mainly on the patient's history and physical examination, I will also use additional supportive materials such as acellular dermal matrix or biosynthetic mesh. This procedure serves to reconstruct the lower poles of the breasts and prevent migration of the breast implants too far inferiorly. Associated issues with positioning of nipple/areola complexes and visibility of the inframmammary fold scars should improve with this operation.There are several important "factors" involved in this type of revisionary breast surgery. Most important (in my opinion): plastic surgeon experience level.     In other words, experience level and technical expertise play the biggest role when it comes to successful  outcomes with this type of revisionary breast surgery.   In other words,  make sure you select a board certified plastic surgeon who can demonstrate lots of experience helping patients with this type of revisionary breast surgery.  Careful attention to postoperative activity limitations as well as use of appropriate postoperative support of dressing/garments are also important.
I hope this helps.

Thank you for your question. It appears that your breast fold is too low and the implant has bottomed out. I recommend a Ryan flap procedure to recreate a fold . Your bottom incision should sit right at the fold and not on the lower part of the breast skin. I recommend consulting with a board certified plastic surgeon in your area who has had success fixing these problems. Ask to look at before and after photos as well. Best of luck with your procedure.