Very bad results after breast lift. What treatment, or mix of treatments would be the best? (photos)

Brandy 1999, Thank you for your pictures and questions. Unfortunately, you did have some wound healing issues. You are likely genetically predispositioned to hypertrophic/keloid scarring.There are certainly other treatments that can be done to help prevent that (but you might develop scars like that again). If you want to be "perkier" I would definitely recommend  another breast lift (mastopexy) and if you want tjhe upper pole of your breast to be more full, a small implant can achieve that for you. You should see a board certified plastic surgeon for a consultation. Best wishes, Dr. Suzette Miranda Board Certified Plastic Surgeon 

Scar revision to reduce and reposition areolae plus implants for fullness will also allow restoration of cleavage and perkiness.An exam and consultation with a/your plastic surgeon is recommended to discuss your options and expectations. 

Hi
and welcome to our forum!
Secondary
stretching of the skin envelope occurs after mastopexy if the overlying skin
has lost its elasticity (usually after pregnancy or massive weight loss) and
stretches further following the breast lift, especially if a large implant
was utilized as well.  You have developed "pseudoptosis"
(sagging of the breast below the areola) as well as areolar
enlargement. You
would be considered a good candidate for secondary mastopexy with areola
reduction and removal of excess skin. . The areolae aren't high...the
breasts and nipple-areolar complexes are low. If an implant was used, you may
wish to downsize. Your ability to breastfeed may be altered with any breast surgery. If you are
anticipating future pregnancy and breastfeeding, it may be wise to delay revisional surgery as subsequent pregnancy may require revisional mastopexy as well.
Best wishes...

hello thank you for your question and provided information as well.. based in your question and the picture you showed you are a good candidate for breast lift with small implant to get projection ,is recommended if get a consultation with a plastic surgeon to determinate how many cc do you gonna need and what technique do you apply.

Thank you for your question and photos. I am sorry to hear that you are unhappy with your results after surgery. The best option right now is scar and areola revision with augmentation to give you the perkiness that you desire. I would advise you to schedule a consultation with a board certified plastic surgeon to discuss treatment options. Please see the attached link regarding breast augmentation. Many of my patients find it very helpful.

Your photos reveal recurrent drooping of the breast tissue, widened scars , and dilated areolae. The only way to adequately address this would be to undergo a  revisional breastlift. This would allow reshaping of the breast , correction of the nipple areolar location and diameter, and improved scarring. One might consider use of an internal bra , to help maintain correction if the breast tissue is quite dense. This is unlikely to have any significant additional affect on your ability to breastfeed in the future. I would also recommend skin testing any tape or adhesive to be used prior to the procedure to prevent a recurrence of your original problem.

Hello,There are a number of things at play that lead to this result, the most conspicuous is the 'punctate' distribution of hypertrophic scarring (not keloid). This suggests multiple suture abscesses. The key to minimizing scars is rapid healing and avoiding excess inflammation. It would be fruitful to determine the type of suture used. Second, it appears that your breast skin has a strong tendency to stretch, or more precisely expand, leading to recurrent sagging and dropout. This problem varies with the individual, and in your case  you would benefit from a reduction/revision lift to reduce the size and weight of your current breasts. Finally, post surgical tape is one of the most important components in scar management. Using a porous, elastic tape like Hypafix, worn constantly for 2 to 3 months, can lead to much finer overall scarring. 

If you desire small perky breasts then the technique I recommend is The Bellesoma Method.  This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage.  The weight of the breast is transferred to the underlying pectoralis major muscle resulting in long term stability.  Vertical scars are avoided, nipple sensation and the ability to breast feed are maintained, if not injured during your previous surgery.  No one can guarantee that keloids will not form again.Best Wishes,Gary Horndeski, M.D.

Thank you for your question.  There are several issues with the result.  The scarring is unfortunate, but you do have areas that have healed well and others where the scar is quite thick.  The thicker scar may be due to inflammation with the deeper sutures taking longer to dissolve, or the more superficial sutures being placed too close to the epidermis.  In patients with similar problems that I have seen in my practice, revising the scars with either removable nylon or the use of Prineo/Dermabond (medical grade crazy glue) may help.  In the healing phase we have had better scar with the use of silicone gel or tape products for 2-3 months.  Blistering with tapes is often due to traction from swelling and I have personally moved away from using steristrips to the tissue glue option with better healing in the last year.
The shape of the breasts has settled and redoing the lift can address that.  Elevating the breast tissue will help or possibly eliminate the visibility of the areola in clothing since this is often a consequence of bottoming out or pseudootosis and getting the breast volume positioned higher will generally help.
Repeat breast surgery does have additional risks but you have a good chance of improving this situation as well.  I would speak to your original surgeon and review your concerns.  Alternatively it is worth getting a copy of the original OR report from their office and getting another opinion.

Thank you for your question.  Unfortunately, your surgery was performed poorly.  This is not a reflection of your underlying anatomy, it was just poorly performed.  A large portion of my practice is dedicated to revisionary breast surgery.  You should be able achieve the result that you would like with a meticulously performed breast lift, re-augmentation, and pocket modification with capsulorrhaphy. This combination of surgery is termed "Reductive Augmentation" which I published in the International Journal of Aesthetic Surgery 2 years ago.  Your case would be fairly straightforward to fix using these techniques. Best wishes to you