What would be the best revision surgery for my breasts? (Photo)

To achieve an optimal breast shape, it is recommended to consider changing the implant while also undergoing a mastopexy (breast lift), though it's worth noting that this procedure may result in visible scars. If you opt to only change to a larger implant without a breast lift, the shape of the breasts may improve and the upper pole may appear less sunken, but the breasts may still appear to sag.
To minimize the gap between the breasts, it may be helpful to switch to a larger implant and receive a fat transfer to the cleavage area. This technique can increase the thickness of the currently thin tissue, which can improve the look and feel of the implant.

The technique I recommend is explantation with lift 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 (in 95%) and the ability to breast feed are maintained if not injured during your previous surgery. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

An in person evaluation is always best, but it appears you would do fine with just an implant exchange of silicone implants placed under the muscle. A conservative lift may be indicated depending on your goals and implant selection.

I do not think that you need lift; implant replacement would be a good option, possibly some fat grafts over upper pole and medialy to cover/improve soft tissue deficit. In person consultation is needed to exclude possiblity of breast implant contracture. Good luck.

It looks like you would need a pocket tightening in exchange of implants ( we would have to make sure that they are under the muscle)