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

Question

I'm a 48 year old mother of 2. I’m 5’4” and 135lbs. I had my saline implant surgery in 2005 (via armpit/ under the muscle). My kids were born in 2014 and 2018. I breastfed for a total of almost 8 years. I would like to update my implants with silicone ones now. Can i just get a larger implant to make them look more full? Or will I need to get a lift? I would prefer not to get a lift because of the obvious complications/scars etc. I would like my cleavage area to be smaller, if possible.

Randal Haworth, MD, FACS · Answer

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)

Chul Hwan Seul, MD, PhD · Answer

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.

Gary M. Horndeski, MD · Answer

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.

Best Wishes,

Gary Horndeski, M.D.

Zoran Potparic, MD · Answer

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.

Ronald J. Edelson, MD · Answer

Your breasts are too low. You need a lift and the implants placed under the muscle. It’s a tricky operation so make sure you go to a surgeon with a lot of experience. Also don’t be surprised if someone recommends doing it in two stages. It’s safer and you'll get a better result

Daniel Barrett, MD · Answer

Dear AngelaCM007,
breast revision surgery is the most difficult plastic surgery procedure performed. Botched breast surgery alters normal tissue planes and laxity, the ability of breasts to heal properly, and leaves scar tissue that dramatically affects the level of difficulty of the corrective surgery.Many patients come in to correct poor outcomes from their initial surgeries. The most common problems are due to implant malposition, bottoming out of the implant, poor scarring, and incorrect implant size.While the type of revision required will depend on the result of the previous surgery and the desired result of the patient, some revisions involve extensive pocket repair that may or may not need specialized external bras.If you are considering breast surgery revision, you should speak with a board certified plastic surgeon and have yourself properly assessed. Only after a thorough examination you will get more information and recommendations. Also, you have to make sure that your surgeon understands your breast augmentation goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Antonios Mitsakos, MD · Answer

the breasts naturally as they dangle they move to the side because of the orientation but also the size of the skin. That means that I feel that your skin has stretched to an extend (likely as a result of the implant) and would benefit from skin rearrangement in the contest of an uplift. You can upgrade to silicon implants and perhaps consider a dual plane (partly under the muscle) for extra support

Connie Hiers, MD, FACS · Answer

Naturally, your breast sit low on your chest and the bases of your breasts cannot be changed. However, I would suggest changing the placement to behind the muscle to avoid seeing the edge and doing a lift. Your cleavage can probably not be changed much because the bases cannot be moved. Fat transfers could be added to help soften the area.

Camille Cash, MD · Answer

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.

Hilton Becker, MD · Answer

Your implants no longer appear to be under the muscle 
Saline is heavier than gel and are causing the sagging.
I would recommend  replacement with silicone  implants, mesh support and possible breast lift

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

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