Years after explant. I want to be done with surgeries. Love smaller breasts but saggy. Do I repeat lift or minor tweaks?

Dear 40yearoldtuneup,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

I would recommend a complete breast revision including placing a new implant, capsular work (possibly removing any residual capsule as well), placement of Galaflex, and performing a minimal lift to remove the excess skin and previous scars in the process.

To add more volume to the upper pole, fat transfers can be done since you do not want implants. Also, your areola needs to be made more symmetrical to match the opposite side. You have excess skin inferior, which can be resected transposed higher on the chest to give more breast fullness.

Best Wishes,

Gary Horndeski, M.D.

Have the lift repeated to position the tissue better and remove the excess skin. The Montgomery glands on your areolae can be excised and the areolae can be made smaller at the time of the lift. You still will not have upper breast fullness since you do not have much breast tissue in the position. Fat could be added later if you do not plant to lose weight.

Great series of posted photos. Also your questions and desires, though lengthy most likely 2 to 3 additional surgeries. I recommend in virtual consultation to discuss each area and possible number of surgeries. My opinion is to start with liposuction and fat transfer to the breast ultrasound guided transfer. Fee $8000-$12,000 Then possible revision of surgical scars, etc. Again, best of virtual consult with.