Did my lift fail? Will it happen again? Is removing the excess skin an adequate solution? (Photos)

Hi. Your skin has stretched either because you don’t have good skin elasticity or because the implants are heavy or most likely a combination of both. To fix this you need to address both issues. You need to have more skin removed to tighten your breast lift. You also need better support of your implants to keep them higher. This can be done with internal sutures called capsulorrhaphy, and you should consider the use of additional mesh or Galaflex for added strength. Your surgeon can explain these solutions to you in more detail so I suggest you talk to him/her in person about the options. Best of luck!

I agree with Dr Minniti. A vertical shortening in the form of an incision in the inframammary fold is the answer. A lift and implant at the same time is always a bit challenging but an anchor pattern lift gives the best control of the reshaping and lift. I perform these revisions under local anesthesia in the office.

Thanks for submitting your questions and photos! I'm sorry that you're not completely satisfied with your results. Based on your photos, a mastopexy revision with tightening of the lower pole skin would be a good option. Usually, once more skin is removed, this won't be a recurrent issue. However, you may notice breast enlargement and loose skin if you have significant weight changes, have a pregnancy, breastfeed, etc. It is important to feel confident in your plastic surgeon's plan, therefore, I'd recommend getting a 2nd opinion if that's what you need in order to feel comfortable moving forward. Good luck and thanks again for reaching out.

The most common problem associated with a scar pattern that doesn't include an inframammary scar, the 'lollypop' scar pattern, is dropout. The correction is removing the skin necessary to directly address the vertical skin excess, and this will leave the inframammary scar. In three decades we've come full circle with anchor to lollypop to anchor again with patients that have significant vertical skin excess or poor skin elasticity.

It would not be accurate to make a final judgment without an in-person evaluation, but from the photos you shared, it appears that the lower part of the breast has stretched again under the weight of the implants.
Removing excess skin can improve the appearance temporarily, but it may not be enough to prevent the same problem from happening again. Long-term stability usually comes from combining skin tightening with structural support. For example, adjusting the implant pocket, modifying implant size or projection or adding internal sutures to strengthen the lower breast. In some cases, reinforcement with mesh or acellular dermal matrix can also be considered to help the breast maintain its shape over time.
It would be best to have a consultation to carefully assess the degree of laxity, tissue quality and implant position before deciding on the most appropriate plan for revision.
— Güray Yesiladali, MD

What I recommend at this time is smaller implants and the pockets plicated more medial and lateral. You will probably need a curvilinear inframammary incision to take out any excess skin. Another alternative would be explantation and 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 or small implants can be placed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Answer from Dr. Sean Hill, Board-Certified Plastic Surgeon at Lone Star Plastic Surgery – Frisco, TX:
Thank you for your thoughtful question and for sharing your photos. I can understand how frustrating it must be to feel that your lift may not have achieved the long-term result you hoped for. Based on your images and description, I’ll walk you through some key points to help clarify what may be going on and what your options are.

Based on your nicely series supposed to photos, the first comment is the L shaped lift was the incorrect lift option. The anchor lift would’ve most likely given a more long-term lasting lift effect. With that said, most likely, Visteon should involve an internal bra material with conversion to anchor lift. Expect fee to be $10,000-$15,000. Best to virtual consultant with.