BA Revision or Removal?

I will be seeing a Kaiser plastic surgeon about removal on 5/25. The pain in my right breast is constant now. There is sensitivity in both sides just a lot more on the right-kind of reminds me of how my boobs felt at the beginning of pregnancy. I'm not sure why this is happening, kind of wonder if it's all in my head.

My primary care Dr has referred me to have a mammogram and then to be evaluated by a breast surgeon. She thinks that an implant removal might be covered based on the pain and deformity I have. I'm uploading more photos. These look bad! I will be surprised if there isn't a ruptured implant involved based on how painful my breast has become in the last 36 hours.

I always was self conscious of my very small breasts. In the 80's and 90's big was the look, and mine were tiny. In the early 90's I nursed my baby for nine months and had grown to a 34DD then shrunk back to a 34AA. My first surgery was in November 1996 when I was almost 26. The implants were textured, round, & saline filled to 350 ccs- placed under the muscle through an incision in the mammary fold. After the surgery (in 1998 and 2000) I had two more babies and I nursed with no trouble for a total of 40 months. Eventually I had discomfort with the implants and I was diagnosed/rated a grade IV capsular contracture, my health insurance covered removing them (but not the revision). The surgeon was Dr. Fred Wilder in Austin, TX (for both surgeries). I think he did a very good job both times, although I feel the implant size was too large for me, the size was left up to Dr. Wilder since we were avoiding a lift with the first surgery. I was also very thin-5'8" and 120 pounds the first time around.

For the revision surgery the original capsule was left in place in the left breast and partially removed on the right breast. I took the asthma medication Accolate for six weeks prior to and almost a year post surgery to discourage a repeat CC. I have continued to do the breast massage as directed to keep the pocket open. I had extreme bruising on the right breast after the revision surgery (it was completely black/dark purple and the Dr. was surprised by the amount and severity of the bruising). I did not have drains placed after the revision. The 2nd set of implants are smooth, round, 360 cc, silicone (I think the brand is mentor) placed under the muscle through the original incision (in March 2003 & I was 32). Initially they looked and felt great but over time the right implant has become very uncomfortable. It feels tight, itchy, and often hurts or is sensitive. I believe it is a grade III CC at this point maybe IV. The left breast is probably at a II CC. I need a lift, the look is round breasts that sit high on my chest with the nipples and natural tissue appearing to slide off of the implant. I always have cleavage and can't ever hide that. I wish I had gotten a lift and smaller implants when I had the revision, I'm not sure why I didn't. I think I just wanted to get it over with and was afraid of recovery from a lift since I had three small children at the time.

With the first surgery I wore a 34C bra, after weight gain and body changes I was wearing a 34D (weighing about 130 pounds) now I mostly wear a 34DD or 34E (the brands that fit best are Le Mystere, Wacoal, & FirstLove). I am now 46, still 5'8", and hover between 145-150 pounds. In clothing I look proportional since I carry most of my natural weight in my hips and thighs and have broader shoulders.

It's difficult for me to say that I regret getting implants. I do wish I had gone smaller. Even though in 1996 the internet wasn't a thing I actually researched a lot, I bought a book on BA's, consulted with 5 different surgeons, asked many questions, brought in nude pictures for size and shape reference ([RS bleep] magazines I made my husband buy for me!) I knew that multiple surgeries for upkeep were likely-but I was young and didn't know what the future held. I am now a widow, support my kids on my own and so of course don't have extra money for cosmetic surgery. I didn't anticipate having to date again or having to tell anyone I have fake boobs. I also didn't think about how my daughters would feel about their bodies compared to mine as they grew into teenagers-they always noticed my gigantic boobs compared to how they have (not) developed so I've been very open with them about implants and why I got them and why they aren't really working for me anymore.

If I can figure out how to get the funds together I want to have these removed, a lift, and a very small silicone implant put in- I wonder if 150 ccs is a thing?! I thought about fat transfer but #1 it sounds super invasive with a long recovery time due to liposuction #2 results are not known/size might not be uniform #3 they can be lumpy, bumpy, uncomfortable! I am afraid that I will only be able to afford a removal anyway; the constant discomfort and frequent pain is beginning to wear me down and removal is going to have to happen soon. I have a lot of fear that I will look so ugly with just skin hanging where the implants were and that everyone is going to know when I am suddenly flat chested.

I'm posting a few photos. They look better in photos than in real life.