Any experience about peri-nipple mastopexy to correct tuberous breast . Thank you

a 29 year old lady, presented one year after breast augmentation done elsewhere complaining of saggy breasts. No information is available about the implants, however, she said that her implants were put above the muscles. Her main concern is low lying implants and loss of upper pole fullness. she does not breast lifting  nor fat grafting, just changing the implants and any internal modifications. on examination, she  suffers from implants' bottoming out (implants slide 2-3 below the IMF scar), loss of upper pole fullness, and slight lateral deviation esp on right  I had discussion with patient about the possible options as changing the implants to wider ones in order to fill the upper pole +- using a mesh to reconstruction the IMF since her implants slide 2-3 cm below the scar. the only meshs available are either vibrio mesh or vicryl mesh. I thought about pocket change to submuscular with mesh , but I am not sure since she is athletic.

a 24 year old girl with free past medical history presented with right breast lump of 9 months duration.  US was performed and showed at 3 o’clock ther is an irregular hetergenous thickening like mass area with shadowing suspicious measures 2.5x2 cm. also at 1-12 o’clock, there is hypoechoic nodule measures 1 cm. No LNE US guided core biopsy: fibroepithelial lesion showing tubular adenosis and foci of fibrocystic changes. Complete excision with safe margins should be considered for definite diagnosis. on clinical examination there was an irregular suspicious lump occupying  alomst the UIQ. The girl has got small flat breast ( cup A) Her maternal cousin had a breast cancer at age 32 and she is a carrier of BRCA, however the girl was tested for that genetic mutation and  found to be negative. Excisional biopsy will definitely leave her with breast deformity. I had a chat with the patient about the possible options. therapeutic mastopexy is not an option due to small breasts as well as volume replacement technique due to the location of the lump in UIQ. I told her that we can do wide local excision through IMF approach and put and implant ( propbly submuscular) to prevent deformity and augmentation of the contralateral breast for symmetrisation. any other thoughts?? attached a photo of the girl breasts with a marking for the footprint of the lump.

Hello,  I would like to discuss this case a 28 year old lady, underwent bilateral breast augmentation, dual plane II, through IMF incision, using microtextured, extra-high profile , 485 cc. After a couple of days, she started to notice gradual swelling in the left breast. The swelling was uncomfortable rather than painful. On day 8, she came for follow-up. On examination, there was swelling in the left breast mainly upper pole, soft non-tender. there were bruises mainly in LIQ that started to change in color ( started to fade). US exam showed hematoma. Hb is 10. she is asymptomatic My question is: should I observe as long as she is asymptomatic   and then try to aspirate the hematoma once liquify,  or should I take her to the operating room for evacuation of hematoma to prevent complications such as infection, persistent asymmetry or capsular contracture?

I need an advise about which pedicle should I use when performing augmentation mastopexy esp when the nipple is required to be lifted more than 5 cm. I have tried the superomedial pedicle but then I faced difficulty when trying to inset the NAC and closing the implant pocket at same time (suturing the rotated pedicle to tissue at IMF).