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Small Breast Implants for Sagging Breasts After Lift?

I had a breast lift 3 months ago and it's sagging already (loss of tissue and mass above areola).  A doctor suggested tiny breast implants, however, I am already 95 lbs. and a large C. Please advise.

Doctor Answers (12)

Sagging after breast lift

+2

It is very difficult to answer this question specifically in your case without seeing before and after pictures. Sometimes the procedure can be altered to prevent this from happening, sometimes an implant is required. My concern with a small implant is that it will be very difficult to make sure it is placed and stays where you want it. If it settles into the breast you will have a worse situation. On the other hand if the breast continues to sag and the implant stays you will have the breast drooping off of the implant. I would encourage you to wait another 3 months and reassess the situation, see you plastic surgeon again and see another plastic surgeon to get a second opinion.


Harrisburg Plastic Surgeon
4.5 out of 5 stars 17 reviews

Maldistribution of breast volume

+2

It sounds as if you have a maldistribution of breast volume. That is, your volume and size are adequate or even too much, but it is in the wrong place creating a displeasing appearance. Although it sounds odd, some patients need a reduction-augmentation-mastopexy. You essentially remove tissue in the wrong place and replace it with implant volume in the desired place. In you, a reduction combined with the associated lift will make you smaller but more ideal in distribution of the breast tissue. Then you can augment them with an implant that produces the fullness you want. The problem with very saggy breast tissue is that it is very difficult to lift the tissue superiorly where women want fullness and maintain it there.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 8 reviews

Sagging after breast lift

+2

Once your breast settles following a breast lift, upper pole fullness is very difficult to maintain. Even though you have large breasts for your size, it is nearly impossible to achieve upper pole fullness without using an implant. Yes, it does sound strange but you need volume to be placed in a specific part of the breast that gravity normally doesn't allow. All you probably need is a small implant, but it seems like that might be the answer. I recommend going to see your surgeon again and discuss your concerns with him/her. If you are not satisfied then seek a second opinion with another board-certified plastic surgeon. Good luck!

Dr. Singer

Elan B. Singer, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 11 reviews

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How to deal with sagginess after a breast lift

+2

Hi,

Your sagginess seems to be loss of upper pole fullness, which is a problem that a lot of women have after breast lift. This is usually because the supporting ligaments of the breast are simply not strong enough to combat the effects of gravity. There's really nothing you or your surgeon can do to prevent this sagging, short of having you wear a strong support bra at all times. Given your large breasts and relatively small frame, it's not surprising that you have already begun to experience some loss of upper breast projection. In patients like you, placement of a breast implant usually is most helpful for maintaining upper breast fullness and shape.

Hope this helps. Best of luck.

Sam Jejurikar, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 31 reviews

Small breast implants for sagging breasts after lift?

+1
Hello! Thank you for your question! The mastopexy (breast lift) procedure raises the breast, which ultimately provides a more youthful and perky breasts. This is done by removing the extra loose skin and rearranging the surrounding breast tissue in order to reshape and support the newly formed breast. At the same time, the nipple-areolar complex (NAC) is raised to the ideal position above the fold beneath your breast (the inframammary fold) as well as being placed at the most projecting portion. Oftentimes with age or following pregnancy, the NAC becomes widened and enlarged. This may be reduced in size during the breast lift procedure.

It is common for the breast to lose its firmness and uplifted appearance over time, which is also accentuated with age, pregnancy/breast feeding, weight gain/loss, and gravity. This results in breast ptosis, or sagging of the breast, with a “deflated” appearance. Women seek the mastopexy procedure to regain the previous youthful appearance of her breasts and women report increased confidence, self-esteem, and femininity once achieving this desired shape and fullness. Breast lifts may or may not be performed with implants – the implant would add increased size but also greater fullness in the upper pole of the breasts which creates more cleavage.

I would discuss your concerns with your plastic surgeon. Increased size of the implants as well as laxity of the native skin do cause increased stretching inferiorly.  The implant itself would give you the additional fullness that you are looking for, as sometimes the left alone will no add that fullness without an implant.  Revisions certainly may be considered - allow your surgeon to examine and evaluate you and then go over which procedure(s), if any, will be the right one for you. Best wishes for a terrific result!

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 12 reviews

Implants?

+1

There are several choices you could make and they all depend upon what you want to see, and what are the sequela of these choices. Some breast lift techniques do cause eventual lack of fullness in the upper pole of the breast. Often, women want this area filled and one technique for accomplishing this is to use an implant.  Ask your surgeon to see several pictures of patients who have had this done to determine if this is your goal.

Marc Schneider, MD
Fort Myers Plastic Surgeon
4.0 out of 5 stars 4 reviews

Breast lifts and breast implants

+1

Breast lifts and breast implants is probably the area of most confusion and misconceptions of what they are and what they do even to plastic surgeons.

Breast lifts (mastopexy) come in all kinds of different techniques, many of which are considered outmoded or old fashioned and some of which are overrated in terms of what they accomplish. As was pointed out in some of the other responses, a modern breast lift involves truly repositioning and reshaping the breast gland itself with the nipple-areola still attached normally and then redraping the skin around it, usually with an incision around the areola and down to the crease (lollipop incision). Using the skin to lift, reshape, or hold the breast gland up does not work in the long run.

However, it is important to understand what a breast lift, properly done, does and does not do. A mastopexy will not add or subtract volume from the breast. It will not give it forward projection and it will not fill in the upper pole of the breast. Breasts that have been properly lifted look bigger but this is an illusion and makes it difficult to judge size when an implant is used at the same time. A careful view of before and after pictures following a lift will show the upper pole concavity to be very close to the same.

Only breast implants acting like pillow volume can give the breast forward projection and fill in the upper pole. The misconception is that implants lift the breast. Breast implants whether large or small DO NOT LIFT THE BREAST. They give the illusion of a lift because of the filled out volume and filling of the upper pole of the breast. The same thing happens in reverse. If an implant from an augmentation is removed, the breast does not sag or fall. It only appears to do that. The implant is pillow volume, not a lifter or weight.

The other misconception is that adding a "small implant" will solve the problem or fill in the upper pole concavity. Implants have to be positioned properly in order to fill the breast out properly and this means the implant has to be measured to fit the inner diameter of the breast, positioned properly behind the nipple-areola, and have forward volume based on the (forward) profile of the implant. The minimum increase in size of the breast is therefore a cup size with a low profile implant. Filling the upper pole of the breast will happen with a round implant if the width of the breast and therefore implant is also tall enough to fill in the upper pole space. If not, then a textured surface, shaped implant would be needed.

I strongly advise against "small implants", implants above the muscle in the upper pole, or implants in order to provide a true lift. You will be disappointed.

Scott L. Replogle, MD
Denver Plastic Surgeon
4.0 out of 5 stars 1 review

Breast lift and implants

+1

This can be a tough problem to address. If you think of your breasts as balloons, it becomes clear that without volume, they will droop. Adding a small amount of volume, as with an implant, can help to fill that "balloon" and lift the breasts. However, without an examination, it's hard to say if you would need another small lift instead or in addition to implants. Sometimes the skin quality is poor secondary to weight loss, which makes it more challenging to achieve good long-term results. I would recommend addressing your concerns with your surgeon, keeping in mind that he or she may advise you to wait another 6-9 months prior to any revisions. Good luck, /nsn.

Nina S. Naidu, MD, FACS
New York Plastic Surgeon
4.0 out of 5 stars 5 reviews

Sagging breasts after lift

+1

It would be difficult to suggest anything without formally examining you. A lift should be performed with molding of the tissue and then redraping the skin over it. Yes, sometimes a breast implant can help fillout the breast. But, It is so individualized that I would have to examine you to tell you what would be best for you.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

You probably need a revision breast lift.

+1

Hi!

1) How a breast lift is done is key to long term perky shape. If a lift is done just by tightening the skin envelope (most common), skin stretches and you rapidly loose the lift ("bottoming out").

2) We believe that a lift should be done by SHAPING THE BREAST INTERNALLY. There is no pulling of the skin. This is the vertical breast lift which leaves a lollipop scar, and produces good long term shape.

3) You should not get breast implants if you are already a C cup. I would wait another 3 months before considering a revision.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
5.0 out of 5 stars 9 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.