I am 25 and had one child when I was 18. My breasts were a 36B pre-pregnancy and blew up to a 36DD during the pregnancy and for the duration of my breastfeeding. I am left with loose skin and no fullness at all. I am now a saggy 36C. I dont want really high breasts, but I want them to have a much fuller, rounder appearance and want to fill them up to a round D or DD. Will I have to go under or over the muscle to achieve?I do not want a lift at all.
Will Implants Correct my Sagging?
Doctor Answers (28)
Breast Lif along with Breast Augmentation or "augmentopexy"
Breast implants alone will not fully lift your breast. You need to also have an inverted-t or anchor mastopexy or breast lift. Both of these procedure can be done at the same time with very good expected outcome.
Breast implants will not lift your breasts
Thank you for sending your photograph and question. Breast implants without a breast lift will fill your breasts and and volume but will not lift the breast. Your nipple position is lowand it is unlikely that your breast implant can be placed beneath your chest muscle and will likely have to be placed under the breast gland. If you do not have a breast lift there is risk that although you will gain breast volume you will feel that your breasts are sagging even more.
Implants alone will not correct your sagging
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Lift or augmantation?
You will certainly need a lift as well. You will need an exam to determine whether a periareolar scar or a 'lollipop' scar is necessary
Implants will not generally correct sagging
In your particular situation, large implants can be placed to increase your size to a full D or DD, which may or may not be the look that you are trying to achieve. Since you have loose skin and a degree of saggin, the lift will mainly be achieved by the bra you are wearing and not from your breast tissue or implants. Furthermore, larger implants will likely look better on top of the muscle rather than underneath. This may be okay for you depending upon your goals. However, most sagging breasts will generally look better in contour and lift by placement of the implants underneath the muscle as well as a lift in breast tissue. The incision will likely be either a "lollipop"-type of incision or a periareolar incision. There are pros and cons with all of these options. A thorough discussion and examination will guide you as to the best option for you.
Yes- but it depends...
Your case is a typical case where implants with a breast lift are recommended. Your desire to avoid a breast lift is not uncommon and I have many cases like yours. Typically the solution involves placing implants over the muscle in a slightly lower than normal postion. Clearly this an advantage in your case- but this procedure does have its disadvantages. Implants placed over the muscle are easier to feel- a bigger issue with saline implants compared to silicone. Capsule contracture rates are definitely higher with implants placed over the muscle- moreso for silicone than with saline. The benefits of avoiding the lift must, in your opinion, outweigh the issues with over-the-muscle placement.
The answer wil depend on what your expectations are. Implants alone (without a lift) will give you more fullness in the upper pole of the breast, but you will eventually need a lift to avoid a "double-bubble" appearance. If you wants more breast projection, then a lift is all that you need. If you want more projection and size, then a lift and augmentation.
Specific recommendation for sagging breasts
To achieve a round full breast appearance with the volume of breast tissue you display as well as the degree of ptosis (sagging), I would likely advise a lift with small glandular reduction followed by subglandular or submuscular implants. You may need a revision in 10 years due to the volume of tissue and the tendency for resurrent sagging.
Choosing whether or not to do a breast lift with breast augmentation
Implants alone will provide a more aesthetic contour to you lateral and oblique profiles. However, the position of your nipple may predispose you to a breast lift in the future.
Breast augmentation together with breast lift
Plastic surgery of the breast is a balancing act between nipple and breast tissue (with or without implant) position on the chest and the skin envelope. We want things a specific size and in a specific position and we want the skin around it to fit it. From your single photo one cannot tell what the skin breast balance exactly is. The nipple position is a little low and the skin is loose around the underlying breast tissue. No matter what you do with respect to implant size and position I suspect you will need to do something to the skin in terms of a lift. If you just throw an implant in there above the muscle it will fall into the loose envelope of surrounding skin. If you put it under the muscle it may not end up centered under the nipple. Either option may not give you a nice looking result and if you just try to fill the stretched skin envelope with the largest implant it will hold you will likely only stretch the skin more and end up with more sagging.
That does not mean you do not have any options. There are different degrees of lifting and you can do less lifting with less skin surgery/scarring and still be happy with the end result as long as you know what you are getting into before hand.
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.