Breast Implants: Q&A

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Preventing Bottoming Implants After Breast Replacement and Lift?

I have huge Breast implants, 1000 cc's. I look like a freak and want to have a Breast lift and replace the implants with one that will make me a D or DD. My skin is very thin - do I have to worry about bottoming out now and also about the blood flow to the nipple?

I have no coloring around my nipple. How can the lift scar be best hidden when there is no areola coloring whatsoever? Thanks.

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7 Doctor Answers | Asked by Jane in Jersey in new jersey

Doctor Answers (7)
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Yes - those issues need to be considered

Even if you have a lift and a smaller implant, the skin that remains after your lift will be thin, stretched, damaged, and prone to stretching again. You are correct that the blood flow to your nipple is already severely compromised. Your situation in fact is more akin in its complexity to a post-mastectomy reconstruction case, though in a sense even worse because of the stretch of your skin. My point isn't to depress you, but rather to emphasize to you that if your surgeon suggests a... more

Your case could be difficult

Hello, Thin tissue stretched by really large implants can make a difficult case for a breast lift and implant exchange particularly if you smoke. I would need to see you to tell you much more. You may need to be concerned about blood flow and tissue healing issues depending upon the way things are right now.

Implant exchange and lift

With 1000 cc's I assume you have saline implants. If you did not have a lot of tissue to begin with, you probably have thin coverage. Without examining you it would be difficult to assess what you specifically would need in terms of a lift.

Steven Wallach, MD

13 reviews

Manhattan Plastic Surgeon

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Saline or gel implants?

You do not give your height and weight, but 1000cc implants do take a severe toll on your tissues(you already know this). Now if you have saline implants, what I would suggest is have your surgeon stick it with a 16G needle and remove about 200cc. This can be done in the office. Over time the saline will come out of the implant and your body absorbs it, but the important thing is that it allows your tissues to slowly relax and retract. This might take 2-3 months. At that time you can have... more

Staged surgeries

In cases of extremely large pockets, synmastia, or the need for simultaneous breast implants and aggressive lifts, patients should consider staged surgeries. That means remove the large implant, allow a period of time to pass, then place new implants and do a lift. This will allow the skin to recover and the blood supply to reestablish itself. It is tempting to "go" with the doctor who does a single staged procedure, but the complication rates for the very compromised tissues... more

Choose a breast implant that fits your breast anatomy and skin type

Your situation is complicated and more facts about your previous surgery/surgeries need to be known before any advice given, I think. There are some general options although you have to decide how to approach your breasts aesthetically and safety-wise and what balance to strike between the two. It is possible that if your skin is very thin, even a D or DD size would require an implant that will cause problems down the road. The prudent thing would be choose an implant that fits your... more

Robin T.W. Yuan, MD

4 reviews

Beverly Hills Plastic Surgeon

You should have revision breast surgery in two stages.

Hi! In Manhattan, we almost always do combination breast lift and revision breast augmentation in one stage. But you are the exception. Without seeing you, it sounds difficult to get a good result safely. So I would do it in two stages. First the implants should be removed, and a good mastopexy (lift) done. The lift has to be done INTERNALLY, without relying on pulling the skin. Otherwise, you get recurrent sagging, because the skin stretches. The scars usually fade nicely, specially... more

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