Breast Augmentation Revision Post-breastfeeding - Can I Go with Larger Implants Alone?

I have small saline implants (180cc, over.) After 2 pregnancies + breastfeeding, they have dropped and I have rippling. I may want to breastfeed again in the far future (6-7 yrs), so I am resistant to a breast lift, but want to improve the appearance of my breasts. I know I may need a lift eventually, but in the meantime, will larger silicone implants help me? My doctor wants to go above the muscle and is thinking 260-300 cc. I want to make sure I'm being smart with this. Help!

Doctor Answers (14)

Breast Implant Revision - Breast Augmentation Revision Post-breastfeeding - Can I Go with Larger Implants Alone?

+2

You should absolutely be thinking long-range, so here's what I'd say:

1)  Placing larger implants will be a good short-term solution as it will fill out your skin.  But it's not good for the long term.  It will stretch out the skin more and cause more sagging ultimately.  Silicone implants are typically associated with less rippling than saline implants are, so if you switch that may be a good option.

2) Placing them under the muscle is not really an option without a lift, because the lower edge of your pectoral muscle (which is the muscle involved with "sub-muscular") is at or above your nipple now.  Unless you do something to block off the extra skin you have below your nipple (nothing personal, of course) your implant will eventually drop down into that pocket.

3) A breast lift will be required to address that excess skin, as well as to elevate your nipple a bit.

4)  Anything that you do now may be impacted by future pregnancies and breast implants, so it's wishful to think that what you do now will stay that way.

5)  In view of the above, I would advise that you finish your pregnancy/breast feeding plans, and then address your breasts.  You will probably need new implants of an agreed-upon size (a whole different issue) and a lift.  There are many different types of lifts, but my sense is that by then you will need a circumvertical (ie, around the nipple with an extension down the front of your breasts).  There are, of course, no guarantees or assurances that this procedure will be exactlyl what you want, and nobody wants that scarring...but I'm not sure you're going to be happy with any of the alternatives.

I hope that this helps, and good luck,

Dr. E


New York Plastic Surgeon
5.0 out of 5 stars 146 reviews

Revisonary Breast Augmentation Surgery

+2

I do think you would benefit from larger breast implants (ideally silicone gel implants).  I do not think that changing the breast implant pocket at this point is in your best interest.  This changing the pocket to the sub-muscular position may be indicated when you have the breast lift performed.  You do have breast asymmetry (left breast appears lower and/or larger than the right breast) and I agree that you may need a breast lift (mastopexy) in the future but in the meantime, internal work (capsulorrhaphy) may be helpful.  I would need to examine you to give you my best advice.

On this site, I do my best to give advice without a physical examination but I want you to know that a physical examination by a board certified physician is always the best way to get the most accurate information.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 681 reviews

Go larger with an implant alone

+2

We feel breast lift is about nipple position, and you are still above the breast fold. A larger implant alone will fill out the breast and give you better upper fill, and we would stay with  the same pocket that you have already. Silicone is a very good choice to reduce some of the ripple.

Best of luck,

peterejohnsonmd

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 26 reviews

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So many questions...

+2

I agree that larger implants will help to fill the areas that have been stretched out and changing to gel implants will help with the rippling.  Placing the implants behind the muscle would help with the rippling also, but leaving the implants in the same pocket, as your physician has suggested will help more with the sagging than if the implants are behind the muscle.  Either way, without a lift you are not going to have a round full breast, but you will have a natural looking breast so it depends a little bit on what sort of look you are hoping for.   By the way, having a lift is unlikely to make it difficult for you to breast feed, but if you get pregnant and breast feed again in the future, (ie 6-7 years) it might need to be redone.  Hope this helps.

Daniel Sherick, MD
Ann Arbor Plastic Surgeon
5.0 out of 5 stars 3 reviews

Breast Implants after breast feeding

+2

The implants you have are currently too small for the shape of the breast you have developed over the years. A larger implant will be necessary and you may want to consider going larger than the 300 cc you are thinking about if you want the upper part of you breast to  be more full. Silicone implants under the muscle will give you a better outcome in terms of rippling...a nd of course plan on having that breast lift once you are ready for the definitive improvement.

Morad Tavallali, MD
Vienna Plastic Surgeon
4.5 out of 5 stars 11 reviews

As long as you are aware that you need lift , larger silicone implant would help

+2
You need to have to have higher breast. If you want fuller breast and less rippling, you may benefit with silicone gel implant 325 high profile. I would place the implant under the old pocket to help with the rippling.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
5.0 out of 5 stars 51 reviews

Breast Revision

+1

A lift should be on hold until the breastfeeding  is resolved.  Larger implants will help, but they will still be a limitation for active people.  Larger silicone may help the appearance, but talk with your Board Certified Plastic Surgeon, and they will help you with the decision.

Vivek Bansal, MD
Danville Plastic Surgeon
5.0 out of 5 stars 9 reviews

Breast revision with the COLD-SUBFASCIAL plane to restore beautiful breasts

+1

While you can probably get by without a lift, your nipples will be slightly on the low side.  It looks like you could certainly do with a 300-350cc silicone LOW_PROFILE with good results.  I would recommend that you avoid high profile implants to avoid the 'rock in a sock ' appearance.  I would also strongly recommend that you avoid subglandular or over the muscle as there will be no support for your breasts.  I would recommend changing to low profile 300-350mL implants places in the SUBFASCIAL plane.  Subfascial breast augmentation allows creation of a natural teardrop shaped breast with internal support.  Also sine the breast tissue is never entered It is protected from fruther surgical damage which you wish to avoid.  I use a tachnique called COLD-SUBFASCIAL augmentation in which I protect the fascia from heat and traumatic damage to ensure maximal control and enduring support.  I hope this helps!

 

 

All the best,

 

Rian A. Maercks M.D.

Rian A. Maercks, MD
Miami Plastic Surgeon
5.0 out of 5 stars 31 reviews

Larger implants post breast feeding

+1

I agree larger implants will help fill in the superior pole of your breasts, but I think you will need to go larger than the 300 cc's you mention. However, the larger you go, especially if it is over 500 cc's, will lead to further thinning of the soft tissue (skin, fat and breast tissue) over the implants. This may make the rippling worse. Silicone gel implants and especially high profile implants may help limit or decrease the rippling. Placing the implants submuscularly with mastopexies would be the way to go when you're ready. You should discuss the options for type of implants and implant styles with you surgeon. Also, trying on implants may help with picking a size you'll be happy with for the next 6-7years.

Todd C. Case, MD
Tucson Plastic Surgeon
5.0 out of 5 stars 28 reviews

Breast revision surgery

+1

it is a tough call for you to decide what to do. Having implants  and wanting them larger is one thing. But, you need a lift.  To wait until after your next child 6-7 opr more years later is your call.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 15 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.