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Advice for Breast Augmentation Redo After Pregnancy?

I currently have 350 HP breast implants, but I had a baby and the now sag. My nipple is just above the crease and I have about 1-2 inches of breast underneath.The bottom portion is full but I have no upper fullness. I never did, even after the first augmentation. My plastic surgeon says using a larger implant (500-600 HP) will fill the breast back up and make them high and tight like I want. He says no to any type of lift (I'm Black, so maybe he's worried about scarring). Is this a sensible solution? What would you suggest for a patient like myself? A Breast lift or have Breast implants? I am a big girl 34-27-46, 5'6". Thanks.

Asked 32 months ago by MIYALOVE in ALPHARETTA,GA

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breasts bigger

A breast lift is your best bet.

You are experiencing what many women do after pregancy. Larger breasts commonly become somewhat looser after pregnancy. The reason for this is usually that the increased size and weight of the breast during the pregnancy streches out the breast tissues. The best approach is to treat the underlying problem -- the loose tissue of the breast. This is done with a breast lift or mastopexy. The problem with placing larger implants is that you will have even heavier breasts. And,... more

David B. Reath, MD

Knoxville Plastic Surgeon

ASAPS ASPS

Breast augmentation versus lift after pregnancy

Hi, As you can see from the many and varied responses to your question, there are several solutions to your problem. The best solution really depends on what you are looking for. If you like the size you are now when you wear a bra (which naturally lifts the breasts), then a breast lift with your current implants is the best option. This will bring the tissue higher on your chest. If you want to go larger, then breast augmentation is indicated. However, you will probably also need a... more

Nina S. Naidu, MD

New York Plastic Surgeon

ASPS

Adverse change in breast shape after pregnancy

Hi there- In my experience, changes that occur in the shape of a woman's breast as a result of pregnancy and/or breast feeding are not easily correctible through replacement of the implant alone, especially if you don't necessarily want to be significantly larger than your current size. Replacing your implant, even with one of a different shape or style, is only going to make you larger... subtle changes in the shape may occur, but over time, the breast shape will sag even more, because nothing more

Armando Soto, MD

Orlando Plastic Surgeon

ASAPS ASPS

Do nothing

You have naturally shaped breasts that do NOT have drooping of the nipple (as you mention yourself). As such, doing a lift will only buy you scars without any significant improvement in the long run. Using larger implants will also get you no improvement in the long run. You may look fuller in the upper breast right after surgery but this will only drop and look the same as you are now but bigger. I'm not sure why you have high profile implants as they tend to fill the upper breast less. A... more

Parham Ganchi, MD

Wayne Plastic Surgeon

ASAPS ASPS

Change the styple of implant

Your picture exemplifies nicely shaped breasts. The normal position for the nipple is on level with the breast crease. Your nipple is slightly above which is excellent. I see that you have lost some upper pole fullness. If you didn't have that before the last surgery I'm not sure why your surgeon used a high profile implant. These implants have a lot of projection with little base diameter which does little for the upper pole fullness. If you're planning on having more children than... more

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Christopher L. Hess, MD

Fairfax Plastic Surgeon

ASPS

Revision breast augmentation and lift

Puitting a larger implant will make it bigger and tighter in the short term but set you up for sagging in the long term. It sounds as if you are recieiving conflicting advice and that makes it difficult to make a decision. From your picture, it appears that you have relatively litttle sagging according to our classifications. I would be reluctant to adivse you to do anything at this time if you are looking to have them high and tight. This is especially true because you state that your... more

Otto Joseph Placik, MD

Chicago Plastic Surgeon

ASAPS ASPS

Breast lift is required for sagging breast after pregnancy

Since you did not achieve the fullness that you wanted after your first breast augmentation, a larger implant after the breast has sagged further following pregnancy will not achieve fulness and may make the descent of your nipple look worse. In addition, adding volume and weight to the sagging breast may increase the sag. A dermal mastopexy or breast lift is frequently done on African American patients with excellent results. The procedure is just more complex than placing an implant and... more

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Brooke R. Seckel, MD

Boston Plastic Surgeon

ASAPS ASPS

Lone dissenter

I've put 500 cc implants in patients like you and had them thrilled with the result. It requires that you feel OK about being in a D or DD cup. There are parts of your story that are still missing. If you're 6 ft tall for example, you're able to handle a larger implant than if you a 4'11". I would not recommend a lift of any type and would consider the new implant ONLY if you were persistantly troubled by the appearance of your breasts.

Robert Frank, MD

Munster Plastic Surgeon

ASAPS ASPS

Would not advise larger implants.

I'm not sure how long after your pregnancy this photo was taken, or if you are breast feeding or your breast size is back to your pre pregnancy size. If your nipple is just above the crease, that is the ideal position. Moving it higher will make them "look" to the ceiling and will give the impression that your breast implants buttomed out. Looking at your side view photo, your nipples are at the most projecting part of the breasts, which is the ideal position and you have a nice... more

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George Marosan, MD

Bellevue Plastic Surgeon

ASAPS ASPS

Larger breast implants are not a good idea.

Hi! Trust me, very large breast implants do not age well. Your size looks fine. Hard to be sure without seeing your front view, but you probably get the look you want with a "doughnut" breast lift, where the scar is just around the nipple. Most African Americans make fine scars. Don't do anything for at least 4 months after your delivery!

George J. Beraka, MD

Manhattan Plastic Surgeon

ASAPS ASPS

First, decide what you want

Ask yourself, "Am I happy with the size of my breasts when they are lifted up in a bra?" If you are, you don't need a larger implant, you just need to have the implants placed higher on your chest wall. BTW you can do this with a periareolar lift which will leave minimal scars. A repair of the capsule in the bottom part of the bra will insure higher placement of your implant. If you are not happy with the size when you are in a bra, you need a bigger size implant, to address the... more

Ricardo Rodriguez, MD

Baltimore Plastic Surgeon

ASPS

Breast Lift vs. Breast Implant Enlargement

The choice for breast lift or mastopexy is dependent on the degree of skin laxity and the position of the nipple. Larger implants will temporarily improve the position of the implant if done appropriately, but this will inevitably result in further droopiness of the breast and nipple. I would suggest a breast lift with or without exchange of your implants.

Raffy Karamanoukian, MD

Los Angeles Plastic Surgeon

Implants vs. lift

You look like you need a lift. I do it all the time on my darker skin complexion patients. Obviously, if you have a history of keloid formation than that would be a bad idea. Putting a bigger implant in will only make you sag more.