Already Sagging After Breast Lift and Silicone Implants
Doctor Answers (8)
It seems to me that you had a skin lift with an augmentation. As a result, your scars are stretching, your areolae are stretching, and your breast and implant are bottoming out. Using your existing scars, you can have a "Vertical lift" which plicates the breast tissue on the bottom of the breast and internally lifts the breast - not just uses the skin.
Breast lift revision or larger breast implant
Since you stated the surgery was in Jan., I assume of 2009.
After 6 months of healing I would revise the inverted T incision, by removing more in the vertical dimension. This should elevate the breast more giving a fuller upper pole effect.
Other choices are a 600 to 700 cc implant (I feel a poor alternative but it is still an option).
Only a revision will give you what you are looking for.
It seems that your implants have bottomed out and there is significant asymmetry in the size an location of your nipples. I would encourage you to wait at least 6 months from your original surgery to allow things to settle. Then I would do a revision mastopexy to make the nipple areolar complex the same size and location. I would bet you have silicone gel implants that are smooth walled which allows them to move down the chest wall. In my experience I have found replacing these with silicone gel implants that are textured and using a drain until the pocket closes down on the implants can help maintain the higher fuller position which you are seeking.
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Sagging after breast lift or mastopexy
overall your breasts look fine and your plastic surgery results are reasonable. it is not uncommon to get some asymmetry in the nipple position and the shape. all breasts do re-sag to some extent after a breast lift. You might want to let your surgery to heal and then consider a larger implant in order to get a better cleavage.
Web reference: http://www.beautifulself.com/p_breast_lift.htm
Breast lift results
No breast lift result is perfect. I do see your asymmetries and irregularities of the nipple areola complex. Fullness in the upper pole usually means a bigger implant with the lift, but it never stays up as high as I think some patients expect. And I have to say "natural" breasts do not stay that high either unless a bra is puschng them up.
Breast lift revision will help.
1) You don't have a bad result, but I see what you mean. You don't have much upper fullness, specially on the left. The left breast may be a little smaller. The right areola is larger and lower. And the right scar is thick.
2) I think all these problems can be improved with a breast lift revision.
Are you happy with the breast lift result?
If you are happy, leave it alone
If you are unhappy, ask him what he has in mind AFTER you have figured out what it is exactly what you don't like. That way you will be able to talk to the surgeon in a much more productive and less emotional way.
For what its worth, I tell all my mastopexy and lift patients that they may need a "tweak" to get the best possible results. Some experts even advocate doing the lift first, then the augmentation to minimize the chances of implant and gland settling out differently.
Mastopexy /lift is a very demanding procedure and I know of no surgeon who gets it right every time.
To truly determine what can be done will depend on 1)...
To truly determine what can be done will depend on
1) time from surgery- a minimum of 6 months
2) what your breasts looked like before surgery
3) what level the implants were placed
4) any post operative complications
Revision surgery is an option. The implants can be elevated in position to give more upper pole fullness. The degree as to which the "sagging" can be eliminated is partially dependent on the quality of your tissue. Your implant size will cause some tissue thinning and stretch the skin of the breast to a degree.
With Warm Regards,
Trevor M Born MD
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.
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