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Sagging After Breast Lift Revision

Breast Lift Revision 15 Months Post-Op. 5 Months from Revision Right nipple was higher a year after initial surgery. Had BL revision 5 months ago. The right breast looked perfect initially but now seems to be lower. I have realistic expectations but fear the right breast will continue to sag. The right breast also has a wider profile and measures an inch fuller under the nipple. Should i be concerned? My PS says i did not bottom out, but i'm not so sure.

Doctor Answers (10)

A Physical Exam Is Necessary

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It’s hard to say whether or not you’ve bottomed out from your photo. A physical examination is necessary to determine that.

However, if you’re still concerned after seeking out your revision surgeon, I suggest seeking the opinion of another Board Certified Plastic Surgeon. Find another surgeon you can talk candidly with and trust in order to put your mind at ease, or to help provide information on additional breast revision options.
Good luck,

Dr. Franco-Webb


Denver Plastic Surgeon
4.5 out of 5 stars 8 reviews

Sagging after breast lift revision

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Hello! Thank you for your question! The mastopexy (breast lift) procedure raises the breast, which ultimately provides a more youthful and perky breasts. This is done by removing the extra loose skin and rearranging the surrounding breast tissue in order to reshape and support the newly formed breast. At the same time, the nipple-areolar complex (NAC) is raised to the ideal position above the fold beneath your breast (the inframammary fold) as well as being placed at the most projecting portion. Oftentimes with age or following pregnancy, the NAC becomes widened and enlarged. This may be reduced in size during the breast lift procedure.

It is common for the breast to lose its firmness and uplifted appearance over time, which is also accentuated with age, pregnancy/breast feeding, weight gain/loss, and gravity. This results in breast ptosis, or sagging of the breast, with a “deflated” appearance. Women seek the mastopexy procedure to regain the previous youthful appearance of her breasts and women report increased confidence, self-esteem, and femininity once achieving this desired shape and fullness. Breast lifts may or may not be performed with implants – the implant would add increased size but also greater fullness in the upper pole of the breasts which creates more cleavage.

I would discuss your concerns with your plastic surgeon. Increased size of the implants as well as laxity of the native skin do cause increased stretching inferiorly. Revisions certainly may be considered - allow your surgeon to examine and evaluate you and then go over which procedure(s), if any, will be the right one for you. Best wishes for a terrific result!

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 12 reviews

Breast Augmentation/Mastopexy Revision?

+1

Thank you for the question and picture.

Your concerns about the breast implant positioning are well-founded and visible in the picture. At some point, correction can be performed with internal suture repair of the breast implant pockets (capsulorrhaphy)  and/or further skin excision along the lower poles  of the breasts ( horizontal excision).

I would suggest continued follow-up with your plastic surgeon to discuss options.

Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 791 reviews

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Sagging breasts

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It is the natural course over time that the breasts will sag a bit even after a lift.  With your arms are elevated in the photos, tit is hard to say if you have any sagging.

Steven Wallach, MD
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Breast implant bottoming out again

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According to your photo, I appears that the creases are even as well as the level of the nipples. I would certainly discuss this with your surgeon but in this case, I would likely advise you to wear a supportive bra. If this were to become worse, you could benefit from use of an acellular dermal matirx to reinforce the lower portion of your breast.   

Otto Joseph Placik, MD
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revision post Mastopexy-Breast Lift

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This is sort of like the dog chasing it's tail.I tell my patients when doing ANY lifting procedure we are not giving you new skin we are merely removing the effects of aging.You still will have stretch marks and 40 or 50 year old skin. It is not uncommon for the breast to settle or bottom out especially if you have had an implant.How long a procedure lasts depends  on the quality of the skin at the time you do the original surgery.

Robert Brueck, MD
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Asymmetry after breast lift

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It appears from the photo provided, that you took this picture of yourself in a mirror. If that is the case, then yes it does appear that you have a minor degree of sagging of your right breast. This can happen after a mastopexy alone, but is more common in mastopexy-augmentation cases. This is a relatively easy problem to repair in cases where a mastopexy alone has been performed. It is a bit trickier if there is an implant that is malpositioned and bottoming out. Either way, it is reparable. In all liklihood, the inframammary fold will require adjustment on that side.

Kevin Brenner, MD, FACS
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Breast Augmentation Lift revisions

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First of all, there is no such thing as perfect symmetry and perfection. There can be some unpredictability associated with augmentation mastopexy surgery and gravitational effects after surgery which require revision. Based on your photo, Both implants look slightly bottom heavy with a slightly higher than ideal nipple position. Nipple lowering and decreases in your vertical limb length can sometimes be easily achieved with tightening along the inframammary creases. I would ask your plastic surgeon if a minor revision is possible and if the benefit outweighs the risk. 

Hayley Brown, MD
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Augmentation/Breast lift Touch -Ups

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I am going to make an assumption that you have had implants also.  Your right breast has a different shape and appears to have some degree of bottoming out.  I would not get super worried.  Just revisit with your PS to address your concerns and see if he/she has any strategies to address your concerns.  The are many ways to address this issue.

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Earl Stephenson, Jr., MD, DDS
Atlanta Plastic Surgeon
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Revisional breast surgery woes

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I'm a little confused about your description of the problem- your LEFT breast appears to be bottoming out. This is a progressive problem that does not improve on it own. Sometimes an underwire bra worn for a long time can slow or halt the bottoming-out progression. Sometimes a surgical revision is required to fix the problem. If you are dissatisfied with the responses your getting from your surgeon, then seek a second opinion from a board certified plastic surgeon.

Scott C. Sattler, MD, FACS
Seattle Plastic Surgeon
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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.