Do I need a breast lift during implant replacement?

I have Saline breast implants that are now ten years old. They were beautifully done and look natural, although the doctor went bigger than I had asked for: a full C instead of a full B. It was his aesthetic call, he said, and at the time, (and urged on by my then-boyfriend) I decided I'd live with them.

Ten years later, I am about ten pounds less and much leaner than back then (5'5", 112 lbs, very fit, 18.5% body fat) and the implants have sagged somewhat. When I see photos of myself, I feel my silhouette is out of proportion, and that I would look much better with slightly smaller breasts, as I had originally intended... and perhaps Silicone this time. To go for smaller, firmer, higher breasts after having larger saline implants, would I need a Breast Lift in addition in order to accomplish this? How are these procedures usually done?

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17 answers to “Do I need a breast lift during...”

A: Replacing implants with smaller implants

By Steven H. Williams, MD - Bay Area Plastic Surgeon

Thanks for the question - This can be very difficult to answer. It depends on the laxity of your skin, the amount of ptosis (sag) you had prior to your breast augmentation and the position and shape of your implants and how much ptosis you've had since your original implants. Many patients do need a lift... more

A: Breast augmentation and lift are complementary

By Raffy Karamanoukian, MD - Los Angeles Plastic Surgeon

Breast lifts and Breast implants accomplish complementary tasks. In a breast lift, the position of the breast and breast nipple is elevated. It does not add volume to the breast. In a breast augmentation, the volume and projection of the breast are elevated. Often, these two procedures are performed... more

A: Breast lift with downsizing implants: is it necessary

By Otto Joseph Placik, MD - Chicago Plastic Surgeon

This is a difficult decision. It is not uncommon for plastic surgeons to stage or separate these operations. No one can predict for sure, how your breasts will look after downsizing. Let me offer an analogy which may help to explain: If you look closely at your friends or women after the health club, you will... more

A: Breast lift surgery can possibly enhance your results

By David A. Robinson, MD - Munster Plastic Surgeon

Sometimes patients require a lift, in addition to an augmention, when down sizing or with weight changes. Over time, skin loses its elasticity requiring excess skin to be removed and/or tightened. The amount and degree are determined by the final cup size you you would like to be as well as the... more

A: Breast lift can help you end up with a great result

By Adam David Lowenstein, MD - Santa Barbara Plastic Surgeon

When downsizing the size of an implant, small increments can do well if the skin and other tissue around the breast implant is youthful- this tissue can then contract a small amount for a good aesthetic outcome. You are describing a situation where you already have some "ptosis," or drooping of your... more

A: Tear Drop Augmentation Mastopexy

By Robert M. Freund, MD - New York City Plastic Surgeon

You are right - you will need a lift at the same time as the reduction in size of your implants. My technique called the "Tear Drop Augmetation mastopexy" is ideal for this problem. This technique involves the lifting of the breast tissue from above the breast which yields exact results with... more

A: You will most likely need a lift

By Richard P. Rand, MD - Seattle Plastic Surgeon

The lift of the breast is designed to elevate the nipple to a youthful position on the front of the breast and remove the extra skin that is allowing it to sit too low. First the implants are exchanged then the skin excess is custom tailored out to create your optimal shape and tone. It requires some scars... more

A: Breast lift after implant exchange

By Steven Wallach, MD - Manhattan Plastic Surgeon

It is difficult to give you an answer without seeing you. If your breasts are sagging now and you want to go to a smaller implant, it is more likely that you will need to combine the exchange with a lift procedure.

A: Smaller implants- lift needed

By Brent Moelleken, MD - Beverly Hills Plastic Surgeon

Almost certainly you will want to consider a lift at the same time as your replacement surgery with a smaller implant. If the skin is already loose (droopy), this problem will only become more pronounced once a smaller implant is placed. A board certified plastic surgeon can go over the options with you... more

A: You will definitely look much better with a good breast lift and smaller silicone implants.

By George J. Beraka, MD - Manhattan Plastic Surgeon

To scribemjp, Hi! I have seen any number of women in your situation. So I think I can visualize you even though I have not seen you. I will predict that you need smaller implants (maybe 100cc smaller) and a good lift. You need a lift with either an incision around the nipple only (doughnut scar) or, at the... more

More answers to Do I need a breast lift during implant replacement?
Davenport - A smaller implant would mean more droop
Los Angeles - Most probably yes, but...
New York City - Withdraw saline from your implant with a syringe, on the...
Seattle - Every case is different
Sonoma Valley - Smaller and firmer requires skin removal

Comments

scribemjp
4 posts
14 Jan 2009

Thank you, everyone, for your answers so far. It gives me a lot to think about. Although I'm a big fan of smart, well-researched plastic surgery in general, I'm adverse to unecessary surgery. Part of me says, "they look fine, just live with them." another part sees photos of myself (even in minimizer bras, which I wear most of the time) and feel my old "look" doesn't flatter and even ages me. I REALLY would like to avoid the lollipop scars I see in so many lifts. My skin is very youthful and malleable, except as I have mentioned, due to time, gravity, and weight/fat loss, there is some drooping in my breasts currently. The implants are beneath the muscle currently; I believe they were 300 CC although that's not what I asked for originally. At the time of my original operation I went from a sort of saggy 34-B to a very full 36C; now I'm a 34C and have been for the last 4 years.

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