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: Smaller and firmer requires skin removal

By Francisco Canales, MD - Sonoma Valley Plastic Surgeon

If you think about the breast as the skin envelope to your present implants, going to a smaller size (silicone or saline) will mean that you will have more of a skin envelope relative to the size of the implants. You want "firmer and higher" smaller breasts. By definition, going smaller will make... more

A: Every case is different

By Richard Baxter, MD - Seattle Plastic Surgeon

The answer for you depends upon your goals and the condition of your skin and the other tissues. If your skin isn't too stretched out, it may be possible to go a little bit smaller and do a form of internal lift called a capsulorrhaphy. You would need to be evaluated to see if this is a reasonable option. How... 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

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: 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: A breast lift is not the end of the world

By David Shafer, MD - Manhattan Plastic Surgeon

Scribem, When you downsize breast implants, you usually will need a lift. This is because replacing the implants with a smaller volume implant will lead to excess skin since the implant is no longer filling the full volume of the breast and stretched out skin. However, breast lift is not the end of the world... more

A: A breast lift may be required

By Shahram Salemy, MD - Seattle Plastic Surgeon

It's difficult to know without examining you, but in order to downsize the volume of your implants as well as lift the breast and tighten the skin envelope around it, a lift will likely be required. A silicone implant will also give you a more natural shape, look, and feel in some cases, so this is certainly... more

A: Withdraw saline from your implant with a syringe, on the day of the surgery in front of a mirror.

By Darrick E. Antell, MD - Manhattan Plastic Surgeon

As you stated you currently have saline implants, in the past I have had patient stand in front of a mirror on the day of the surgery and with a syringe and needle, puncture the implant and draw saline fluid out of the implant until you get to the volume you desire. That way you can participate in... more

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 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

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 - Tear Drop Augmentation Mastopexy
Pleasanton - Replacing implants with smaller implants
Santa Monica - Breast augmentation and lift are complementary
Valparaiso - Breast lift surgery can possibly enhance your results

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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