Breast Implants: Q&A

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Replacing Silicone Breast Implants with Moderate Sagging

I currently have 270cc silicone implants that are 30 years old. No problems ever! I am interested in a lift though, but do not want the scars. With moderate sag, is it possible to just replace with larger implants to increse overall fullness?

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15 Doctor Answers | Asked by cherabine in austin, tx

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Larger Implants for Fullness, Not Lift!

Larger implants can provide more fullness, but implants do not lift a droopy breast! Be certain that the added volume will not make you feel too big. Also consult with your surgeon to be sure you don't have too much sagging to just add volume and end up with larger, still saggy breasts!

Breast Implants and Sag

As some of the other plastic surgeons have noted this can be a difficult problem. The issue is how large an implant would be required to correct the amount of sag you have. Plastic surgeons grade breast ptosis (sagging) by comparing the position of the nipple to your breast fold. If your nipple is completely below that fold with the implants you currently have then it is likely a larger implant will not be enough to get you a good result. Some plastic surgeons will stretch the limits of... more

Going bigger may be a trap

The danger of placing larger implants to overcome "droop" can be a trap. The breasts can appear larger, but still saggy. Or the nipple-areolar position can become located on the bottom of the breast, making them appear aged. A board certified plastic surgeon can discuss with you the options based on your measurements, particularly the nipple to notch distance. If this is too great given your frame, you may want to avoid the "larger is better" philogophy. All breast... more

You can consider an INTERNAL lift with larger implants

To cherabine, Hi. If you don't want scars, you cannot have a regular breast lift. A regular lift places scars around the nipples and sometimes, in a "lollipop" pattern. But, depending on your anatomy, you may be helped by an internal lift and larger implants. This will not work if you have a lot of sagging.

Yes there are internal lift and different model implants that can help you.

Dear Cherabine: I agree with Drs. Rand and Goldstein for most patients who have a significant drift of the breast complex (including the nipple/areolar complex - NAC) over the implant. Sometimes the appearance of drift may be from a subtle capsular contracture which has elevated the implant above the NAC giving it the 'snoopy' look. Interestingly, this effect is the principle behind the 'internal mastopexy' which leaves no external scars, and is a type of 'gathering' or 'plication' of the... more

See a qualified plastic surgeon to investigate what method is best for you.

You have asked a very important question--unfortunately, there is not one simple answer. Most women desire a natural look and feel to their breasts. There are many factors that come into play when determining whether or not a breast lift is required. I would strongly urge you to see a board certified plastic surgeon that is experienced in breast surgery, specifically breast augmentation and breast lift. Options are available to you that may allow you to avoid a breast lift. Your physical... more

Possibly, depending on your expectations

The "need" for lifting is dependent on the position of the nipple areola in relation to the crease along the bottom of the breast. The best looking breasts are ones where the nipple is on the front of the breast mound, pointing forward and not downward, and well above the crease. Often, just replacing implants cannot improve that nipple to crease relationship and a lift is needed to create the best result, although with the scars necessary to perform the lift (there are several... more

Moderate breast sagging can be camouflaged with a breast implant-the bigger the better.

Many patients have breast that sag of their own weight or because of pregnancy. Breast implants can augment total breast volume and camouflage the droopiness (ptosis). This applies only to those patients where the problems are modest. Generally placement of the implant above the muscle camouflages better than below. Also, the larger the implant, the better the result.

Lifting with placing larger implants

Depending on the severity and complexity of the case, you may be a good candidate for lifting with implants alone. This will depend on the location of the nipple-areola complex and what look you want to achieve. If it needs to be raised then you will need additional incisions to provide a lift. There are 3 different incision types, each providing a different type of lift. The "donut" incision involves an incision around the areola, providing a limited "benelli" lift.... more

Larger implants do give a modest "lift"

As you age, the skin of your breasts loses it's elasticity and often the nipple drops. This is known as breast ptosis (droopiness). Correction requires either increasing the volume of the breast or reducing the skin envelope to recreate a perky breast. Of course, a combination of the two will also work. If you increase the size of your implants, it will tend to give you a "lift" by filling out the skin and increasing projection. This usually is adequate only if the amount... more

David Bogue, MD

6 reviews

Boca Raton Plastic Surgeon

www.drbogue.com

Breast Lift with Implants

Given the history you have provided, I would say that you would likely need a lift and that an implant that is larger would unlikely help you out. In certain cases, when there is a need to fill the skin envelope and provide some sort of a lift to the nipple, one may be able to have a larger implant placed and get away without doing a formal lift. In my experience when a patient has had implants for such a long time, and given the changes the body goes thru during this time, most patients... more

Implant replacement without breast lift is possible

It may be possible to just replace the implants without having to do a lift. More than likely you would need a larger implant. I would say after 30 years you would probably need some sort of a lift, but it is difficult to tell until you are examined.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Replacing silicone implants with larger breast implants

The skin envelope of the breast plays an important role in the final shape and projection of a breast implant. Thirty years after your initial implantation, you are likely to have developed redundancy in the skin as well as droopiness in the nipple areola complex. Replacement of an old implant with a larger implant will stretch out the skin envelope and may improve nipple position. However, if the distance needed for nipple repositioning is over 2 cm, implant exchange will likely not... more

The right look with a scar is better than the wrong look without scars.

We see a number of patients every year who have had silicone implants in place for many years and now face a decision on what to do. The majority of the patients have breasts that have matured over the 20 or 30 years that the implants have been in place. The decision of increasing size, adding a lift or doing nothing should be one that is reached between you and your surgeon after careful review of options and photos of similar patients. Avoiding a lift is possible in some cases and, yes... more

Spread the word about your silicone implants

Cherabine, It is refreshing to hear about 30 year old implants with no problems. Too often we only hear about the problem implants. In a word the answer to your question is yes. Moving to larger implants will give somewhat of a lift effect. If the implants are under your muscle and you have thick enough tissue on your chest wall/breasts moving the implants above the muscle can also give a lift effect. So, you may have options. See your local board certified plastic surgeon for advice.... more