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What Are the Risks of Breast Lift if a Reduction Was Done 30 Years Ago ?

asked 3 years ago by peanutzmom in Los Angeles, CA
Latest answer by Steven Wallach, MD
Question viewed 502 times
Tags: silicone implant

I had a breast reduction in 1980 and then an over the muscle augmentation in 2003 with very big silicone textured implants that have rippled tremendously. My doctor says he wants to take out the implant and wait 6 months to do another lift and then a behind the muscle implant. Is there risk of losing the nipple blood supply by doing another lift? Are there alternatives? I am a 36D and want to go to a B or C cup that is lifted and in place.

12 answers to What Are the Risks of Breast Lift if a Reduction Was Done 30 Years Ago ?

The risk is to the blood supply of the nipple

The major risk here is to the blood supply of the nipple. The lift needs to be done cautiously, conservatively, and the implant can be removed at that time. A few months later, the new implant can be placed, and I agree with staging the procedure-- this should reduce the risk of a healing problem, but nothing can totally eliminate this risk, and your surgeon will review this with you in detail.

Shahram Salemy, MD
Seattle Plastic Surgeon

Risk with lifts after reduction

There are definitely risks associated with revision breast surgery, especially if the implant was placed below the breast (ie above the muscle), since blood supply is diminished. While your doctor has recommended a conservative and safe route for this process to take place, it is possible in most patients who consent to having their implants removed completely, to having a breast lift in one stage. This procedure is ideal for patients who have enough breast tissue on their own and don't... more

Brent Moelleken, MD
Beverly Hills Plastic Surgeon

Nipple loss

ANny time secondary surgery is performed on the breast there is a slight increased risk of nipple loss. This is very uncommon but potentially could happen.

Steven Wallach, MD
Manhattan Plastic Surgeon

Risky if too aggressive...

Any particular surgeon needs to approach this issue within their own comfort zone. Personally, I would prefer a single stage procedure if there is truly a benefit to you keeping an implant. That implant would be placed behind the muscle and the lift would be done very conservatively. This, of course, all depends on what you look like. Although staging the procedure might reduce the risk to the nipple, it does not eliminate it. You would still face a risk of hurting the blood supply to... more

Robert S. Houser, DO
Columbus Plastic Surgeon

Risks and alternatives for breast lift after reduction

Breast lift following previous augmentation or reduction caries an additional risk because of the uncertain blood supply for the nipple aerola complex. If you are a non-smoker, this could still be done as a one stage procedure. A smaller implant in addition to a lift could be done.The maximum blood supply needs to be left behind to insure nipple blood supply.

Hisham Seify, MD, PhD
Los Angeles Plastic Surgeon

This is not how I would stage it.

Hi! First of all, you should do fine. Everything could probably even be done in one stage (remember I haven't examined you). Everything depends on using the right technique for you. Doing it in two stages is safer. But I would take out the implants and do the lift as the first stage. You might decide that you look fine and stop at that point. If not, then you can have smaller ( sounds like much smaller) implants put in at a second stage.

George J. Beraka, MD
Manhattan Plastic Surgeon

Wisdom and caution

Peanutzmom: The combined lift and augmentation is an issue that surgeons are discussing frequently, because of possible risks. Executing them as two separate stages is often a wise, cautious approach. Your prior breast reduction and the large augmentation each increase your risk for death of the nipple and areola from poor circulation, as well as numbness of the nipple and areola, and fat necrosis within the breast tissue itself. Yes there is a risk of problems by doing another lift. ... more

Sutton Graham II, MD
Greenville Plastic Surgeon

Higher risks

There are different ways that surgeons will approach this problem. The first thing your surgeon will want to know is the manner in which the brest reduction was performed. This will help identify where the main blood supply is coming from that supplies the nipple. I fully agree that you should not try to do every thing at one time. I would suggest removing the implants and doing a conservative breast lift at the first surgery. After 3 to 6 months the new implants can be placed under the... more

Marcus L. Peterson, MD
Saint George Plastic Surgeon

The same risks as with your breast reduction surgery...

All of the same risks exist as with your initial and subsequent surgery. Having said that, I have in selected cases completed the surgery you are interested in with a one stage approach. However, your surgeon may have particular reasons for suggesting a 2 step approach and there is nothing to criticize about that approach. Each patient is different and there are many factors to consider including things like smoking history. In some ways, the blood supply to some of the areas may... more

Darrick E. Antell, MD
Manhattan Plastic Surgeon

There is a higher risk of nipple loss

Because of the previous breast reduction and above the muscle implants, your blood supply to the nipple has already been altered. It is not really necessary to stage the implant removal and lift because time isn't going to significantly increase the nipple blood flow to where it is safer 6 months later. It is important for the surgeon to be very experienced and to do a lift with a conservative amount of undermining of the tissue to protect what blood flow you have. New submuscular... more

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

Risks of breast lift after reduction mammoplasty

Yesterday’s “assets” usually become future "debits" when it comes to large prosthesis. Your history is a perfect example of that adage. In my experience of over 30 yrs, the nipple/areola complex has been repositioned safely without tissue loss after prior reductions, lifts and inferior periolar augments. Patients should be aware of potential tissue loss, especially if there will be an augmentation at the same time.

Barry H. Dolich, MD
Bronx Plastic Surgeon

Yes, there is definitely a risk.

Although extremely rare, you can lose the nipple in a breast lift especially if you need to move it a relatively long distance even without having had implants or a previous reduction. The presence of a large sub-glandular implant over a long period of time and the rippling you describe suggest that there has undoubtedly been some soft tissue atrophy and compression that makes a breast lift even more risky since lifting the nipple will require incisions around the areola and the underlying... more