Will Implants Correct my Sagging?

I am 25 and had one child when I was 18. My breasts were a 36B pre-pregnancy and blew up to a 36DD during the pregnancy and for the duration of my breastfeeding. I am left with loose skin and no fullness at all. I am now a saggy 36C. I dont want really high breasts, but I want them to have a much fuller, rounder appearance and want to fill them up to a round D or DD. Will I have to go under or over the muscle to achieve?I do not want a lift at all.

Doctor Answers 30

Breast Lif along with Breast Augmentation or "augmentopexy"

Breast implants alone will not fully lift your breast. You need to also have an inverted-t or anchor mastopexy or breast lift. Both of these procedure can be done at the same time with very good expected outcome.

Beverly Hills Plastic Surgeon
4.4 out of 5 stars 49 reviews

Implants and sagging

Thank you for the question.  Implants alone would do a great job in increasing your breast size but not much on the sagging.  A breast lift should be able to take care of that and both of these procedures can be done together.  It would be best to visit your board-certified plastic surgeon and get a full assessment. Best of luck. Dr. Michael Omidi.

An in-person exam with a board-certified plastic surgeon is the best way to assess your needs and provide true medical advice.
Best of luck, Dr. Michael Omidi.

Michael M. Omidi, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 92 reviews

Probably Not

Great question Amy

This is a common problem we see in the office.  Pregnancy usually increases the size of the breast and then breast feeding continues this for many more months if not years.  Once breast feeding stops, the breast will often shrink back in size.  This acts almost like a tissue expander.  The skin has now been stretched out and becomes loose and saggy.  For some reason, some woman will not be affected too much by this and the skin will recoil and tighten up.  But in many women it will not.  If there is a small amount of ptosis (the word we use to describe the degree of sagging of the breast), then implants can actually provide a small lift and raise up the nipple.  In someone like you, there appears to be more ptosis than an implant can treat.  A full physical exam would be needed to confirm this, but you will likely need some sort of breast lift as well. It is a trade off: in exchange for a better size and shape of the breast, you will need to accept some extra scarring.  

Going over or under the muscles depends on your surgeons preference as well as how thick the breast tissue is over the muscle.  If it is very thin, then the implant should go under the muscle or it will show the rippling and edges.  

Hope this helps

Brian Arslanian, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 26 reviews

Breast implants will not lift your breasts

Thank you for sending your photograph and question. Breast implants without a breast lift will fill your breasts and and volume but will not lift the breast. Your nipple position is lowand it is unlikely that your breast implant can be placed beneath your chest muscle and will likely have to be placed under the breast gland. If you do not have a breast lift there is risk that although you will gain breast volume you will feel that your breasts are sagging even more.

Implants alone will not correct your sagging

The ptosis of sagging of your breasts is too much for an implant alone to correct. You would need a breast lift. This can be performed together with an implant. An augmentation to a D or DD, however, will leave you susceptible to further sagging so be advised that if you opt to go that large, you may need further surgery in the future.

Robert L. Kraft, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 41 reviews

Lift or augmantation?

You will certainly need a lift as well.  You will need an exam to determine whether a periareolar scar or a 'lollipop' scar is necessary

Rian A. Maercks, MD
Miami Physician
4.9 out of 5 stars 73 reviews

Implants will not generally correct sagging

In your particular situation, large implants can be placed to increase your size to a full D or DD, which may or may not be the look that you are trying to achieve.  Since you have loose skin and a degree of saggin, the lift will mainly be achieved by the bra you are wearing and not from your breast tissue or implants.  Furthermore, larger implants will likely look better on top of the muscle rather than underneath.  This may be okay for you depending upon your goals.  However, most sagging breasts will generally look better in contour and lift by placement of the implants underneath the muscle as well as a lift in breast tissue.  The incision will likely be either a "lollipop"-type of incision or a periareolar incision.  There are pros and cons with all of these options.  A thorough discussion and examination will guide you as to the best option for you.

Tito Vasquez, MD, FACS
Southport Plastic Surgeon
4.7 out of 5 stars 17 reviews

Yes- but it depends...

Your case is a typical case where implants with a breast lift are recommended.  Your desire to avoid a breast lift is not uncommon and I have many cases like yours.  Typically the solution involves placing implants over the muscle in a slightly lower than normal postion.  Clearly this an advantage in your case- but this procedure does have its disadvantages.  Implants placed over the muscle are easier to feel- a bigger issue with saline implants compared to silicone.  Capsule contracture rates are definitely higher with implants placed over the muscle- moreso for silicone than with saline.  The benefits of avoiding the lift must, in your opinion, outweigh the issues with over-the-muscle placement.

Scott E. Newman, MD, FACS
New York Plastic Surgeon
4.9 out of 5 stars 42 reviews

Breast augmentation

The answer wil depend on what your expectations are.  Implants alone (without a lift) will give you more fullness in the upper pole of the breast, but you will eventually need a lift to avoid a "double-bubble" appearance.  If you wants more breast projection, then a lift is all that you need.  If you want more projection and size, then a lift and augmentation.

Shahin Javaheri, MD
San Francisco Plastic Surgeon
4.4 out of 5 stars 6 reviews

Specific recommendation for sagging breasts

To achieve a round full breast appearance with the volume of breast tissue you display as well as the degree of ptosis (sagging), I would likely advise a lift with small glandular reduction followed by subglandular or submuscular implants. You may need a revision in 10 years due to the volume of tissue and the tendency for resurrent sagging.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 81 reviews

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.