I'm Assuming I Need a Breast Lift, but Don't Like the Scarring, Do I Have Any Other Option for Better Breasts?

After pregnancy, nursing children, and weight fluctuations, many women are left with deflated, sagging breasts.

Depending on the degree of sagging, this can be corrected with either a breast lift or breast implants.

Women who have a minimal amount of sagging, would like to have larger breasts with more superior fullness, and have a nipple that is no more than about an inch below the breast fold can consider placement of breast implants to correct sagging breasts.  If women have a moderate degree of sagging that cannot be corrected with implants alone, placement of breast implants may limit the extent of the breast lift needed to fully correct the sagging, thus resulting in smaller, less noticeable scars on the breasts. 

On the other hand, women who have a significant amount of sagging and do not wish to be larger will require a breast lift to fully correct their breasts.

Like with normal breasts, pregnancy and breast feeding will likely stretch out the skin of the augmented breasts, leaving you with some sagging and a loss of fullness of the breasts.  However, because augmented breasts have the added weight of an implant, you may notice accelerated deflation and sagging after a breast augmentation than what may have occured without a breast augmentation.  I recommend that you postpone a breast lift or breast augmentation with implants until after you have had all of your children.

Based on your description, you should do well with breast lift surgery. Unfortunately,  for patients who describe their breasts as “deflated sagging”,  there is no good alternative.

I would suggest that you wait on having the surgery until you have completed pregnancies and are once again in a long-term stable relationship.

I hope this helps.

A breast augmentation also has scarring. If you are planning to have more children then the surgery should be deferred or you may need additional work later on. Pregnancy and breast feeding could result in additional sagging which would require correction. Augmentation can help in patients with a limited amount of sagging, or ptosis. WIthout photos, it is impossible to determine whether this would be appropriate for you. If the tradeoff between the scarring and the lift isn't viable in your case, then the sagging is probably something that you could live with. There are a variety of methods for mastopexy and it is important to see a board certified plastic surgeon in consultation to determine which ones would be applicable to your circumstances and concerns.

There are three possibilities. If your breasts are simply empty, then they can be filled out with implants. If they are simply saggy, hanging down below the breast creases but with adequate volume, they can be lifted. However, if they are both empty and saggy they need both a lift and an implant. Let's hope your condition is the first, because with that you can avoid the scars of a lift.

Dear Satailja,

Breast augmentation alone may help "fill out" and lift deflated breasts if there is a limited amount of sagging. If there is more significant sagging present, then a breast lift with or without implants may be necessary. I would consult an experienced plastic surgeon about your concerns.

Warmest wishes,

Larry Fan, MD

Sometimes with deflation all that is needed is an implant.  Sometimes it also requires an areola lift, and sometimes it requires a full lift. I could not say without an exam.

Breast implants fill out the breast but will not lift it.  They will help what you call your deflation, but they will not help sagging, by which I mean excessive overhang of the breast or a low nipple position.  The bottom of the implant rests at the level of the inframammary fold, so if the nipple is below this level, then it is so far below the "equator" of the implant that it points down at the floor.  And if there is excessive overhang of the breast, this tissue will be too far below the implant for it to be filled out, and it will hang off the implant.  This is not a good look.  Although many of my patients have implants placed before they have pregnancies, there is no way to predict what effect pregnancy and nursing may have on the breast tissue volume and shape.  Therefore, some revision may or may not need to be performed after pregnancies are done. Although neither breast augmentation (through an incision under the breast) nor breast lift should necessarily interfere with the ability to nurse, I think that breast lifts should probably be postponed until after pregnancies to avoid further stretching of the skin that would need to be corrected later.

The rule of thumb is that if your nipple has dropped below the bottom fold of your breast, you need a lift.  If the nipple sits above the fold, then an implant will fill out the excess skin and look nice.  But if it's below, then an implant will sit too high, and your breast tissue will hang off the end (what we affectionately call a "Snoopy" breast), and you will not be happy.  It would be best to wait until you are through child-bearing. Doing surgery now, then having a child, may change your result and necessitate some "maintenance work" in your future.

Breast implants are pillow volume and only address deflation, not sagging, although they can give the illusion of a lift if the breast is not to low relative to its base (breast falling off the pillow). All but the most extreme degrees of lift can be done with a lollipop scar these days and this would address the sagginess but not the deflation. 

The effects of another pregnancy or breast feeding on breast augmentation or lifts is not predictable or controllable. In general, a properly done breast augmentation does nothing to the breast but put a pillow behind it. A lift can be done with minimal alteration of the breast but probably has more effects on it than an augmentation. Since this is not knowable, predictable, or controllable, I would go with what will be best for you now.