Implants on saggy breasts? (Photo)

I'm considering Breast Implants without a Breast Lift. wanted to know the options for women with saggy breast that do NOT want a breast lift. I want a full D or DD look. I'm not lookin for porn star perfect boobs. Just to fill my bras out and feel more womanly. I have lost 160lbs and also pumped for twins that are now 2 yr old I'm a 36 full saggy B/C, I'm 5'7", 165lbs, 5'10". I'm interested in silicone or saline. High profile? I'm thinking 600cchp. The white cloths shows my breast fold line.

Doctor Answers 21

Breast augmentation

Hello and thank you for your question. You are a candidate for a breast augmentation without a lift.  The size of the implant is based on your desired breast size/shape, your chest wall measurements, and soft tissue quality.  This decision should be based on a detailed discussion with equal input from both you and your surgeon.  This entire surgery can be performed with a small incision technique.  Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.   The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon


New York Plastic Surgeon
5.0 out of 5 stars 79 reviews

Implants on saggy breasts

Either implant will fill in the empty skin you have. Since your implant will need to be above the muscle, I would suggest using a silicone implant to decrease the problem with ripples. As long as you are willing to look big and still saggy, I think you are good to go with the implant alone.

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.8 out of 5 stars 26 reviews

BA

You could have a BA only without a lift.  I would recommend shaped textured gel implants in the partial submuscular plane.  600 cc sounds about right.  

Implants an breast lift

By your photos, it seems that you may not need a breast lift at the time of the breast augmentation, or perhaps a mini-lift.  An option may also be to do the lift at a later date if it is felt that you need one at that time.

Arnold S. Breitbart, MD, FACS
Long Island Plastic Surgeon
4.8 out of 5 stars 128 reviews

Implants on saggy breasts?

Weight loss patients are more prone to have worsening sagging with an implant alone due to the stretchiness of your breast  tissue. Having said that, you can have breast augmentation as a first stage, then decide on a lift later. If you don't sag much more, it may be several years before you need a lift.

If your goal is fuller breasts and you are to concerned if they sit low on your chest and have some sag, an implant alone will work. You will not get a lift with just an implant-it will just add more volume to the upper breast. I favor moderate profile implants in situations like yours as it looks more natural. High profile implants sometimes create a rounded full upper chest, but cause your breast tissue to look like it has fallen off the implant.

Implants on Saggy Breasts

From the photographs it looks like you have approximately one and a half finger breadths of sagging in your breasts. An important consultation will help decide whether you will get enough lift from implants alone. If you are thinking 600 cc's, chances are you will get enough rest. The critical point to make here is that I highly recommend that you have the implants placed on top of the muscle around them underneath the muscle to achieve maximum lift potential to the gland from the implant itself

Breast augmentation or breast uplift, borderline case

I have operated on many cases like yours. Correcting the ptosis only with breast implants is a challenge for this type of surgery.

There are some limits regarding the grade of ptosis when we want to lift a breast with augmentation only.

Your case is border line and is very difficult for somebody to tell if with special techniques only (not classical augmentation), breast lift could be obtained without the typical scars of mastopexy.

I think that you are slightly beyond the limits and you will need some type of mastopexy.

If this is a problem for you, I would try with breast augmentation only, using specific techniques and a few months after, if the lift obtained is not enough, I would do a complimentary small operation under local  anesthesia, in the office, in order to lift slightly the nipple.

I hope my opinion is useful to you.

Implants on saggy breasts?

Thank you for the question and pictures.

 After review of your pictures, it is clear that you WILL benefit from breast lifting surgery. You will not end up with an aesthetically pleasing results if you undergo breast augmentation surgery only.


 If you were to undergo breast augmentation surgery only  I think that 2 types of “results” would be predictable:


1. You will end up with “big and low” breasts and unhappy with the aesthetic outcome etc.


2. You will end up with the breast implants sitting high on your chest wall with the breast tissue lower down,  again creating an aesthetically unpleasant outcome. You will find that you will continue to have breast skin sitting on top of upper abdominal wall skin, unless you lift the breasts.


For some patients the necessity of additional scars is a “dealbreaker” ; for these patients it is better to avoid breast surgery altogether.   On the other hand, many patients (If properly selected and who are doing the operations at the right time of their lives  psychosocially) accept the scars associated with breast augmentation/breast lifting surgery as long as they are happy with the improvement in contour, size, and symmetry. This acceptance of the scars is the essential “trade-off” associated with many of the procedures we do in the field of plastic surgery.    



Patients who are considering breast augmentation/lifting surgery should understand that this combination surgery is significantly more complex than either one of the procedures done separately. In other words, the combination breast augmentation / mastopexy surgery differs from breast augmentation surgery alone in that it carries increased risk compared to either breast augmentation or mastopexy surgery performed separately. Furthermore, the potential need for revisionary surgery is increased with breast augmentation / mastopexy surgery done at the same time.  This revisionary rate may be as high (or higher) than 20%. Patients should be aware of this higher revisionary rate;  obviously, the need for additional surgery, time off work/life  considerations,  and additional expenses  our “factors” that should be considered before undergoing the initial operation. I would say that, in most communities,  anesthesia and surgery facility fees (minimally) are patient responsibility,  when returning to the operating room for revisionary breast surgery.  



Personally, I find that the breast augmentation/lifting procedure to be one of the most challenging  of the breast operations I perform, even compared to somewhat complex revisionary breast surgery. On the one hand,  when performing breast augmentation/lifting surgery we are increasing the breast  size with breast implants;  on the other hand, we are reducing the breast “envelope” in order to achieve the breast lift.. These two “forces” must be balanced as perfectly as possible in order to achieve the desired results. Removing too much skin/ breast tissue is problematic;  removing too little breast skin/tissue can also be problematic.  Remember also that patients presenting for breast lifting surgery and general have lost some skin elasticity/thickness making potential incision line healing problems and/or recurrent drooping/sagging important concerns to communicate.  The analogy I use in my practice is that  of a thinned out balloon,  being expanded with additional air; I hope that this analogy helps patients understand some of the issues at hand when performing the combination breast augmentation/lifing operation. To achieve  a surgical result where the breast implant and breast tissue “come together” and behave like a single breast is one of my goals but can be difficult to achieve.  Essentially, we are trying to create a breast implant/breast tissue interface that feels and behaves as naturally ( as a single unit)  as possible. Generally speaking, making sure that the breast implant has some sub muscular and some sub glandular component ( dual plane)  and tailoring the overlying skin/subcutaneous tissue/breast tissue as precisely as possible over the underlying breast implant is key. Despite these efforts, breast implants are after all a foreign body that don't necessarily stay where we wish they would;  therefore, breast implant related problems such as positioning ( too high, too low, lateral displacement etc.) can occur  and may be a reason for returning to the operating room for revisionary breast surgery. I use a “tailor tacking” technique that allows a determination of what breast implant should be used to SAFELY produce the results the patient is looking for. This technique involves use of a temporary sizer and temporary “closure” of the overlying breast skin over the sizer.  The use of the tailor tacking technique is very helpful. 



 Breast lifting involves removal of skin ( and tightening of the breast skin envelope)  while breast augmentation involves expansion of the breast skin envelope. These 2 forces are counteracting each other. Therefore, it becomes important to remove the appropriate amount of breast skin and to use the appropriate  size/profile of breast implants to balance these 2 forces appropriately and to allow for achievement of the patient's goals while minimizing risks of complications.  Again, despite these efforts, breast implant and/or tissue/skin complications may arise causing minor or significant complications.  Generally speaking, it is difficult to achieve the “perfect” result with breast augmentation/lifting surgery, despite best efforts. 



 Patients should be aware of the complexity of this combination procedure and achieve REALISTIC EXPECTATIONS prior to proceeding, and understand that additional surgery ( along with the additional recovery time, stress, expenses etc) may be necessary in the short or long-term. Patients should understand that the results of the procedure will not necessarily match aesthetically the results of patients who have undergone breast augmentation surgery only. For example, some patients who wish to maintain long-term superior pole volume/"roundness" may find that this result is not achieved after the initial breast augmentation/lifting operation.  An additional operation, possibly involving capsulorrhaphy, may be necessary to achieve the patient's longer-term goals ( with superior pole volume/roundness).  It is helpful if patients understand that this breast implant capsule used to provide the support for the breast implant is not present during the initial breast augmentation/lifting operation.  The capsule (layer of scar tissue) forms around the breast implant and may be a good source of supportive tissue during revisionary breast surgery,  Including correction of breast implant displacement/malposition problems ( such as bottoming out, symmastia,  lateral displacement etc). 



 Potential risks associated with breast augmentation/lifting surgery include infection, bleeding, incision line healing problems, loss/change of nipple/areola complex sensation, and blood flow related issues  to causing skin or tissue necrosis.   Poor scarring,  pigment changes, areola/nipple asymmetry etc. are also potential problems. Again, patients may experience implant related problems such as encapsulation, leakage, displacement problems ( too high, bottoming out, lateral displacement, asymmetric positioning etc.), rippling/palpability of breast implants etc.  Patients may also be dissatisfied with breast size, shape, and/or how the  breast implants and overlying breast tissues “interface” with one another.    Occasionally, a breast implant may even have to be removed and the patient will generally be “implant free” for several months at least.  Obviously, this situation can be quite physically, emotionally, and psychosocially stressful to the patient involved. 



  I hope that this summary of SOME  of the issues surrounding breast augmentation/lifting surgery  is helpful to you and other women considering this procedure in the future.  The attached link may also be helpful.  Best wishes.

Implants on saggy breasts

Thank you for your question and photo.  A breast lift with implants would give you the best result.  Your not a good candidate for high profile implant looking at your breast anatomy from your photo.  Please consult with a board certified plastic surgeon to fully discuss your questions.  Best wishes.

Dr Kayser

Thank you for your question. You have deflated breasts which has clearly lost volume. An implant is a device that restores volume. It requires a specific pocket either above or below the muscle to be placed. This would add volume, however, would also stretch and potentially thin the skin envelope that surrounds it. This would lead to likely implant irregularities that could be felt and possibly even seen. In your case, I would absolutely not perform a breast implant without a lift as this would likely result in a long-term result for the implant falls into the breast resulting in what is referred to as a rock in a sock look.

An implant does not lift a breast. The concept called a swing effect does move the breast envelope forward and up, not unlike the hand on a clock going from 6 to 8, however, over time with the added weight and stretching of the skin, the breast unit may fall back to its original position. Although a mastopexy would help reduce the skin envelope and improve your breast contour, this would be a skin reduction procedure that would be in opposition to an implant which stretches the breast. Obviously the larger the implant the more likely you are at risk for irregularities. 

One final option would be to consider using fat grafts transferred from one part of the body to the breast in order to further enhance the contour and add padding to the breast. Please see the video below to further give you an idea of how this may work. I would certainly discuss this with your plastic surgeon. I hope this helps and have a wonderful day. Dr. Kayser - Detroit

Melek Kayser, MD
Detroit Plastic Surgeon
4.9 out of 5 stars 31 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.