Implants on saggy breasts? (Photo)

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

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

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.

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.

Thank you very much for enquire.After having analyzed all the information and photos provided to us, I realize that you have very sagging and small breasts. In this regard, you need volume (implants) and projection (the lift): Breast Augmentation w/Breast Lift.I recommend you to use microtexturized highly cohesive silicon implant ("gummy bear" implants), with high projection, and 450ml will be excelent on you, to fill the breasts properly.Finally, to perform the breast lift I recommend a Periareolar Round Block Breast Lift ("Benelli mastopexy"), which has an unnoticed scar around the areola, and if we see (in the surgery) that we can't obtain adecuate projection just with the Benelli Lift, we have to perform a "Lollipop breast lift".Respectfully,Dr. Emmanuel Mallol Cotes.-

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.  

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.

From your photos you have a lot of skin and ptosis to your breast. you will not have a nice outcome without a lift. I have seen many patients come to me for revisions because they needed a lift to start with.

Thank you for your question and photographs and congratulations on your weight loss!  Depending on your desired appearance, the best enhancement would be obtained through placement of both implants and a lift in the same operation.  The implant will help restore your lost breast volume, while the lift will help position your natural breast tissue over the new implant, while also removing excess skin and elevating your nipple and areola into a more youthful position. This will help prevent additional sagging from the weight of your implant and provide a firmer appearance to your breasts while minimizing the risk of a double-bubble deformity.  You can choose to have an augmentation first and a lift in a second stage if your results are not what you anticipate.  See an ASPS board certified plastic surgeon in consultation for the best treatment recommendations. 

Thank you for your question.Your breasts seems to display severe sagging – ptosis greater
than grade 3.

Current research highlights the following as risk factors
for sagging:

Greater ageHistory of significant weight loss (>50
pounds)Higher BMILarge bra cup sizePregnancy Smoking

A breast augmentation will work to increase the size of your
breast, but it will not be effective as it may not be reinforcing your existing
breast tissue which will be much lower on the chest wall. With breast augmentation,
the implant will also appear low on your chest resulting in bottoming out. The weight of the implant will worsen the
amount of sagging. You may also have a double bubble deformity where the breast
tissue overlying the implant droops below in front of the implant. It may also
cause a snoopy deformity (named after the cartoon character snoopy) that
happens when the implant is held sitting in a high position by tight
pectoral muscles, while the natural breast tissue falls off the implant and
hangs below at the bottom curvature of your breast. We have to think of the
long-term results, not the short-term results.

As such, you need a
breast lift for best aesthetic results.

If you are afraid
of scars brought on by a breast lift, you can get an initial breast
augmentation, and opt for a breast lift in the future if you become unhappy
with your results. You will have to wear a push-up bra to support your breasts without the breast lift.

It would be my
strong recommendation to get a breast lift. I urge you to seek a
board-certified plastic surgeon to have a consultation for an augmentation
mastopexy. A breast lift can raise your breasts and breast augmentation can refill
your breasts. An in-person consultation and exam will allow the surgeon to
address your concerns, while meeting your expectations.Please note that you would also be saving money if you have an augmentation mastopexy compared to a breast augmentation first, and then a mastopexy few months later.

Hope this helps.