Why Do Some Breast Augmentation Results Appear Saggy?

After 3 kids and recent weight loss, my breasts are very saggy. I keep seeing pictures of after breast augmentation surgery and they still seem saggy. Why is this? Aren't the new ones supposed to stay up?

Doctor Answers 32

Protecting Implant Position

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Sometimes breast implants can "bottom out" or change position. I put a great deal of effort into creating an enhanced breast profile that is natural-appearing, and I think it is absolutely critical to protect implant position postoperatively to ensure that the implants heal in the desired position. The implant pockets are made larger than the implants themselves, by design, so that the augmented breasts can move just like natural breasts do. We purchase a comfortable, custom-fit postop bra for our patients that is used for the first two to four weeks after surgery, and two 3-inch Ace wraps are used above and below the breasts as `breast bands' to help stabilize implant position. When the inframammary folds are lowered, we protect the new folds with tape applied to the skin that lasts for one to two weeks, so that the implants do not settle to a position lower than intended.

We see patients in the office three to four times in the first two weeks after surgery to ensure that their breast implant position is ideal and that no adjustments need to be made to the bra, breast bands or taping. In some cases the bra and bands are used into weeks three and four, based on each patient's individual needs.

Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 123 reviews

"Saggy Breasts" Augmentation vs. Lift

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The appearance of "saggy breasts" following augmentation can be attributed to what I think may be --- the wrong procedure for the wrong patient. This can be avoided by making sure you understand all of the surgical treatment options available to you. Your plastic surgeon needs to listen to your concerns carefully to be able to tailor an operation which will satisfy your expectations.

Certainly, there are----the wrong procedures for the right patient. What I mean by this is simply, some patients have realistic expectations when presented with procedures which may satisfy some, but not all of their concerns. Some women may be happy with the location of their areola on their breat ,however do not like the size or the shape of their breast. In this case augmentation alone may be the answer .

In some cases, issues related to size, shape ,projection, and position of the breast need to be addressed. In these women , another procedure such as a mastopexy(breast lift) or a mastopexy with implants is chosen.

The most important way to successfully accomplish your goals is to find a surgeon that can effectively understand your concerns and to then offer you an operation to meet your expectations.

Nick Masri, MD
Miami Plastic Surgeon
4.9 out of 5 stars 30 reviews

A breast lift was needed

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Results after breast augmentations that apperar saggy come from two reasons. The first is that a breast lift with an augmentation should have been done rather than a breast augmentation alone. If breasts are sagging to begin with, adding an implant without doing a lift leads to a larger, sagging breast. Many women are leary of the scars from a breast lift, and either opt for an implant alone, or are advised to do this. Generally this is not a good way to go. The only way to lift a sagging breast to get a perkier look, is to do a breast lift.

The other reason is that the breasts can change after the enlargement. Usually this is due to pregnancy, weight loss, or lack of support for an enlarged breast. In terms of weight loss and pregnancies, there is a larger amount of skin supporting the breast (which may have become smaller) which causes it to sag. In women who have had breast augmentation, there is a greater weight to the breast, and a greater need for good support in a bra maintain this look. If someone who has large breasts routinely goes without a bra (or with minial support in a bra), the breasts will sag over time whether or not she has implants.

The only other thing to understand, is that -- generally speaking -- the mature breast, lifted or not, will not look like a young womens breast. As women age, the breast changes, and this can affect the look. But, this can also lead to a very natural, attractive look to the breast.

But the best advice to you, is to go to a board ceritfied plastic surgeon for a consultation. If needed, have a breast lift with the enlargement. Use an implant that gives you the fullness that you want, but don't overdo the size of the implant. Larger implants are heavier and add more weight to the breast with can lead to sagging over time. (You may also want to consider silicone implants.) Then, in your daily life, and exercise, wear good support in your bras. This should be seen as protecting your investment!

David B. Reath, MD
Knoxville Plastic Surgeon
4.9 out of 5 stars 111 reviews

Why do some breast augmentation results appear saggy?

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The issue of sagginess has two components.

The first is related to the position of the implant on the chest wall. If the implant is placed low on the chest wall, even if it is in harmony with the skin envelope and nipple position, it will appear to hang too low, or sag.

The second has to do with the position of the nipple relative to the breast mass. If the nipple-areola complex is too low relative to the implant, the nipple appears to be pointing south.

In both cases the situation can be improved by performing a lift in combination with the breast augmentation. In my office, I stand the patient in front of the mirror and let her guide me as to where on the chest wall she wants the implant. Once I know what her ideal implant position is, then I decide whether a lift will help her.

For a link on the importance of implant position, see the link below.

Ricardo L. Rodriguez, MD
Baltimore Plastic Surgeon
4.5 out of 5 stars 98 reviews

Aug/pexy May Be the Right Operation for You

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Thank you for your question. The final breast augmentation result depends on the amount of sagginess, or ptosis, present in the breasts pre-operatively, the surgeon's placement of the implants, and other factors. If the breasts have too great of sag (ptosis) pre-operatively, it may be better to undergo an aug/pexy, which both places implants and lifts the breasts through a mastopexy.

Why breasts sag

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In this case the surgeon has to pay close attention to what the patient desires, not just for the augmentation but the nature of the body of the patient to be operated on. Breast augmentation sometimes appears saggy as a result of improper placement of the implants by the surgeon, but this can actually be addressed by the surgeon, most cases, if the patient is advanced in age there is a tendency that the breasts would sag after the surgery.

Colin Hong, MD
Toronto Plastic Surgeon
4.6 out of 5 stars 40 reviews

Saggy looking results

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There are three possible reasons for this:

1. The implants enhanced the pre-existing ptosis (sagging). Before they had the augmentation, they should have been assessed for a lift as well.

2. The implants were not positioned properly.

3. The weight of the implants accelerated the rate of sagging. This is worsened with larger implants.

Ronald Levine, MD
Toronto Plastic Surgeon
4.6 out of 5 stars 25 reviews

Saggy breasts after augmentation

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Breasts that are saggy after augmentation require a breast lift. Why was a lift not done in the first place? Basically there are two reasons. The surgeon may not have recognized the need for a breast lift. Choose your surgeon carefully - this is the most important decision of all the decisions patients make. Second reason is that the patient may have refused a breast lift. Many patients are not willing to accept the scarring necessary for a breast lift. Such patients are interested in their appearance when clothed rather than when topless. These types of cases are representitive of a common trade-off in plastic surgery - scar for contour.

Depends on the breast shape

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The implants augment the breast shape.  If there is aging before surgery, there will be sagging after surgery.

Breast lift may have been more suitable

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If you see photos of women with saggy breasts after breast augmentation, then chances are a breast lift may have been needed prior to surgery. While some implants can help lift the breasts to a certain extent, if there is a lot of sagging then a breast lift is necessary. Also, changes can occur after surgery that contribute to sagging, such as weight gain, pregnancy and aging.

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.