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 30

Protecting Implant Position

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 109 reviews

"Saggy Breasts" Augmentation vs. Lift

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
4.7 out of 5 stars 14 reviews

A breast lift was needed

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 104 reviews

Why do some breast augmentation results appear saggy?

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
4.4 out of 5 stars 89 reviews

Saggy looking results

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
4.8 out of 5 stars 23 reviews

Residual Breast Sag Following Breast Augmentation

It’s not unusual for patients who have breast hypoplasia to also have associated breast sag. How this sag is dealt with at the time of breast augmentation may explain why some women have persistent sag following this procedure. When this situation arises patients are often willing to make compromises to avoid scarring. They’re willing to trade scarring for residual breast sag.

Under these circumstances, breast implants are occasionally placed on top of the muscle or biplanar breast augmentations are performed with the implants partially beneath the muscle. This avoids scars that are associated with breast lift surgery but results in persistent breast sag.

In other cases breast sag may develop following breast augmentation surgery. This can occur following pregnancy, breast feeding, weight loss, weight gain, hormonal replacement, menopause, and normal aging.

It’s important to realize that the type of procedure performed is dependent upon the patient’s anatomic findings and aesthetic goals. When these decisions are made a series of tradeoffs are necessary. In many cases patients are willing to accept persistent breast sag to avoid scarring.

Saggy breasts after augmentation

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.

Michael B. Tantillo, MD
Boston Plastic Surgeon
4.7 out of 5 stars 29 reviews

Depends on the breast shape

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

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.

Breast augmentation addresses volume not lift

Implants help to fill out the volume lost with weight loss or after breast feeding - they are not intended to lift the breast (though you will get a very modest lift due to the swingset effect). You may benefit from a lift as well as an augmentation. Schedule a consultation with a plastic surgeon in you area to discuss your options. Best of luck.

Grant Stevens, MD
Los Angeles Plastic Surgeon
4.8 out of 5 stars 137 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.