Breast Implant Exchange. Do I Need a Lift? (photo)

I currently have saline 375cc. BA done 10 yrs ago. The doctor that did them said he could place a larger implant in, remove some tissue so that the implant drops lower in the breast, and make my nipples appear more in the middle of my breast instead of their current placement, at the bottom. I would like to go with a 500cc implant. Do you think I could achieve good results without a lift? I really dont like the breast lift scars, but if that's my only option, then so be it. Thank you

Doctor Answers 10

The Benefits of a Lift with a Breast Revision

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The most common #breastprocedures include #mastopexy or #breastlift, #breastaugmentation, or #breastreduction. A #mastopexy or breast lift operation is designed to improve the shape and position of the breasts without reducing their size. It is the most suitable for #breasts which sag or droop (ptosis) as a result of development, aging, pregnancy, breast-feeding and weight loss . Some patients will experience better results to restore superior fullness if an #implant is used at the time of mastopexy; better known as #AugmentationMastopexy. Also, a breast lift may also be achieved with current implants if a patient is satisfied with their current size, type and volume.

Altogether, the surgery will create an elevated, more youthful breast contour. Also, the nipple and areolae of the desired size and correct height may also be addressed. I prefer to use a #shortscar technique, #LollipopScar or #DonutLift” rather than the majority of surgeons in the United States that use an anchor pattern lift which involve more significant scarring.The best method and #technique for your #procedures will be discussed in greater length during your one-on-one consultation with a board-certified plastic surgeon.

Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Revision breast surgery

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If you are unhappy with the fact that your nipples are slightly low on your breasts, the way to correct that would be to have a mastopexy, or breast lift.  he trade off is the scarring that is needed to accomplish that.  If you are okay with the way your breasts look currently, there is no need to have them revised.  Entirely up to you!  As far is size is concerned, they can be made larger,but personally, I think they are large enough.  If you go with larger implants, I think you are asking for problems, including further sagging, not to mention the expense.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 29 reviews

Stick to principles

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I believe that the exchange of your implant to larger or the same size, can not achieve the result of a breast lift. I believe you need a breast lift. the picture is not a substitute for physical examination my judgement is only based on what I can see from this picture. further evaluation is required prior to a surgical plan.

M. Ryan Khosravi, MD, FACS
Los Angeles Plastic Surgeon

Implants without a lift?

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It looks like you need a lift now, and adding more volume will do just that and not lift the breasts or nipples.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Revision Breast Surgery

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We all want to believe that there is an easy way out, so we put our faith in those that tell us there is.  However, you know that your breast doesn't look the way you'd like, specifically that your nipples aren't in the middle of your breasts, and that is why you've posted this question.  So, don't believe that using some special or high profile or extra large implant using a 'special technique' will circumvent the need for the obvious: a breast lift. 

You should visit at least 2 surgeons who specialize and are well renowned in all forms of cosmetic breast surgery, including breast lifts, reductions, and revisions.These surgeons would, by necessity, be certified by the ABPS, as well as be members of the ASAPS.

Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 100 reviews

Implant exchange surgery is very popular

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I am unable to give you accurate advice without more information on your previous surgery, detailed measurements and more photos.  But, since the silicone implants have come back on the market place in 2006 we have found them to be wonderful!  I perform at least 2 saline for silicone exchanges per week for old saline implants.  All the women love the feel of the new silicone as compared to the saline.  So, I would encourage you to proceed with the exchange without any worry.  As for the lift and implant placement/size I don't have enough information to give you advice.  Perhaps you can give us more info and we can give you some more advice.

David Finkle, MD
Omaha Plastic Surgeon
4.9 out of 5 stars 82 reviews

Probably a lift and exchange of your saline implants under your muscle to gel implants under your breast would be best

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While you photos are a little difficult to evaluate fully because of the cloths across the top, it looks like you have nipple areolar complexes that are below the bottom crease of the breast. It also looks like your implants are staying some what higher creating what I refer to as a reverse double. That is because the muscle is holding the implant higher and the some what droopy breast tissue is hanging off of it. This creates an unnatural bulge above you breast. Just putting a bigger implant in will just make this worse. In my hands the best result would be from removing your implant from below your muscle, performing a breast lift and replacing your implants with textured silicone gel implants under your breast tissue and on top of your muscle. This would move you nipple areolar complex to sit on the median of your breast, give you a more natural feeling and looking breast wit a tear drop shape. 

Carl W. "Rick" Lentz III, MD
Orlando Plastic Surgeon
5.0 out of 5 stars 17 reviews

Breast Implant Exchange. Do I Need a Lift? (photo)

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There are a number of ways we determine the ideal nipple and areolar position. One is a measurement from the top of the breast bone, and we look for 20-22 cm. The better one is the relationship of the areola to the breast fold. The bottom of the areola should not be lower than the fold.

On your photos, it appears that the areolas are below the fold on both sides. Although the implants may be high riding, and lowering them would give some improvement, this will not fully correct the problem. The larger implants will also work against you if no lift is done. 

i can't tell if your surgeon recommended a lift and offered a compromise, but I think you are likely to have an unsatisfying outcome with implant replacement alone. Discuss with your surgeon, or with second consultant if you so choose.

All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

Breast implant exchange and lifts

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It is important in considering options and "needs" to identify issues and what does what. 

Changing from saline-filled to gel-filled implants will improve the feel only and has nothing to do with the issue of implant position, size, and lifts. 

Increasing the size of an implant does nothing to lift the breast and it appears the existing implants are quite wide and would not do well to be increased. . 

The position of the implant can be moved down into the lower pole of the breast up to a point and this would give the impression of a lift. A larger implant would make this more difficult and only an exam can determine how much the implant can be lowered. If the nipple-areola is too low relative to the inframammary crease behind it then the only real option is a lift to move the breast and attached nipple-areola up to the appropriate level with or without changing the implant. The lift could also help the asymmetry with the right side being lower. 

I would guess from the picture alone that the best approach would be a lift without changing the size of the implant (although it could be changed to silicone gel-filled). 

Scott L. Replogle, MD
Boulder Plastic Surgeon

Breast Implant Exchange. Do I Need a Lift? (photo)

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Try exchanging to larger size, like 500 cc. Also lowering infra mammary folds before incisions on the N/A and breast as in a lifting. If still unhappy than do a lift as a secondary operation. 

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.