Waited for Breast Implants Until I Was Done Breastfeeding?

I had silicone implants under the muscle in 1989. They were great... Got them after one child. Now, 18 years later and breastfeeding 3 more.... I now need a breast lift. I am not sure I want the scars, but my I only have about 1 inch of skin visible under my nipple :-( I wonder if I had waited on the implants if I could have just had the implants now without the full lift and horrible scars....?

Doctor Answers 35

Don't second guess yourself!

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

You've had four children, think you need a lift, and blame it on the implants?

Possible, but unlikely.

Odds are that you would have had to have the lift by now even if you never had implants. In fact, your implants may have helped keep your breasts perky all these years. Many women even get implants after losing weight or breastfeeding just to help perk up their breasts a bit.

However, if you did have tiny breasts and put in huge implants, that in itself could have contributed. That's one reason why I try to dissuade women from choosing very large implants.

The bottom line is that you have had them for 18 years and said they were "great." So you enjoyed them for almost two decades. No one will ever be able to tell you for sure whether or not the implants did or didn't lead you to need the lift now, but chances are that you would have needed the lift anyhow.

No patient looks forward to getting them, and no surgeon likes to give them. Though the scars can be horrible, in most cases, they fade with time, and the higher, tighter, and fuller breast becomes far more apparent to most patients than the scars.

Los Angeles Plastic Surgeon
4.6 out of 5 stars 49 reviews

Mastopexy scars

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

This is an interesting question.  It's difficult to predict breast behavior following breast feeding with implants.  Some women undergo size fluctuations, but maintain aesthetic breasts.  Other women undergo more dramatic changes and develop ptosis (sagging) that you have described.  On the bright side, you have had implants for 18 years, which is a good implant lifespan.  Scars are always difficult to justify in breast surgery, but it's important to focus on your goals and whether they can be met with techniques available today.  What may be possible is a circumareoalar lift or a vertical lift.  These techniques avoid the traditional wise pattern (inverted anchor) scar while leaving a less visible scar only around the areola or the areola and front of the breast.  You can get a more thorough answer in this forum by including a picture.  Additionally, plastic surgeons in your area are likely to offer free consultations.  Good luck!!

Jason Hess, MD
San Diego Plastic Surgeon

Waiting for Implants Until After Breast Feeding Won't Eliminate Needing a Lift

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

It is not likely that postponing your implant surgery would have eliminated the need for a breast lift.

The changes in the breast that occur during pregnancy and nursing include deflation of the breast or loss of breast tissue, as well as drooping (the descent of the nipple and breast below the height of the breast crease), which is more an issue of tissue tone or elasticity.

Implants do not lift or support the breast.  

If you have developed drooping with nursing, this most likely would have occurred even in the absence of breast implants.

If you have developed drooping, implants alone would not have provided the necessary lift.

Paul C. Zwiebel, MD
Denver Plastic Surgeon
4.7 out of 5 stars 43 reviews

The More Things Change, The Less They Stay The Same

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Breast augmentation is a wonderful operation, but patients must realize that every operation has its limitations. Patients should be aware that they will most likely require more than one, and possibly several, operations over their lifetime in order to maintain the appearance of their breasts.

A breast augmentation that gives a woman a beautiful outcome at age 25 cannot be expected to look the same at age 35 or 45, for a variety of reasons. Pregnancy, breast feeding, and the usual slow but gradual weight gain as we age will all conspire to undo the previously beautiful appearance of the breast when you were 10 years younger and/or 15 pounds lighter, and before breastfeeding your children.

Even in the absence of pregnancy and breast feeding, the effect of gravity and natural atrophy of your breasts as a function of age and time will take their toll and make the breast appear somewhat saggy. Add to that the possibility of capsular contracture around the breast implant or age-related deterioration of the implant (silicone or saline), and it is almost expected that the breasts will need a revision in order to restore them to an attractive appearance.

With many cases of revision breast implant surgery, and even in some cases of primary breast augmentation, a breast lift or "mastopexy" is also required in order to restore the proper proportion of skin envelope to breast volume that makes the breast look attractive.

Although more scars are necessary for this procedure than for augmentation alone, the scars are a worthwhile trade-off to achieve a well-proportioned breast, rather than placing a larger breast implant to take up the slack in the skin.

Even younger women who have not had pregnancies or breast fed sometimes require the mastopexy lift, and waiting until they have had their children and finished breast feeding will not change the requirement for the lift if the intention is to make the most attractive breast possible.

The mastopexy lift can also be "re-lifted" if needed, after age and child-bearing have changed the appearance of the breast.

The implants are not lifetime devices, and it should be expected that they need replacement after 10+ years of service.

Your breasts will age in tandem with other changes taking place with your body, and change is inevitable. It is expected that you will need to do some maintenance and upkeep in order to keep your breasts looking good after they have done their work!

Athleo Louis Cambre, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 6 reviews

In general, you want to be done having children before...

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

In general, you want to be done having children before having breast implants if you are in the midst of starting your family. This is only so you have less chance of needing a revision if your breasts change after having another child. There is no health risk to having the implants and then getting pregnant, though.

The implants don't promote or prevent sagging of the breasts, so you probably would be in the same situation either way right now. Just make sure the surgeon you go to has shown you many photos of lift patients because this is much more of a sculpting art form than just placing breast implants. If you can get a great shape, most patients will not mind the scars needed to get there.

That is hard to predict. The quality of each patient's...

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

That is hard to predict.  The quality of each patient's tissues varies tremendously.  As one ages the skin elasticity changes.  Also, pregnancy alters the skin quality by stretching it out when engorged.

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

Breast feeding and breast implants

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Pregancy and breast feeding can change the shape and size of your breasts, and having implants before pregancy can certainly lead to revisions. That being said, going 18 years without the need for a revision is quite a good result!!

Patients need to understand that breast implants are not a lifetime devices. Having breast implants guarantees you at least one additonal surgery somewhere in your lifetime. The risk of a spontaneous rupture of a breast implant is very, very low, but after about 11 or 12 years, it begins to slowly trend upward.

  • Current recommendations by the American Society of Plastic Surgeons is a replacement surgery every 10 years.

Breast implants can speed the inevitable drooping of your breasts with age- the larger the implant, the heavier it is, and the faster drooping will occur. After having 4 children and breast feeding, I would be very suprised if you would not have developed some drooping whether you had gotten implants or not.

Robert Steely, MD, FACS
Houston Plastic Surgeon
4.8 out of 5 stars 61 reviews

Breast Lift following Breast Feeding/Augmentation

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Most women without your implant history but with 4 births and breastfeeding would also need a lift - welcome to the human race. Fortunately there is much that can be done including use of a short scar, lollipop technique, breast lift that will help to restore your pre-pregnancy  appearance. This falls into the Mommy Makeover category.

Breast Implants and Breast Feeding

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

After 3 additional pregnancies and breastfeeding along with the normal process of aging, the likelihood is that you would have needed a breast lift regardless whether you had breast implants or not. 18 years for implants is an excellent success story for the surgery.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 55 reviews

Breast Implants, Breast Feeding and Breast Lifts

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Large breasts, whether provided by a plastic surgeon or by God, all have a tendency to succumb to gravity with time. When this is a patient concern at a breast augmentation consultation, I will discuss the need for a lift later in life (especially if the patient contemplates pregnancy and breastfeeding).  Breast lifts are suited for the patient who is willing to trade some scarring for a more pleasing and youthful breast shape. After reviewing before and after photos, I will not perform a lift if the patient tells us that she can not accept the scars.

Douglas J. Raskin, MD
Colorado Springs Plastic Surgeon
4.9 out of 5 stars 68 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.