Already Sagging After Breast Lift and Silicone Implants

Combined breast augmentation/lifting can be tricky, and having a more "natural" or lower than hoped-for appearance of the breast tissue is not uncommon.  It is often difficult to provide or maintain enough fullness in the upper pole of the breast to please the patient that desires an "augmented" appearance.  in many cases, the use of a larger implant further strains the tissue and causes sagging.  The options include performing a revision mastopexy to tighten the tissues through the same incisions, and considering an implant exchange for a smaller or possibly a textured implant at the same time.

Sorry to learn about your post op experience so far. While I acknowledge your concerns based on your description and shared photo, I think it can be difficult to judge without seeing what your breasts looked like before.

Breast augmentation lift is a very complex procedure to get right. There are multiple factors that your surgeon will need to address at the same time which include: resecting all the redundant breast tissue that's causing the droopiness, filling the volume deflation with a reasonable sized implants as well as optimising the shape with more prominent upper pole fullness and tightening the breast skin envelope & lifting the nipple positions with reference to the new breast mounds. It generally takes 4-6 months for the final result to settle and eventuate. So it'll be best to wait for at least 6-9 months before considering any further revisional surgery.

Best wishes

Ellis Choy

Your best option is patience and allow proper healing to fully take place. One way to obtain upper pole fullness is to use a larger implant

Thank you for your photos.  I certainly understand your concerns.  It is important to discuss this with your board certified plastic surgeon to determine if there are any options for you.  It is difficult to tell just by photographs without a face to face exam, but it appears that your breasts are beginning to develop a "bottoming-out" deformity.  This can occur when the natural tissues of the breast have loosened up and are worsened by the presence of an implant.  The tell-tale sign of this is that the distance from the nipple to the inframammary fold gets larger, and the upper portion of the breasts get flatter.  In essence, the pocket of the breast implant has stretched out.  In these scenarios, I find it helpful to replace the implant into a better position with the assistance of a tissue scaffold such as Seri, Strattice or TIGRmesh.  There are various products to reinforce the breast pocket, but this often adds significant cost to the operation. Performing another lift (i.e. an incision around the nipple and vertical) without tissue reinforcement may only loosen up over time.  The important thing is to consider your options and choose a board-certified plastic surgeon who performs these techniques frequently.  Best of luck to you!  Dr. Pacella

Its early days to see the final results but it is apparent that nipple positions are different. You can benefit from revision mastopexy to improve the upper pole fullness. Please discuss with your surgeon if a mesh can help with your results and support the tissues. You will get better results buying textured or nano textured implants. I would wait for another 6-8 months befogging contemplating any further surgery.

The picture appears to have implants that are "bottoming out" after surgery. It's generally best to wait 6-12 months after surgery before a revision is performed. I would then perform a revision breast lift to help fix the deformity.

Hi, thank you for your inquiry. I believe you are still too early to do anything. I am in agreement with others here that you should wait at least six months before contemplating your next move (if needed).  For patients where upper pole fullness is a priority, the new Allergan Inspira cohesive implants maintain upper pole fullness better than the similarly sized Mentor HP or the Allergan Inspira of similar size.  A slightly larger implant and a switch to the Allergan Cohesive Implants may be of some benefits to you.

Hello and thank you for posting your photo. I can understand what you are saying and a revision is always an option. You should talk to your PS about your concerns and expectations. But please understand implants don't help lift the breasts, sometimes even do the oposite. Large implants may weigh down your breast. You have considerable tissue and you have large heavy implants. This is why there will always be some eventual sagging.Best of luck,Dr. Miguel Mota

Without good before pictures, it is hard to tell if you implants have sagged below your original fold, but that is a common problem with this type of surgery.    Some surgeons feel that a textured implant maintains its position better, but that is no guarantee.     There are methods to raise the fold (and implants).        Such sagging is more likely to occur with a larger implant such as yours.       You might want to discuss revision with your surgeon.     Fixing the fold in a better position with or without some support (mesh or ADM) may be helpful.

You are still too early to do anything!  I am in agreement with others here that you should wait at least six months before contemplating your next move (if needed).  For patients where upper pole fullness is a priority, the new Allergan Inspira cohesive implants maintain upper pole fullness better than the similarly sized Mentor HP or the Allergan Inspira of similar size.  A slightly larger implant and a switch to the Allergan Cohesive Implants may be of some benefits to you.Best of Luck.Dr. Greenwald

Your concern is not uncommon after a breast lift/augmentation.  The recurrent tissue sag can be corrected by a revision of the lift if significant.  As to the loss of upper pole fullness from your implant- this may require an adjustment of the implant position by closing up the pocket of tissue around the implant.  Best, Sergio P. Maggi, MD, FACSDirector- Austin Plastic Surgery Center