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.

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

I have answered questions regarding breast lift and breast augmentation at the same time and your result depicts why I generally don't recommend these procedures by done at the same time.  Breast lift and augmentation at the same time is one of the most technically difficult procedures plastic surgeons do on the body.  The procedures actually "fight" each other:  the breast augmentation stretches the skin and the breast lift tightens the skin.  This places increased forces on the repairs and the soft tissues that can impact healing in a negative way:  increased scars, displaced nipple position, residual hanging of skin, implant decent, etc.  I generally recommend these be done separately at least 6 months apart for optimal results.  The order of procedures depends on the patients breast anatomy.To answer your question though, please allow at least 6 months to a year for complete healing to occur.  You would need revision surgery which would include a tightening of the lower soft tissues, possibly larger implants to help fill the upper breast (if you want to be bigger), and a tightening of the breast lift in select areas.All my best.

Thank you for your question.In the absence of a physical exam and without seeing your pre-operative photos, it is difficult to assess your current cosmetic state.  Anatomical variances can affect the decision of what type of implant to use and technique of placement, especially when the patient will also require a breast lift or mastopexy.  This often requires an experienced plastic surgeon who specializes in cosmetic breast surgery to use all of the imaging, implant availability and techniques available to optimize results.I would recommend following up with your operating surgeon to discuss your concerns and your recovery thus far.  It might be too soon to begin considering or planning for a revisional procedure, but in any case, follow up would be strongly recommended.  I hope you find this helpful and I wish you all of the best!

You have several options if you feel like your breasts are still sagging after breast lift and augmentation surgery. There are many contributing factors to excess skin and sagging breasts: age, pregnancies, breast feeding, living on planet earth-gravity, genetics, and weight changes. A breast lift is designed to remove the excess skin and re-position the nipple to give you a more youthful nipple position and better shape to your breasts. However, breast skin can still have a tendency to relax or stretch even after an adequate lift procedure. A combined  breast lift with placement of an implant are two procedures heading in opposite directions. The implant is increasing the volume of your breasts at the same time as the lift is trying to decrease the amount of excess skin of your breasts. The goal is to find the point where these two procedures are at the maximum benefit for both-giving you perfectly shaped and lifted breasts without compromising the skin and healing. Depending on the condition of your skin, you may get some recurrent sagging after the procedure that will require additional tightening after the swelling has subsided and your skin has relaxed. Most of the time when this happens it only requires a minor procedure to get the desired result. This can sometimes include a minor re-positioning or re-sizing of the nipple as in your case.  I typically sit my patients up during the procedure many times to assess symmetry and ideal nipple position. The other issue that you might have is an implant position that is too low.  This also can be corrected by tightening the implant pocket along the bottom (or infra-mammary fold) and sides.  This re-positioning of the implant will give you that upper breast fullness and better cleavage you desire and allow additional tightening of the skin to give you a better result. I would encourage you to follow up with your surgeon to discuss these options.

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