Sagging After Breast Lift Revision

Question

Breast Lift Revision 15 Months Post-Op. 5 Months from Revision Right nipple was higher a year after initial surgery. Had BL revision 5 months ago. The right breast looked perfect initially but now seems to be lower. I have realistic expectations but fear the right breast will continue to sag. The right breast also has a wider profile and measures an inch fuller under the nipple. Should i be concerned? My PS says i did not bottom out, but i'm not so sure.

Kevin Brenner, MD, FACS · Answer

It appears from the photo provided, that you took this picture of yourself in a mirror. If that is the case, then yes it does appear that you have a minor degree of sagging of your right breast. This can happen after a mastopexy alone, but is more common in mastopexy-augmentation cases. This is a relatively easy problem to repair in cases where a mastopexy alone has been performed. It is a bit trickier if there is an implant that is malpositioned and bottoming out. Either way, it is reparable. In all liklihood, the inframammary fold will require adjustment on that side.

Lewis Albert Andres, MD · Answer

Hello!  Thank you for your question!  The mastopexy (breast lift) procedure raises the breast, which ultimately provides a more 
youthful and perky breasts.  This is done by 
removing the extra loose skin and rearranging the surrounding breast 
tissue in order to reshape and support the newly formed breast.  At
 the same time, the nipple-areolar complex (NAC) is raised to the ideal position above the fold beneath your breast (the 
inframammary fold) as well as being placed at the most projecting portion.  Oftentimes with age or following pregnancy, the NAC 
becomes widened and enlarged.  This may be reduced in size during the 
breast lift procedure.
It is common for the breast to lose its firmness and uplifted appearance over 
time, which is also accentuated with age, pregnancy/breast feeding, 
weight gain/loss, and gravity.  This results in breast ptosis, or 
sagging of the breast, with a “deflated” appearance.  Women seek the 
mastopexy procedure to regain the previous youthful appearance of her 
breasts and women report increased confidence, self-esteem, and 
femininity once achieving this desired shape and fullness.  Breast lifts
 may or may not be performed with implants – the implant would add 
increased size but also greater fullness in the upper pole of the 
breasts which creates more cleavage.I would discuss your 
concerns with your plastic surgeon.  Increased size of the implants as 
well as laxity of the native skin do cause increased stretching 
inferiorly.  Revisions certainly may be considered - allow your surgeon 
to examine and evaluate you and then go over which procedure(s), if any,
 will be the right one for you.  Best wishes for a terrific result!

Tom J. Pousti, MD · Answer

Thank you for the question and picture.

	Your concerns about the breast implant positioning are well-founded and visible in the picture. At some point, correction can be performed with internal suture repair of the breast implant pockets (capsulorrhaphy)  and/or further skin excision along the lower poles  of the breasts ( horizontal excision).

	I would suggest continued follow-up with your plastic surgeon to discuss options.

	Best wishes.

Otto Joseph Placik, MD · Answer

According to your photo, I appears that the creases are even as well as the level of the nipples. I would certainly discuss this with your surgeon but in this case, I would likely advise you to wear a supportive bra. If this were to become worse, you could benefit from use of an acellular dermal matirx to reinforce the lower portion of your breast.

Hayley Brown, MD, FACS · Answer

First of all, there is no such thing as perfect symmetry and perfection. There can be some unpredictability associated with augmentation mastopexy surgery and gravitational effects after surgery which require revision. Based on your photo, Both implants look slightly bottom heavy with a slightly higher than ideal nipple position. Nipple lowering and decreases in your vertical limb length can sometimes be easily achieved with tightening along the inframammary creases. I would ask your plastic surgeon if a minor revision is possible and if the benefit outweighs the risk.

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Sagging After Breast Lift Revision

Answers (10)

Answer: Breast implant bottoming out again

Answer: Breast implant bottoming out again

Answer: Breast Augmentation Lift revisions

Answer: Breast Augmentation Lift revisions

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Our mission is to create a world where every investment in modern beauty is Worth It.