Why are my breasts still so saggy 4 months post-op? Can I achieve firmer, perkier breasts with another lift? (photos)

I cannot differentiate whether there was inadequate skin resection, recurrent skin expansion, or both. Regardless, you would benefit from a revision lift, which would include a more artfully placed nipple-areolar complex position slightly more superior to its current position.

Overall, it is not a bad result. However, as you mentioned, there is still skin on skin and not necessarily maximally tightened. I think a revision mastopexy will be helpful in maximally lifting and tightening the breast. They will not become "firmer" because your tissue will not be changed in overall character. They key will be to remove breast tissue as skin-only lifts tend to bottom out, even thought the nipple position may be adequate.

Upper pole fullness cannot be achieved with breast lift surgery, fat injection or breast prosthesis is required for this. Breast lift with implants may be a good solution for you .
Best Wishes
Erman Ak MD

Dear Ejsss,
I understand your concern. However, without a proper assessment, it would be difficult to determine what is wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Thank you for your question. After your original surgery, if you're still having drooping and lack of firmness in your breasts, you can benefit from a revision or further operations to get firmer, perkier breasts. For example, to enhance volume and stiffness, some patients choose to combine breast augmentation with lift surgery. However, it would be best if you spoke with a board-certified surgeon about your concerns and desired results. They can evaluate your case, review the initial operation's outcomes, and suggest the best management for another procedure.

Thank you for your question. After your original surgery, if you're still having drooping and lack of firmness in your breasts, you can benefit from a revision or further operations to get firmer, perkier breasts. For example, to enhance volume and stiffness, some patients choose to combine breast augmentation with lift surgery. However, it would be best if you spoke with a board-certified surgeon about your concerns and desired results. They can evaluate your case, review the initial operation's outcomes, and suggest the best management for another procedure.

I always recommend waiting 6 months before doing any revisions. At that time, I would recommend The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

It appears that your nipple are too low and the lower portion of the breasts has bottomed out. A revision could correct these issues

I would have to do an examination to know whether another lift would help. You probably will not be able to get a perky result without an implant to help create a more rounded, youthful breast.

First, you do not have "tubular", shaped like tubers, breasts. Second, your breasts naturally sit low on your chest and the bases cannot be raised. You may have stretchy thinned skin from weight gain with pregnancy or weight loss and this type of skin does not hold well. Please discuss your concerns with your surgeon. More skin can be removed, and if needed, mesh can be added. Your actual breast tissue cannot be made more firm, but implants can be added which will be more firm.