Do my Breasts Appear to Have "Settled" Too Low?

I had a BL/BA in mid-March 2011. I'm concerned that my breasts are too low and lack upper pole fullness. I have a follow-up with my doctor in a week and am wondering how to approach the subject or if I'm simply being unrealistic? What could be done to address my concerns at this point?

Doctor Answers 12

Results after Breast Augmentation/Lifting

Thank you for the question and pictures.

I think you have a very nice result after your procedure. Achieving more superior pole volume can be relatively simply accomplished with a larger implant.  Discuss your goals with your plastic surgeon.  in my practice I find the use of photographs of “goal” pictures (and breasts that are too big or too small) to be very helpful. I have found that the use of words such as “natural” or “C cup” or "fake looking" or "top heavy" or "upper pole fullness" means different things to different people and therefore prove unhelpful.

I hope this helps.

San Diego Plastic Surgeon
5.0 out of 5 stars 1,498 reviews

Expectations After Combined Breast Lift/Augmentation

A combined breast lift/augmentation is one of the most difficult procedures to do and end up with an excellent result because there are really two independent procedures done on each breast and the goal is to have them settle in perfect harmony. If the breast implants have not settled below the breast fold, then they are not too low and for you that appears to be the case. It is normal to lose some of the initial upper breast fullness because of gravity. You have an excellent result. If you change to significantly larger implants, they will be heavier and in the long run you will have more sagging, not less.

Joseph Fata, MD
Indianapolis Plastic Surgeon
5.0 out of 5 stars 101 reviews

Augmentation mammoplasty/uplift

It would be helpful , if you could post your pre-op pictures for comparison . We normally assess the shape of breasts , its contour (configurations ) when patient is standing in upright position with arms resting relaxed on sides. In this position nipples are at the center of breasts and are lined up with the mid arms (halfway between top of shoulder and elbow) . They should be slightly above inframammary folds ( where breasts meet chest wall) . In your case you have a pretty good results ,considering  challenges associated with performing breast uplift concomitant with augmentation . I suggest to wait at least another two more months before considering any revision. If you want to have more fullness on the upper pole of your breasts your infra mammary fold could be slightly elevated which will improve the illusion of " bottoming out " in the same time.

Fereydoon S. Mahjouri, MD
Minneapolis Plastic Surgeon
4.9 out of 5 stars 16 reviews

Great result

Your results are a natural result following a fine job performed by your surgeon.


Dr. Lille

Sean T. Lille, MD
Scottsdale Plastic Surgeon
4.7 out of 5 stars 31 reviews

Breasts too low after lift plus implants?

Here is a perfect example of implants "dropping" into their "final" position. Imagine how you would look now if your surgeon had placed your implants into "perfect" position initially--you would now be looking at "way-too-low" implants and a guaranteed re-operation. But although you have legitimate concerns about your present appearance, you really have a very good result, and you should be appreciative of what your surgeon has done for you. Any "complaints" should be reviewed in the setting of you seeking additional improvement rather than "blaming" your surgeon for your innate healing characteristics.

At 4 months post-op there is still some subtle additional softening, settling, and scar maturation to occur in both your breast and abdominoplasty scars, but your implant position will not change very much more. As you age, you may notice some additional skin stretch, just as women with naturally larger breasts, and particularly in women like you who have the genetics of slightly less skin elasticity (why you needed a lift in the first place).

You truly have a very nice result, but your observation is also accurate and not to be dismissed lightly. Larger implants will give more overall and upper pole fullness in the skin brassiere you presently have, but the additional weight will inevitably cause more skin stretch over years (gravity is one of those ever-present forces!), and your breasts will sag more as time goes by. "Ideal" size is in the eye of the beholder, and you have every right to ask for larger implants if you so wish. You just need to understand the consequences!

Another option is retightening the inframammary scar, decreasing the crease-to-areola distance. This can be done slightly more on one side than the other, further improving symmetry. This can be done with the same or different implants as you choose, and this choice also stretches over time.

In any case, please adress your concerns with your surgeon. He or she has given you an excellent result, but may be as interested as you in obtaining the best result possible, and at the lowest additional cost to you.


Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 255 reviews

Breast lift and augmentation combinations work well

I think you have a nibe pexy-aug result. This is a difficult procedure for any surgeon to get 'perfect', and I think your result is quite good. I'm not a fan of larger implants, especially in this setting. I would caution against the notion that replacing your current implants with larger implants will somehow make your result look better. It won't, especially over the long term.

Scott C. Sattler, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 65 reviews

Breast implants challenge shape after lift

The stability of the breast lift is affected by the pressure of the implant and can result in a recurrent droop, stretching of the lower breast skin, and dilatation of the areola. Overall your result is quite good, however as you notice the implant had settled into the bottom of the breast. You could consider a larger implant to fill the upper breast, though revision of the lift to reduce the lower skin envelope will also push the implant up and better center it within the breast. Wait a year to make certain the shape is stable first.

Best of luck,


Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 43 reviews

Breast lift

You will always get some bottoming out- that is the nature of the process. You have an excellent result. 

Morad Tavallali, MD
Vienna Plastic Surgeon
4.7 out of 5 stars 30 reviews

Breast position

It appears that your breasts have settled out over time form the first to the second photos.  Upper pole fullness is hard to maintain/achieve for most people. A larger implant with a wider base diametedr may help as well as a little more skin tightening. But over time. they may look the same except for the bigger implants.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Your results are better than avarge

The combination of the breast lift and augmentation is a difficult procedure and the revision rate of 40-70% is common. Your results in your post pictures shows both breast bottoming out and the right breast little more. I would not do any revision for at least 6-9 months till breasts are settle. Most surgeon will not do the combined BA/BL because of the higher risk of redo and complications. Your surgeon has done a great job with the breast lift and tummy tuck.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.7 out of 5 stars 124 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.