Lift, replace implants or both? (Photo)

I am currently size 30 H, 120 lbs. 16 yrs ago I had 350 cc saline over the muscle implants via axillary approach to take me From my original a cup to a c/d. Years and children later, I have large pendulous breasts, visible capsules on the medial sides of both breasts and back problems. I want to maintain a perky natura D cup. Are there surgeons who specialize in replacement implants? Do I need a lift in addition to new implants? Will my recovery be longer than with my original sx? Thx!!!!

Doctor Answers 7

Quo Vadis - Breast Lift with or without replacement of implants or both?

There are no hard and fast rules regarding your situation.
First a few comments: Your breasts sag because of the interaction of having saline implants (which are heavier than silicone), Over the muscle (which stretch the skin more) interacting with gravity and the changes of pregnancy. 
IF all you want is a "re-perkying" of the breasts, then a Breast Lift with your present implant is all that is needed.
IF you wanted to "downsize", I would recommend putting in silicone gel implants under the muscle which would bring you to your desired cup AND perform a Breast Lift at the same time, understanding that there may be less complications IF the Lift is done in a staged fashion anywhere from 3 months to years later.
However, it would be a SERIOUS mistake to think that putting in large implants would lift the breasts long term. Such a miscalculation results in full breasts which rapidly plummet and thin the breast envelope making further surgery more challenging.
The recovery depends on what is done but is usually similar to a breast augmentation.

Dr. Peter A. Aldea
Memphis, TN

Memphis Plastic Surgeon
4.9 out of 5 stars 101 reviews

Lift, Replace Implants or Both

The intentional result of a Breast Lift (#Mastopexy) is to improve the shape and position of the breast without reducing their size. It is used especially for breasts which sag or droop (#ptosis) as a result of aging, weight loss, pregnancy, or breastfeeding. However, many women report more satisfaction if an implant is used at the time of #mastopexy. The implants further shape their breasts, restoring superior fullness or volume which may be decreased over time.
In regards to implants alone, this is usually said to be mistake by patients reflecting back at the decision. Most breasts will look larger and more droopy with solely implants. They will sag more and sooner, due to the sudden and excess weight. At times it's possible for a “Snoopy” breast or double bubble to develop as a result. There are a variety of techniques for a #BreastLift. I prefer to use the short scar technique, “#lollipop scar” or “#donut lift” rather than the majority of surgeons in the United States that use an anchor pattern lift which involve more significant scarring. Although the “anchor-shape” or inverted “T” incision is still more popular in the United States, it represents an older technique with extensive #scarring and a less optimal result in many cases.
It is imperative you select a plastic surgeon who is #board-certified and has a great deal of experience with breast #augmentation and the incision type, #implant placement, and implant type. Plastic surgeons who have specialized in breast surgery and cosmetic surgery are suitable to perform your breast augmentation. Aside from checking board-certification, it is suggested that you look at before and after photos of the surgeons actual patients, and read patient reviews. Gathering all of this information will help you make a well-informed decision.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 94 reviews

Breast Augmentation Revision 16 Years Later

This is an excellent question! We see many women in our practice with similar concerns and issues. Judging from the photos alone, it would appear that you would need a lift to achieve a "perky" look. Since the implants are 16 years old, I would seriously consider changing them. Options would include sticking with saline implanst similar to what you have, changing to silicone gel implants which will have a softer more natural feel and look or changing to the Ideal Implant, which is a double shelled baffled saline implant. It offers the softness of silicone implants without any of the liabilities of silicone. They are excellent implants! If you change implants then you could also change implant size to whatever size will get you the final desired look.
All this is very achievable but should be done by a plastic surgeon with experience in augmentations with breast lifts as well as breast surgery revisions. For the best results seek the consultation of a plastic surgeon certified by the American Board of Plastic Surgery. They have a website listing all the certified plastic surgeons. Members of the American Society of Aesthetic Plastic Surgery will all be board certified in plastic surgery and have demonstrated an interest and special skill in cosmetic plastic surgery as well.
For more information about breast revision surgery please see the web link below.
Good luck and best wishes!

Alexander G. Nein, MD, MS, FACS
Nashville Plastic Surgeon
4.4 out of 5 stars 25 reviews

Breast augmentation and lift candidate, some advices:

Thank you very much for enquire.
After having analyzed all the information and photos provided to us, I realize that you have very sagging and small breasts. In this regard, you need volume (implants) and projection (the lift): Breast Augmentation w/Breast Lift.
I recommend you to use microtexturized highly cohesive silicon implant ("gummy bear" implants), with high projection, and 400ml will be excelent on you, to fill the breasts properly.
Finally, to perform the breast lift I recommend a Periareolar Round Block Breast Lift ("Benelli mastopexy"), which has an unnoticed scar around the areola, and if we see (in the surgery) that we can't obtain adecuate projection just with the Benelli Lift, we have to perform a "Lollipop breast lift".
Dr. Emmanuel Mallol Cotes.-

Emmanuel Mallol Cotes, MD
Dominican Republic Plastic Surgeon
4.7 out of 5 stars 149 reviews

Breast Lift / breast augmentation

Your saggy breasts after pregnancy, saline implants, above the muscle placement are an occasional outcome. Sounds like you have them a good amount of time and it's time for a new set. Most plastic surgeons recommend silicone implants which may be better for your situation. A full lift to reposition and reduce your areolas would be beneficial. see a board certified ASAPS plastic surgeon. Good luck...

Larry Weinstein, MD
Morristown Plastic Surgeon
4.9 out of 5 stars 11 reviews

Implant revision options.

From the appearance in your photos, I believe you will be happy with an implant removal/replacement and mastopexy (breast lift).  There are many techniques for this procedure and it is best to consult with a board certified plastic surgeon to go over the pros and cons of various options.  Good luck!

Kelly Killeen, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 5 reviews

Revision augmentation

Thank you for your question.  For a more lasting, natural, perky appearance, I suggest replacing your implants with silicone, changing to a submuscular pocket, and a full lift.  Consult with one or more board certified plastic surgeons to discuss your options.  Best wishes!

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.