Anatomical implants or breast lift
Based on your photos, a breast lift with an implant may be your best option. Anatomic implants alone will not correct your sagging and tend to feel stiffer than regular silicone implants.
This is the most common question I get in my office and the answer is simple. It depends on you. I divide the patients into 3 categories.
1. Patient who only need implants. For these patients, the easiest way to determine what they want is based on a "wish pic." Try to find a picture of someone who has a similar body to you beforehand. Discussions about cup size or how natural or unnatural rarely help. I even had a patient tell me she wants completely natural breast in the C cup range just like Pamela Anderson.
2. Patients who can have a lift or just an implant. I have found 50% want the former and 50% want the latter. Their nipples may sit at or just above the inframammary fold. For the ones that want a lift, they usually specifically say they want their nipples to be higher and the whole breast to sit higher on their chests. For the one who only want an implant, they usually don't care about the nipple position and prefer to have large implants without the extra scars from a lift. These patients may be little saggy but their wish pictures are also someone who is a little saggy and they like the "natural" appearance of tear-dropped shaped breasts.
3. Patients who need a lift. Their nipples may be below the inframammary fold or pointing down. Usually these patients also need an implant.
From your photos and description of going from a D-cup to a B-cup after your pregnancies, a breast lift is beneficial. If there is loose, sagging skin, an implant, no matter anatomical in shape or round, would magnify that due to the weight of the implant stretching your skin even more over time. Discuss your skin tone with your surgeon and what type of breast lift would benefit you the most. The type of implant used will not be as important as your breast lift surgery.
The general rule of thumb is that if your nipple is below the crease or bottom fold of your breast-then you need a lift and an implant. The lift will center your nipple on the breast mound (implant). Otherwise, the nipple and breast skin will continue to slide downward, as your skin is too loose.
Sometimes we try to avoid the lift by going bug with the implant. The goal is to fill the empty skin. This can work, but more often one ends up with a sagging big implant.
I don't think an anatomic implant would help your situation at all. You need the upper volume.
Best wishes to you.
Excellent question. There is no doubt
that you have some ptosis (sag) of your breasts, but could have an acceptable
outcome with implants alone. If need be, you can always stage
a vertical mastopexy at a later date. Make sure you choose implants that are
appropriate, proportionate and fulfill your desires and goals. It is not an
uncommon scenario that too large implants are placed to "lift" the
breasts resulting in too large and more saggy breasts . . . Good luck and thank
you for sharing.
Anatomical implants for saggy breasts or lift?
Anatomical implants would fill in the skin but the breast would remain in the position they are at present. A lift with an augmentation would put them up higher on your ribcage, but in time a re-do of the lift is likely with the combined procedure. I would suggest the combined procedure as a better choice
Anatomical implants for saggy breasts or lift?
You can get an Ok result with just implants, but you are low enough I think I would go with the lift as well if you aren't opposed to the extra scar. BTW, studies have shown repeatedly that after 1 year you cannot tell the difference between breasts augmented with round implants or anatomic ones.
I am not a big fan of anatomical implants because they can shift,. As for lift vs no lift, I will say that implants in general do not lift the breast to any great extent.
Anatomical Implants, saggy breast, and lift?
Great question! Your photographic assessment puts you in a gray area in my opinion (Meaning a physical exam and measurements by a plastic surgeon may clarify this question). First Anatomical Implants are thought to give the surgeon a bit more control in filling out the breast in a way that might avoid a breast lift. Secondly, using technique called "Dual Plane" technique, while doing the breast augmentation (Through its same incision) can give about an additional 1 cm of lift. The breast implant itself can also get between 1-2 cm of lift. The use of a VASER superficial skin tightening technique has also been shown to get 1-2 cm of lift by skin tightening. I hope this helps!
Thank you for your questions and concerns, which are unfortunately all too common after many pregnancies. Two issues here: The first is the projection of the implant rather than anatomical implants. The more projection the better the position of the nipple areola. If large high projecting implants were chosen, it would be possible that an augmentation alone would be appropriate for your desires. Anatomical implants are firmer, have more edge palpability, and can be problematic if they rotate.
Which brings me to the second issue: your acceptance of anterior breast incisions from a lift to provide a higher positioned breast mound. Most patients would favor a lift in this situation, but it has to right for you.
I will show my patients photos of different options and see what their response is to the somewhat low position of the breast augmentation alone versus the scarring of the lift with an implant. Best of luck