Anatomical implants for saggy breasts or lift? (photos)

Question

After giving birth to two beautiful daughters and breastfeeding one of them for 6 months (mostly expressed milk with a breast pomp) an another for 9 months my breasts left empty and saggy. Had 32D before pregnancies, after first pregnancy and breastfeeding-32C, after second-32B. Will anatomical implants work well on my breasts or I should ask for lift? Is there a big risk that my breast will look nice after surgery and after few year they will look droppy again?

York Jay Yates, MD · Answer

It would take a formal consultation with evaluation of tissue thickness and skin elasticity for any of us to give you a very meaningful opinion.  Based on the photos, if you want a very tight skin envelope and significantly higher breast and nipple position a lift would be necessary.  The trade off is a significant scar that should not be taken lightly.  To get the most "lift" as possible with the implant alone I would recommend an anatomical implant over the muscle (assuming you have enough coverage for the implant).  An anatomical implant pushes the nipple up more significantly and tighten and supports the lower skin envelope more.  Going above the muscle allows the implant to fill the breast more fully without compression and blunting the effect from the muscle.  I have many patients who have been told they "needed" a lift who were candidates anatomical subglandular implants and were very happy that they did not do a lift.  The link below is a recent realself.com post about a patient with a similar story.I personally never recommend going larger than you would like to get better "fill".  Ultimately this is defeating and you will end up both larger AND droopier than you would like several years later.

Joel Patrick Maier, MD · Answer

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.

Don W. Griffin, MD · Answer

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.

Gary Lawton, MD, FACS · Answer

I would either go with smooth round high profile implants or the lift.  The HP implants would have to be large and there would be still some residual ptosis.  However, the scarring would be less.  A lift would control the breast shape more but there would be scarring and the breasts would be smaller.  I would wait six months between the lift and implants if you did both.  I do not see any use for anatomic implants here.

Rodney A. Green, MD · Answer

During my Breast Augmentation consultation I estimate what volume implants you need by trying on externally, various sizes of implants.Usually my patients can tell quite accurately what volume they would like.Once this is done, an experienced Plastic Surgeon will be able to advise you if a lift will also be needed.Sometimes you can only tell after the implants are in place. This can be decised in surgery, or at a later time.If you choose larger implants, a more minimal lift will be needed.You will need to have a consultation will a Plastic surgeon.Goos luck.

J. Jason Wendel, MD, FACS · Answer

Thank you for your question about breast implants and pictures.Based solely on the pictures you've shown, you may need a small lift with anatomical breast implants.To be sure, see two or more board-certified plastic surgeons in your area for a full and complete evaluation to make sure you are a good candidate and that it is safe for you to have surgery.I hope this helps.

Jacob Freiman, MD, FACS · Answer

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.

Bahram Ghaderi, MD · Answer

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.

Aras Tijunelis, MD · Answer

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.

Steven Wallach, MD · Answer

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 for saggy breasts or lift? (photos)

Answers (19)

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