Anatomical implants for saggy breasts or lift? (photos)

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?

Doctor Answers 20

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.

Breast lift or 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.

To lift or go too big

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. 

Aras Tijunelis, MD
Libertyville Plastic Surgeon
5.0 out of 5 stars 7 reviews

Lift needed?

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.

Joel Patrick Maier, MD
Cincinnati Plastic Surgeon
5.0 out of 5 stars 28 reviews

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

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.7 out of 5 stars 21 reviews

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.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 24 reviews

Lift and implants

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.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

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!

Anatomical implants?

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

Ronald A. Lohner, MD
Philadelphia Plastic Surgeon
4.7 out of 5 stars 19 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.