Breast augmentation exchange - a lollipop lift or a downsized augmentation with internal mesh support? (Photos)

Question

Hi there, I’m a trans woman with 10-year-old 550cc Moderate Plus implants placed through an inframammary incision . I currently wear a 40DD, but the implants have bottomed out and don’t look lifted. One provider suggested a lollipop lift, but another said I may only need a downsized augmentation with internal mesh support. I’d love a smaller, higher, perkier look with better cleavage. Given my limited natural tissue (due to inconsistent hormones), would I need a lift or could mesh and smaller implants achieve that? Thanks so much for your insight!

Wayne I. Yamahata, MD · Answer

Your nipples appear to be in a good aesthetic position. To achieve a higher perkier look would be best addressed by raising the implants with capsulorraphies. Smaller implants will reduce your breast size but will also result in some upper pole fullness loss. This is a tradeoff that you can address during further discussion with your surgeon.

Camille Cash, MD · Answer

If you are wanting a perkier look with more fullness at the top a lift should be considered.  An implant exchange to smaller implants can also help to prevent bottoming out from occurring again.  See a board certified plastic surgeon near you to learn more.  I've included a video I hope you find helpful.

Karl William Schwarz, MD · Answer

A lift will raise your nipple and areola to a higher position. An internal bra supports the implant. Your problem is not your nipple position, your problem is the implant has descended. You don't need a lift, you need the implant positioned in the correct position and that would best be achieved with a capsulorraphy to tighten and correct the pocket (especially with a smaller implant), and a mesh or strattice as an internal bra to support the implant.

Brian K. Reedy, MD · Answer

Thanks for your question! I think a lift is the wrong choice. Your nipple/areola is already too high on the breast mound with bottoming out. I would recommend a replacement with a bilateral capsulorrhaphy (with or without Galaflex) to support the lower pole and correct what you have going on. Best of luck!

Gary M. Horndeski, MD · Answer

I recommend explantation and lift using The Bellesoma Method.  The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage.  Vertical scars are avoided and nipple sensation (in 95%) is maintained.  Later, fat transfers or small implants can be placed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Breast augmentation exchange - a lollipop lift or a downsized augmentation with internal mesh support? (Photos)

Answers (6)

Answer: Capsulorrhaphy

Answer: Capsulorrhaphy

Answer: Explant with Bellesoma Method

Answer: Explant with Bellesoma Method

Recommended reading

Everything you need to know about Breast Augmentation

Our mission is to create a world where every investment in modern beauty is Worth It.

Breast augmentation exchange - a lollipop lift or a downsized augmentation with internal mesh support? (Photos)

Answers (6)

Answer: Capsulorrhaphy

Answer: Capsulorrhaphy

Answer: Explant with Bellesoma Method

Answer: Explant with Bellesoma Method

Browse related questions

Recommended reading

Everything you need to know about Breast Augmentation

Our mission is to create a world where every investment in modern beauty is Worth It.