What Are My Options For Implant Revision After Breast Feeding?

Question

I had breast augmentation 14 years ago with small (~100cc) saline implants under the muscle. Since then, I have nursed two children for a year each. I feel like the implants look too high on my body, my nipples should point ahead not down, and I would like my breasts to be closer togather so it isn't obvious that they are fake when I am wearing a swimsuit. I am also interested in silicone. What would you suggest I do? Also, I would like to preserve nipple sensation if possible. Thank you!

Ronald Schuster, MD · Answer

You're in a good situation and have several option available to you. It will range from just having larger implants placed to just having a lift, to a combination of both. It all depends on the "look" you are going for and how large (or not large) you want to be. I suspect that you would do best with implant replacement (silicone gel is perfectly safe) with perhaps a small elevation of your nipple. Losing senesation in your nipples should be a very low risk unless you are wanting to get very large implants. Hope this helps.

Adam Hamawy, MD · Answer

There are several ways to approach your problem. Based on the photos above I recommend replacing your current implants with slightly larger ones to fill the breast and center your nipples and lowering your breast fold. Another option is to keep the current size and do a small breast lift however, the breasts still are likely to look high on your chest. There is problably a lesser chance of losing nipple sensation during the revision than during the first surgery but it is still a possibility.

Tom J. Pousti, MD · Answer

I think you would benefit from revision of your breast augmentation. Lowering your breast implant into the existing &ldquo;breast envelope&rdquo; will help with the cosmetic concerns that you raise. In other words, the breast implants will sit lower on the chest wall and the nipple-areola will point forward. Unfortunately, lost  of sensation is always a possibility with breast surgery;  although,  not very likely given the dissection involved  in your case.

	Make sure you're working with a well experienced board-certified plastic surgeon. Best wishes.

John Whitt, MD (retired) · Answer

It is difficult to see the position of your nipples in relation to your inframammary folds in the photo and an exam would be needed to state your best option. However, I think that you would probably benefit from some degree of breast lift. Your implants are quite small (100cc) and I doubt that they are simply too high. Your best option is likely placement of new implants (I agree with selecting silicone) under your pectoralis muscle in conjunction with a vertical mastopexy.

Charles Gruenwald, MD (retired) · Answer

You have correctly analyzed your present problem with respect to your existing implants. The implants are being held too high, and this causes your nipples to point downward.

	Since you're now finished with breast feeding, it's probably a good time to consider surgical revision of your breast augmentation. My suggestion for an operative plan would include:

	
		Further Pre-operative assessment to determine the possible need for surgical elevation of your nipples. Additional photo angles would be helpful.
	
		Exchanging your saline implants for somewhat larger silicone implants is a good idea, particularly if you would like your breasts to appear closer together.
	
		Decide, during surgery, the cause of the implant elevation (capsules vs. incomplete release of inferior pectoralis attachment) and correct it.


	Nipple sensitivity is always somewhat at risk, but your result should be breasts with good shape, texture and symmetry. Most women are happy with this decision and its outcome!

What Are My Options For Implant Revision After Breast Feeding?

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