Are breast implants supposed to look this floppy? How do I achieve a more large, round, perky look? (photos)

 A breast lift with implants really is a difficult procedure, more complex than sometimes we all realize. I’m always nervous to use a very small implant and leave a lot of the patients own breast tissue because I don’t think it’s very good tissue. That’s why a woman is looking for a lift! So I try to reduce the patient’s breast tissue as much as I safely can and then use a well supported (usually kept completely sub muscular)  good size implants to achieve the roundness. 

I think your result looks nice so no need to rush into another operation.  Going with larger implants will only cause more sagging and thinning of breast tissue so I would hold off on having this done.

Given that you have significant amount of breast tissue, it is very difficult for you to get that fake rounded look.  That is a lot easier with patients who dont have a lot of breast tissue and those who dont need a lift. What I have done in patients like yourself is to stage the procedure, perform a breast reduction  initially and then 4 months later come back and place high profile implants at that time.  In your case, what I would recommend would be to do just that.  You can certainly do it in one session, where you can have a breast reduction and replace the volume lost from the breast tissue removal with an implant.  The issue is that when you do it in one session, not as much breast tissue can be removed.Hope that helps.

The technique that you chose for your lift required the vertical scar.  This technique uses the skin envelope to push the breast higher.  This was unsuccessful since you are dissatisfied with the result.  The technique I recommend is The Bellesoma Method.  This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage.  Vertical scars are avoided, nipple sensation and the ability to breast feed are maintained, if not injured during your previous surgery.  At the same time or later, fat transfers can be performed if additional volume is desired.  Implants are not lifetime devices.  Fat transfers are permanent and incorporated into the body.Best Wishes,Gary Horndeski, M.D.

While I agree somewhat with the previous surgeon on use of the high profile implants, I will politely disagree that this will guarantee you a more perky look.  Since you have already had a lift, it is clear that the internal ligaments providing structure to your breasts lost some of their integrity which created drooping.  Unfortunately, by simply adding volume alone, the likelihood of creating a very perky look is very low.  To achieve that you would need to add a significant amount of volume which would then mean a significant amount of weight which would simply cause the breasts to stretch even more. I would start with a narrower base implant (like the High Profile) but also start with very realistic expectations.  I hope that helps and wish you the very best.Warmest regards,-Gregory A Buford MD FACS PCEOBoard Certified Plastic Surgeon and Author

Dear Mommy_Makeover25,
breast revision surgery is the most difficult plastic surgery procedure performed. Botched breast surgery alters normal tissue planes and laxity, the ability of breasts to heal properly, and leaves scar tissue that dramatically affects the level of difficulty of the corrective surgery.Many patients come in to correct poor outcomes from their initial surgeries. The most common problems are due to implant malposition, bottoming out of the implant, poor scarring, and incorrect implant size.While the type of revision required will depend on the result of the previous surgery and the desired result of the patient, some revisions involve extensive pocket repair that may or may not need specialized external bras.If you are considering breast surgery revision, you should speak with a board certified plastic surgeon and have yourself properly assessed. Only after a thorough examination you will get more information and recommendations. Also, you have to make sure that your surgeon understands your breast augmentation goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Thanks for your question and photos. The situation isn’t too bad. The mastopexy would need to incorporate GalaFlex to maintain a higher position and an extra high profile implant would help too. The quality of the scars isn’t the best. So next time wear silicone nipple scar shields or tape to improve them. Hope this helps. 

Patients attempting to achieve the "more fake" look often benefit from the use of  higher profile silicone gel breast implants or overfilled saline filled breast implants. Adjustment of the breast implant capsules (capsulorraphy) may be a very important part of the procedure as well.  The adjustment of the breast implant capsules may keep the breast implants higher on the chest wall and prevent displacement when patients lie down.  Best wishes.