Sagging after lift and implants! Help! (Photo)

Question

I received a lift and implant about 8 months ago. My breasts had gotten droopy from pregnancy and affected my self-esteem. I wanted to achieve perky, round, full breasts with lots of round volume. I wanted them to look fake, in regards to the roundess on top. I feel they have dropped back to my old breasts just bigger. The nipple placement is better. I still have to wear a bra for perkiness. I received 450cc saline over the muscle high profile, with an anchor lift.

Richard A. Mouchantat, MD, FACS · Answer

You have chosen a look that requires strong tissues to stay supported. The size of the implant is an issue with respect to accentuating that problem. At this point a full revision with a high profile textured silicone implant and support with Strattice to support the implant would be the best way to achieve your desired result. The longevity of the results would be excellent with the additional cost of the Strattice. Strattice is made of porcine dermis and has a strong collagen network that acts as a graft to support the implant pocket. Changing over to silicone may have less of a bouncing effect on the tissues supporting your implant.

Richard J. Bruneteau, MD · Answer

Unfortunately, gravity is an unrelenting force that continuously impacts the female breasts. Even when patients undergo breast lift surgery, recurrence of breast sag is inevitable to some degree. Several factors have been associated with the early recurrence of breast sag including the use of large implants, sub-glandular implant placement and poor skin tone. Your history suggests that all of these factors have been operative in your case.For this reason, revisional breast surgery would be appropriate to correct your recurrent breast sag. Under these circumstances, smaller breast implants placed in a sub-muscular position would be helpful. This procedure could be easily combined with a revision of your previous breast lift as well.Although breast sag is inevitable to some degree, these steps would definitely slow the rate of progression of this problem.  In addition, the addition of a small breast implant in a sub-muscular position might add some longevity to upper breast fullness as well.If you're considering correction of this problem, consultation with a board certified plastic surgeon is appropriate. This surgeon should be able to formulate a treatment plan that addresses your anatomic findings and achieves your aesthetic goals.

Earl Stephenson, Jr., MD, DDS, MBA · Answer

Thank you for the picture. It's going to be hard for you to achieve around St. Louis because the skin of your breast has been stretched out from changes due to pregnancy. If you truly want to look better you need to more than likely remove the implants and only have a breast lift

John Nguyen, MD, FACS · Answer

Very large implants, augmentation mastopexy, poor skin quality can all lead to recurrence of breast ptosis.  I would suggest revision mastopexy and conversion to a much smaller implant.  In my practice, I have also used Stratus or Seri to create an internal supportive sling for the implants to help prevent sagging.  Good luck and be safe.  John T. Nguyen, MD, FACS, FICSDouble Board Certified Plastic Surgeon

George Marosan, MD · Answer

You showed that your tissues cannot support a large implant. Going larger to fill the upper poles and look "fake" will work for a short time until your tissues relax and stretch and the implants drop again. You might benefit from a vertical lift, without nipple repositioning to cone the breasts and raise the implants to a higher position. After surgery, the lower poles of the breasts should be taped and also wear a supportive bra for at least one month. Good luck.

Sagging after lift and implants! Help! (Photo)

Answers (10)