What Will Happen to my Already Too-High Scars if I Go Bigger?

I had a terrible anchor lift and augmentation that left me with scars about 2" up my breasts (not to mention other problems). I have 397cc silicone implants, but would like to go with 500cc's, but one doctor told me I can't go bigger because of where the scars are. I'm really hoping I can. Is it possible?? Thanks!

Doctor Answers 8

Too high scars?

Dear Orange County,

Your scars aren't too high, your implants are too low! 

Do you really want to increase your implant's size by 25% (397 to 500), or would you like to see more fullness in your upper part of your breasts, above the nipples? 

I recommend you see a surgeon who specializes in revision breast surgery and who is certified by the American Board of Plastic Surgery.  The surgeon will have a thorough discussion with you about your situation and how it could be fixed.  The most important part of the revision will be to close down the bottom portion of the pockets where the implants arre located, so when implants are replace they will sit much higher on the chest wall.  Once this is accomplished, the scars should be revised so that the vertical scar is shorter, and the distancd between the areola and the inframammary scar and crease are closer.  This should give you a very pretty breast and you will have much more upper pole fulness (above the nipples).

I wish you the best of luck, and I'm certain you will get a result you will like!

Beverly Hills Plastic Surgeon
4.9 out of 5 stars 90 reviews

Your implants are bottoming out

The problem with lift and augmentation is the unpredictable results and high rate of the complications after the augmentation. You implant pockets are too low and that is why you have lost the breast volume over the upper pole of the breast. I would suggest to revise your lift and the pocket without going bigger.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.7 out of 5 stars 126 reviews

Scars and Bigger Implants

Dear Orange County, Going bigger is a poor idea. Making your present breast better is the answer. Your implants are too low and the inframammary fold needs to be reconstructed with a well done capsulorraphy. This Will enable your implants to go up, the nipple to come down to the proper point on the breast mound and give you more superior fullness. Going with a larger implant is more likely to make matters worse.

Richard Linderman, MD
Indianapolis Plastic Surgeon
4.9 out of 5 stars 9 reviews

Revision of lift

You do not want to go bigger.  You bottomed out, and you  may want to go smaller with resuspension of the breast folds.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Fixing A Bottoming Out Breast Augmentation

Large implants have one consistent effect in that they cause excessive stretching of the breast skin and increase the weight on the breasts leading to a higher incidence of bottoming out. What you have is bottoming out associated with the lift and this could be do to a number of reasons.  The fact that the scars are wide as well indicates some degree of tension or insufficient support of the breast tissue.

Fixing this would involve several steps in one procedure. Increasing the volume in your breast implants will likely lead to more of the same for the reasons above - something I do not recommend. However, if the implants are properly supported and lifted from the inside of the breast "pocket" it is likely that they will appear fuller once they are put in the proper position.  The scars can be revised and there is a small possibility you could need additional support in the form of a dermal matrix - this adds strength to these kind of procedures.

All of this need to be addressed after an in-person consultation with a board certified plastic surgeon with experience in this arena.

Best of luck

Vincent Marin, MD, FACS

San Diego Plastic Surgeon

Vincent P. Marin, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 47 reviews

Implant bottoming-out after pexy-aug

Going bigger would be a mistake - you are already demonstrating poor support for implants- both are bottoming out. This process carries the horizontal scar up onto your breast and also makes your nipples appear to be too high relative to the top of your breast. Your nipples have not move at all, but the implants have slid beneath them. To fix this issue - you need smaller implants and a revision of your breast lift, plus an inferior capsular repair using sutures or Strattice, which is an acellular dermal matrix product. This will likely be an expensive revision.

Scott C. Sattler, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 65 reviews

A Bigger implant is NEVER the Solution to ALREADY Sagging Breasts

Regarding: "What Will Happen to my Already Too-High Scars if I Go Bigger?
I had a terrible anchor lift and augmentation that left me with scars about 2" up my breasts (not to mention other problems). I have 397cc silicone implants, but would like to go with 500cc's, but one doctor told me I can't go bigger because of where the scars are. I'm really hoping I can. Is it possible?? Thanks

I know this is the last thing you want to hear. But - "going bigger" is NOT the answer. Going bigger is what got you to this point and result. It appears that the implants you have now were sufficiently big to sag below the old breast fold scar AND put enough tension on the scars to stretch them out.

The solution? - First recognize WHY you are here. As the saying goes "When you find yourself in a hole - stop digging!". Putting in an even larger implant would turbo charge the breast stretching and sagging and make a subsequent attempted repair harder.  Ideally, an slightly smaller implant than the ones you have now combined with lifting of the implants by repairing the stretched out lower floor of the implant pockets is in order. If you must keep these implants, you should consider having the implants lifted,  floor repaired and supported with a biological sheet such as Alloderm or Strattice. Of course all this surgery will be significantly more involved and expensive than your original operation.

Dr.Peter Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon
4.9 out of 5 stars 109 reviews

Scars too high

It does appear that your scars have migrated up onto your breast but there is a solution. In your picture your arms are up which tends to lift the nipples up a bit on the breast but they are a little high as well. I would recommend finding a plastic surgeon who feels comfortable tightening up the lower pocket to elevate the implants and try to get your scars back into the crease where they are less visible. This can be accomplished with suturing alone or sometimes with the help of an acellular dermal matrix such as Strattice. At that time your scars can be revised as well with the goal to make them thinner.

I hope this helps.

Dr Edwards

Michael C. Edwards, MD, FACS
Las Vegas Plastic Surgeon
5.0 out of 5 stars 35 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.