Heavy Impants, Want Perkiness, Too Broke for Breast Lift, Should I Do Under Muscle? (photo)

I have PIP impants that are leaking, replacing next month. I have them 6 years, never happy with result. Was 34b got 290cc silicon above muslce implants, now 32F, I think they just look heavy, I wanted perky boobs, all the fullness is at the bottom and nothing at the top, I would like perky boobs, I'm afriad if I go down a size they will be still saggy, would under the muscle help? I don't have the money for a breast lift.

Doctor Answers 12

Need a breast lift to acheive goals

Time, weight and gravity are not on your side.  It appears that, at least for now, your soft tissue will support a larger implant and will achieve your goal of more fullness and some uplift to the nipple area.  A gel implant will feel a bit more natural and will not be as round as an equivalent saline filled implant. If you just want the perkiness and not a larger size then you would be a candidate for a breast lift.  There are always consequences to the choices we make be sure to understand both sides of the story.

Atlanta Plastic Surgeon
4.5 out of 5 stars 19 reviews

Perkiness without a breast lift

With your goal of perky breasts, this would be achieved only with a breast lift. If you do not have proper expectations for the surgery, then you may be disappointed. You may want to have additional in person consultations with experienced and expert board certified plastic surgeons to explore your options.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 39 reviews

Treatment of Droop when Using Smaller Breast Implant

You already have droop as evidenced by where your nipples are in relation to your inframammary crease (revealed by the bra strap mark). By going smaller, you will generally have more droop. The only way to assure that this does not happen is to do a lift at the same time as the breast implant exchange. I would normally tell you to save your money until you had enough for both. In your case, with the problems with the PIP Implants, I would suggest putting the implants over the muscle and waiting to see if your skin will shrink. You appear young and you may have enough elasticity after the excess weight is removed. By placing the implants over the muscle you also allow the breast tissue to move up (if you hold it up continuously for a while) and contract. Otherwise the breast tissue is attached to the muscle and cannot move up unless the muscle is released significantly.


Robert T. Buchanan, MD
Highlands Plastic Surgeon
5.0 out of 5 stars 6 reviews

Breast lift or just implants

Perhaps a good alternative for you would be to have these implants removed and then wait 3-6 months to see where you stand. From that point you may decide to do just implants, do just a lift, both or neither. If you decide to have these implants removed and replaced with smaller or even the same size implants you would need a lift in order to achieve the perkiness that you desire.

John P. Stratis, MD
Harrisburg Plastic Surgeon
4.5 out of 5 stars 34 reviews

Heavy Impants, Want Perkiness, Too Broke for Breast Lift, Should I Do Under Muscle?

Thanks for the posted photos. I recommend small cc size and some form of lifting. Save or seek more in person consults. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

Best Option for Perkier Breasts?

Thank you for the question and pictures.

Given that your emphasis is on achieving “perky” breasts,  it is clear that you will benefit from breast lifting. Any  other operation will likely leave you disappointed. I would suggest that you avoid any surgery until you are financially stable and are willing to accept the scars  associated with breast lifting surgery.  Make sure you educate yourself about these scars and are willing to accept the “trade-off” of the scars for the “perkier" breasts.

Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,485 reviews

Breast implants and lift

It looks like based upon your photos that you may need a lift to get the "perky" look.  Implants alone will not do it.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

Breast implant removal and lift

Not having a mastopexy (breast lift) is not a wise choice. Based on your pictures, description of cup size and current implant size, you may benefit just from implant removal and a breast lift. This will likely place you in a C to D cup range. This should be of benefit financially as well. Please discuss this option with your surgeon.

Kevin Tehrani, MD, FACS
New York Plastic Surgeon
4.8 out of 5 stars 95 reviews

Looking for a Shortcut in Plastic Surgery is ALWAYS a mistake...

Hi there-

Please don't cause yourself any more problems!

You are in this situation (almost certainly) because before you had your current implants placed, you expressed reluctance to undergo a breast lift.

Now, you are in a situation where it is clear you need your implants replaced, and you are very clear that you are unhappy with the current appearance of your breasts- and that you want them to appear more "perky"- something that could only be accomplished through a procedure that involves a breast lift- but are asking us to tell you that placing the implants under your muscle would give you the same benefit...

The reason this is dangerous behavior on your part is because I can assure you that if you continue to look for a surgeon who will tell you that you can have what you want without a breast lift (or with a breast lift that only requires a cute little scar), you will find one....

And only after the operation will you realize that you did not get what you wanted (lovely, naturally perky looking round breasts), but rather funny looking breasts with a cute scar on them.

The most unhappy women I ever meet in my office are those who needed a breast lift, but didn't want one, and so found a surgeon willing to offer them a shortcut- and now they have funny looking breasts.

You need to be careful and not have ANY surgery until and unless you are ready to have the procedure that is truly likely to achieve your goals.

Armando Soto, MD, FACS
Orlando Plastic Surgeon
4.8 out of 5 stars 157 reviews

Have the right operation!

Only a mastopexy will lift the breasts. If you exchange implants now, the mastopexy can be performed at a later date. 290 cc implants would not account for a B to F cup increase. I agree that submuscular insertion may produce a poor cosmetic outcome.

Robert L. Kraft, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 39 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.