Saline to silicone exchange with no lift? Will it cause a problem with sagging in the future? (Photo)

Your breasts are a little low but they look pretty good to me. I don't see what benefit it is to get larger implants. I would leave it alone,

450 cc saline implants weigh 1 lb each. Your breasts are falling inferior and laterally and will continue to fall over time. Adding larger implants will not solve the problem but make it worse. I recommend a lift using The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained, if not injured during your previous surgery. At the same time, fat transfers or smaller implants can be placed.

Best Wishes,

Gary Horndeski, M.D.

Good afternoon,
While a donut mastopexy is not the full answer, it's better than no lift at all in your situation- I would ask your PS if they would be willing to do that for you at the same time during your upcoming surgery. What you really need is the Internal Bra, but your surgeon probably doesn't know how to do that.

Dear Eclectic229691,
determining whether you need simply a breast augmentation versus a breast lift can be somewhat complicated. It depends on a number of factors including skin laxity and current nipple position. Generally speaking, if the nipples are lower than the inframammary line the patient will most likely need a breast lift. If the nipples are at or above the inframammary line we can generally get by with just a breast augmentation depending on the size of the implant the patient wants. I often still using implant when I perform a breast lift because it provides more upper breast fullness after the lift. To be sure a consultation with a board-certified plastic surgeon will help determine what the patient actually needs.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Your heavy implants are sagging now from the weight. A doughnut lift will not correct this. If you go even bigger, that is more implant weight to stretch and thin your tissue and cause more sagging. Please do not go larger.