Can I get implants if I have big breasts and scar tissue? (Photos)

I had a breast lift back in september 2015 and I now have scars due to the fact I was a smoker prior to surgery. Not only are my breast not as perky as i wanted (They have dropped) but they are smaller then what i want as well. Currently I am a 36C and would like to be on the DD side or whatever looks big and nice on my body. Will I have to get a reduction to get implants and how will my scars affect my new surgery?

Doctor Answers 5

Can I get implants if I have big breasts and scar tissue?

Dear Nicole8668,You could certainly place an implant and revise the scars of the lift, but I would not recommend that you do this until you are a non smoker. The weight of the implant will add stress on the healing incisions that you didnt have the first time around so you want everything to be working in your favor. The surgeon you work with will have their opinions on size and implant type. I have been happy using textured silicone implants when doing a lift because I think there is less pressure on the incisions and the scars have been looking quite good. Best of luck, 


Denver Plastic Surgeon
4.8 out of 5 stars 23 reviews

Finding the right surgeon

Far more important than the technique is the skill and experience of your plastic surgeon. Choose your surgeon rather than the technique and let them explain why one technique may be better than another. 
See the below link on some suggestions on finding the most qualified Plastic Surgeon for a breast lift. 

Complicated Breast Lift

If you have quit all forms of nicotine, implants can be added with or without another breast lift or scar correction.  See a few surgeons and keep in mind your case will require a person experienced in these more difficult cases.

John LoMonaco, MD, FACS
Houston Plastic Surgeon
5.0 out of 5 stars 256 reviews

Can I get implants if I have big breasts and scar tissue?

Provided you have continued to avoid smoking, you should do well with implants but some additional lifting will most likely be necessary. The incisions would be completely redone and should heal with much better aesthetic results.

Can I get implants if I have big breasts and scar tissue?

Yes, you should be able to undergo breast augmentation and additional breast lifting. 
Generally speaking, patients who are considering breast augmentation/lifting surgery should understand that this combination surgery is significantly more complex than either one of the procedures done separately. In other words, the combination breast augmentation / mastopexy surgery differs from breast augmentation surgery alone in that it carries increased risk compared to either breast augmentation or mastopexy surgery performed separately.

Furthermore, the potential need for revisionary surgery is increased with breast augmentation / mastopexy surgery done at the same time. This revisionary rate may be as high (or higher) than 20%. Personally, I find that the breast augmentation/lifting procedure to be one of the most challenging of the breast operations I perform, even compared to somewhat complex revisionary breast surgery. On the one hand, when performing breast augmentation/lifting surgery we are increasing the breast size with breast implants; on the other hand, we are reducing the breast “envelope” in order to achieve the breast lift. These two “forces” must be balanced as perfectly as possible in order to achieve the desired results. Removing too much skin/ breast tissue is problematic; removing too little breast skin/tissue can also be problematic. Remember also that patients presenting for breast lifting surgery and general have lost some skin elasticity/thickness making potential incision line healing problems and/or recurrent drooping/sagging important concerns to communicate. 

To achieve a surgical result where the breast implant and breast tissue “come together” and behave like a single breast is one of my goals but can be difficult to achieve. Essentially, we are trying to create a breast implant/breast tissue interface that feels and behaves as naturally ( as a single unit) as possible. Generally speaking, making sure that the breast implant has some sub muscular and some sub glandular component ( dual plane) and tailoring the overlying skin/subcutaneous tissue/breast tissue as precisely as possible over the underlying breast implant is key.

Despite these efforts, breast implants are after all a foreign body that don't necessarily stay where we wish they would; therefore, breast implant related problems such as positioning ( too high, too low, lateral displacement etc.) can occur and may be a reason for returning to the operating room for revisionary breast surgery. I use a “tailor tacking” technique that allows a determination of what breast implant should be used to SAFELY produce the results the patient is looking for. This technique involves use of a temporary sizer and temporary “closure” of the overlying breast skin over the sizer. The use of the tailor tacking technique is very helpful. Breast lifting involves removal of skin ( and tightening of the breast skin envelope) while breast augmentation involves expansion of the breast skin envelope. These 2 forces are counteracting each other. Again, despite these efforts, breast implant and/or tissue/skin complications may arise causing minor or significant complications. 

Generally speaking, it is difficult to achieve the “perfect” result with breast augmentation/lifting surgery, despite best efforts. Patients should be aware of the complexity of this combination procedure, achieve REALISTIC EXPECTATIONS prior to proceeding, and understand that additional surgery ( along with the additional recovery time, stress, expenses etc) may be necessary in the short or long-term. Patients should understand that the results of the procedure will not necessarily match aesthetically the results of patients who have undergone breast augmentation surgery only.  
Potential risks associated with breast augmentation/lifting surgery include infection, bleeding, incision line healing problems, loss/change of nipple/areola complex sensation, and blood flow related issues to causing skin or tissue necrosis. Poor scarring, pigment changes, areola/nipple asymmetry etc. are also potential problems. Again, patients may experience implant related problems such as encapsulation, leakage, displacement problems ( too high, bottoming out, lateral displacement, asymmetric positioning etc.), rippling/palpability of breast implants etc. Patients may also be dissatisfied with breast size, shape, and/or how the breast implants and overlying breast tissues “interface” with one another. Occasionally, a breast implant may even have to be removed and the patient will generally be “implant free” for several months at least. Obviously, this situation can be quite physically, emotionally, and psychosocially stressful to the patient involved.

 In my practice, I ask patients to avoid  nicotine in all its "modalities' of delivery 6 weeks prior to surgery. It is a powerful constrictor of blood vessels, decreasing blood flow to the “flaps” used during these procedures. As you know, this decreased blood flow could potentially lead to wound healing problems and/or tissue necrosis. 
I hope that this summary of SOME of the issues surrounding breast augmentation/lifting surgery is helpful to you and other women considering this procedure in the future.  The attached link may also be helpful. Best wishes.


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.