Implant Replacement After Having Kids. Will a Larger Implant Work Instead of Lift?

I am 39, 5'7, 145lbs - In 96 I had smooth/round saline implants via periareolar incisions positioned subpectoral, on the right 375 and left was 360cc I have since had 2 children and nursed both of them for 1 year + - weight gain and loss..And now see some loose skin. I am interested in Silicon replacements and can't afford to include a lift - Will a slightly larger gel implant help with upper pole fulness? Also, what profile implant do you recommend?

Doctor Answers 10

Will droopy breasts benefit from implant placement without lifing?

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In my experience, implants in droopy breasts without mastopexy (lift) will result in larger droopy breasts due to the increased weight.  The droop is not only caused by loss of volume, but also loss of elasticity, and enhanced by gravity.  Implants may help to restore lost volume, but also work against the other two forces.  Be very careful to discuss this with your surgeon to avoid being disappointed if you choose augmentation for the wrong reasons. 

Implants alone do not lift breasts

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Exchanging a smaller implant for a larger one to correct drooping creates the illusion of correction by adding more volume to the upper part of your breast thus taking away from the bottomed out breast. However, the position of your breasts is not lifted. It may look good, especially when you wear a bra. However you have to understand you are only masking the real problem, and having a larger, heavier implant, will over time cause even more drooping. One day you will need a real lift. Thus in your situation and given your pictures, your plan may give you good temporary improvement and it will buy you time to save up for a formal lift later down the road. Sincerely, Martin Jugenburg, MD

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 521 reviews

Whether or not you need a lift depends on what you are looking for.

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Dear papillon39,

This type of question ("do I need a lift?") always elicits varying responses from surgeons. The answer ultimately depends on what the patient is seeking. Here are some questions to ask yourself:

  1. Do you want your nipple position to be higher on the breast mound? If yes, then you should have a lift.
  2. Do you want the entire breast mound to be higher on the chest (IE do you want the breasts to be lifted higher on the chest wall)? If yes, then you should have a lift.
  3. Is your nipple position well below the breast fold? If yes, then you should have a lift, unless you don't mind a sub-optimal appearance (when in the nude). If the nipple position is at the fold, you can get away without doing a lift, assuming you answered 'no' to questions 1 and 2.
  4. Do you have nipples at differing levels that you want corrected? If yes, then you should have a lift.

Your specific question did not state an obvious reason for wanting a lift, aside from the reference to some loose skin. A lift will tighten up the skin, but I am not sure whether you mentioned the loose skin as a complaint, or assumed that loose skin is an indication for having a lift. 

Yes, a breast augmentation will increase upper pole fullness, regardless of what implant profile is used. A high profile implant will give more upper fullness than a regular profile implant; if you are looking for more of an exaggerated upper pole, go with the high profile.  If you want a more natural (but still fuller) look, go with the regular profile. Hope this help, good luck.

Best regards,

Lawrence Tong MD FACS FRCSC

Lawrence Tong, MD
Toronto Plastic Surgeon

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Sometimes breast augmentation alone can help provide a lift

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A breast lift can help make your breasts perkier in appearance. You can also consider the Allergan Inspira Truform 2 (formerly known as Soft-Touch gel) with a smaller base width to give you more projection. These implants are slightly firmer to maintain their shape better, but still retain their natural feel. However, a successful outcome depends on your expectations and the experience of a board certified plastic surgeon.

Breast Implant Exchange and Lift

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Yes, larger  high profile implants will give the illusion of a slight lift as well as fill the upper pole. They will not however truely move the nipple up to a higher position on the breast.  Be certain that you will be happy with this small change and that you wish to increase your overall breast size.


Dr. Pedy Ganchi

Pedy Ganchi, MD
Ridgewood Plastic Surgeon
4.9 out of 5 stars 98 reviews

Bigger implants vs. Adding a breast lift is a very common question.

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This planning discussion is very and neither approach is without tradeoffs. In order to increase the firmness and fullness of your upper breast you need to better fill out your stretched breast. A larger and more projecting implant will accomplish nice improvements and would meet your goals in the short term. However, your new implants will need to be 450 cc or larger. Even if you do not mind having larger breasts, larger implants will accelerate the streching, thinning and drooping of your breast shape. Frequently patients return in 1 or 2 years with the same problem but now with larger, heavier and more damaged breasts. Choosing a similar or smaller volume gel filled implant combined with a mastopexy may result in a better breast shape that will require less maintenance. Neither approach is perfect but only can decide what you want in the short term and what you are prepared to do and pay for as your breast shape continues to age. Dr. Mosher

Mathew C. Mosher, MD
Vancouver Plastic Surgeon
4.5 out of 5 stars 34 reviews

Lift and implant

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A larger implant will give you more fullness, but I think you will need at least a circumareola lift to place the areola in a bit higher position.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Will implant or larger breast implant give the breasts a lift?

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The answer is yes.  Is the lift real?    Well kind of, sort of, or indirectly at least.   If breast ptosis is not profound then larger breast implants will give the impression of a lift and this is a technoque I employ when appropriate.  This indirect lift saves longer and more incisions and saves money.  I feel lifts of one sort or another are often done when an implant alone will sufficeand  will give a lovely result.   Surgeons vary on this and some are hard line lifters and some are hard line avoiders of  the lift.  The answer is usually somewhere between.   Get 3 opinions and see where you are. Its either cut the extra skin away or fill the extra skin up....right?  In my opinion, from review of your photos a larger implant is very likely to please a person with the anatomy of some extra skin but not much nipple descent.   Go for an implant about 100 cc or more larger....high 400s or low 500s.  I think this will give you what you are seeking.  In 5 or 10 years plan for another procedure , which at that point would be a verticle uplift.  NEVER, NEVER, NEVER do an inverted T uplift.  That procedure is best relegated to ancient history. The verticle lift is quicker, has a shorter scar and just looks a whole lot better and more natural.   My Best,  Dr Commons

Larger Implants Versus Mastopexy / Breast Lift

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While larger implants may temporarily make improvement, the added weight of the implants will continue to stretch out your skin.  My suggestion would be to do an augmentation and mastopexy at the same time to achieve the best results.  However, it is your body and you have to choose what is best for you.  Alternatively, you could choose to have the new implants and then have a mastopexy at a later date.  


Good Luck.

Implant replacement vs lift

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From the looks of your pictures at some point you would likely benefit from a lift, the trade-off being the scars. Saline implants from the 90's were mostly moderate profile implants which were often under-filled leading to superior pole collapse. Switching to larger high profile gel implants (for example Natrelle style 20 or 45) should give you the fullness that you seek, at least in the near term. Since the implants are not filled with helium the additional weight may eventually result in more breast sag making a lift more necessary. Hope this helps!

Marcel Daniels, MD
Long Beach Plastic Surgeon

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.