Have my breasts fallen since surgery? Do I need a lift? (Photo)

With such heavy implants, you will sag over time from the weight and stretching and thinning of your own tissue. However, right now you are fine just based on 2 photos. Please discuss any concerns you have with your surgeon.

After surgery it is common for the implants to be very high and "tight" as the soft tissue envelope of the breast has not had time to accommodate the new volume. This can be particularly notable in subfascial/subglandular augmentations. A 500cc implant in a subfascial position might cause some problems with lower pole stretch, as this is quite a large implant without any muscle coverage. This is my own personal opinion.

As a plastic surgeon, it's essential to have an open and honest conversation with patients regarding there concerns. Firstly, breast sagging a year after breast augmentation can be influenced by various factors, such as your weight loss, your breast and nipple ptosis (droopiness) before surgery and the technical aspects of your sub-fascial implant placement. It's also important to understand the other specifics of your case, including your age, skin elasticity, and breast tissue characteristics, to determine the best approach.

Based on the photos you have provided, a breast lift, also known as mastopexy will be recommended by most board-certified plastic surgeons. This procedure is required to raise and reshape sagging breasts - to create a more youthful and lifted appearance. This procedure is appropriate and maybe necessary for patients who have experienced breast sagging, especially after having large breast implants.

While scars are inevitable with a breast lift, they typically fade over time and become less noticeable. It's essential for you to have a thorough discussion with a board-certified plastic surgeon about your concerns regarding scars, so the surgeon can explain the expected results and their specific surgical techniques and after-care steps that can be taken to minimize scarring.

One other important option to address regarding your problem is the addition of an Autologous Dermal Matrix (ADM) as an “internal bra” to support larger breast implants (that are known to accelerate breast and nipple ptosis or “sagging”). ADM is a biological material that can provide additional structural support to the breasts, potentially helping to improve the shape and reduce sagging over time. This procedure might be suitable for some patients, but individual considerations must be made - the plastic surgeon’s experience with this material and the extra cost. ADM can cost as much as two breast implants.

It is important to emphasize that a thorough consultation with a board-certified plastic surgeon (drreichner.com) is essential to assess your unique situation accurately. We have the expertise in handling cases like yours and can provide personalized recommendations based on your needs and goals.