Is my breast lift not tight enough? Should I get larger implants for upper pole fullness? (Photos)

Question

Aug. will be 1yr exact that I exchanged my 15yr implants & had a full anchor lift w/520cc. I have no upper pole fullness and I feel the lift was not tight enough. I am 5”3 140lbs. When I lay on my back I feel like my implants swim around the pockets a little too much. They feel amazing. Do breast lift tend to have a slighter sag/droop. Thank you kindly for your advice.

Richard Baxter, MD · Answer

Breasts that need a lift by definition have skin and internal ligaments that have stretched and weakened, so all versions of breast lifts lose upper pole fullness over time. Adding implants helps in the short term, but the larger and heavier they are the more they will sag as well. a tighter breast lift can make worse scars. Probably the best option is to add support with an internal bra using Galaflex mesh.

Jed H. Horowitz, MD, FACS · Answer

hello dizquierdoThey look good, you visit or contact your plastic surgeon if you are dissatisfied with  them. #lift #result

Farbod Esmailian, MD · Answer

Given the larger implants that you have, they do tend to stretch the tissues more over time.  Given that you needed a lift is already an indication that your soft tissues have a tendency to stretch excessively.  Not sure if you implants are in front of the muscle (it does appear so), but having implants placed behind the muscle would give you more upper pole as would more cohesive implants like the Allergan Soft Touch implants.Just tightening the skin is only temporary solution and the skin will stretch over time.  If you are considering breast revision surgery, I would recommend you see a board certified plastic surgeon to discuss your options.Hope that helps.

Gerald Minniti, MD, FACS · Answer

Hello,Large, high profile implants like yours reek havoc on any mastopexy result. HP implants are narrow and projecting, like a ball, and stretch out the lower pole, leaving the upper pole of your breast empty. You would have much more upper pole fullness with a lower profile, highly cohesive, textured implant. Go visit a few ABPS certified/ASAPS member surgeons who specialize in revision breast surgery. Best of luck!

Daniel Barrett, MD · Answer

Dear Dizquierdo,Upper pole fullness is achieved with appropriate implant selection but more importantly, submuscular placement, and precise pocket dissection. The submuscular placement allows the muscle to cover the top part of the implant which allows the upper pole to appear more full. Keeping away from the lateral chest during pocket dissection allows the implant to remain higher and prevents it from falling off to the side. If you are considering a revision surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Curtis Wong, MD · Answer

can be done BUT realize that your results are considered good by everyone.  But if you're wanting more upper pole fullness still, you could either have a plication of your lower pole to shorten it and push  more volume upwards or fill the upper pole with fat grafting but if your implants settle further, it could leave a funny look to the breasts.  If you want to be larger, larger implants could be used as well but they also succumb more to gravity so watch out what you ask for.

Daniel Brown, MD, FACS · Answer

Thanks for your questions and photos.  Anchor lifts are notorious for "loosening" over time and sagging again.  Very typically patients with full anchor lifts, especially with moderate to large implants will need a revision lift in 3-5 years. You appear to have a very nice result as far as symmetry and shape, but your breast tissue has stretched and the implants have fallen.  I would advise you to see your surgeon to discus a revision lift and possible internal mesh placement for support to avoid the same outcome occurring again.Best wishes!Daniel Brown, MD, FACSBoard Certified, American Board of Plastic SurgeryMember, American Society of Aesthetic Plastic SurgeonsMember American Society of  Plastic SurgeonsCastle Connolly Top DocReal Self Top 500

Tom J. Pousti, MD · Answer

Thank you for the question. I think that you have a good understanding.  
 It can be challenging to maintain long-term upper pole fullness with breast augmentation/lifting surgery.   Sometimes a secondary operation (capsulorraphy) plus/minus the use of larger or more projecting breast implants may be necessary to achieve the upper pole fulness (high and round look) that many patients want. 
 My best advice: select your plastic surgeon carefully. Make sure that he/she has significant experience achieving the types of outcomes you will be pleased with. Then, communicate your goals carefully, as well.   The use of goal photographs and/or computer imaging may be very helpful in this regard. Working together you will come up with a good plan to achieve your goals.  
 Best wishes.

Norman Bakshandeh Day, MD, FACS · Answer

You have a very nice result. Revising the scars and tightening the skin may result in wider and thicker scars that are not as appealing

Marc J. Salzman, MD, FACS (retired) · Answer

The symmetry and shape of your breasts, in my opinion, looks quite good. All lifts, especially with larger implants will settle leading the upper pole relatively devoid of fullness. A larger implant will be only a temporary fix. In our patients, a "hybrid breast lift" seems to work well. This procedure the upper pole is filled with fat usually taken from the abdomen. Because this fat inside the breast and not behind it it tends to keep the upper pole more full. Hope that's helpful.

Is my breast lift not tight enough? Should I get larger implants for upper pole fullness? (Photos)

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