Recurrent ptosis of breasts
Some recurrence of ptosis is common early after surgery in patients who have lost a great deal of weight.
It's also common in patients with large breasts or implants.
I'm glad you are overall pleased with your results! Like most well designed surgeries, we hope for a net significant improvement!
Breast lift breast augmentation sagging
Roacharama, thanks for the photos and details of your surgery and weight loss. It does appear that your skin has relaxed and the implants are lower than I'm sure you or your plastic surgeon want. After massive weight loss the skin does not have much elasticity. If you ask 10 different plastic surgeons, you would get 10 different answers. Doing a breast lift and augmentation is a hard procedure especially in someone with massive weight loss. I usually stage those patients because when you lift at the same time you do a augmentation you are doing two opposing procedures. The lift is making the breast tighter and the implants are making them bigger....exactly opposing forces. My opinion is if a patient wants the best results, they need to stage the procedures. If a patient insist I do the procedures together, I tell them there is a 20-30% revision rate because there are too many variables doing the procedures at the same time. I will occasionally do a augmentation lift together, but this changes patient to patient depending on how much "sag" they have.
Now, how does that help you? Well, you need to go back to your Plastic Surgeon and discuss your concerns. None of us like an unhappy patient. If the implant moves around too much you may need the pockets tightened and you may need more skin removed, but only you and your plastic surgeon can decide on that. Good luck.
Results after an augmentation lift when starting with tuberous breasts
are good... but what you expected was not achieved. Did you communicate this to your surgeon? If you did, you should be able to discuss your results with your surgeon and see if there are ways to achieve what you desire. Realize that it will cost more and you should know what your surgeon's revision policy is. Your results are good and you should be supporting them with a good bra. With massive weight loss, its even more challenging to get a tight pocket.
You appear to have naturally low breasts on your chest. No one can change the location of the base of your breasts. Breasts should naturally fall to the sides when you lay down. From what you described prior to surgery, you look good. I would suggest meeting with your surgeon and discussing all your concerns.
My breasts are sagging 3 months after an augment-lift. Bottomed out? Implant displacement?
Although it does appear as though your breasts are still somewhat ptotic, it does not appear as though you have bottoming out or displacement of the implants. Its tough to know for sure without seeing what you looked like before, but based on your description it sounds like you have a very good result by comparison. Being overly aggressive in lifting the breasts can result in significant complications including necrosis of the nipple so it is likely that your surgeon did the most aggressive lift that was safe.
You can't cheat Mother Nature
When you have had massive weight gain followed by massive loss, your tissue elasticity will never be good. This makes it impossible to have high full "perky" breasts. You just need to reset your expectations because you look to have had well performed surgery and I am sure they are much better than they were before surgery. Be happy!
It is very difficult to evaluate your results without first seeing a preoperative photo and physical exam. In my experience, massive weight loss patients have poor elastic skin properties and the skin tends to stretch more than those patients who undergo a breast lift without such significant weight loss. You should discuss your results with your surgeon and voice your concerns.
Would have been better to have lift first then implant later
The combination of lift with implants can sometimes result in outcomes that the patients were not adequately prepared for. A staged lift first with subsequent implant can give a much higher tighter look because of the technical limitations of of under lifting in order to fit an implant in one surgery.