Breast augmentation in 2014 - do I need a lift now? (Photos)

Question

I had a breast augmentation in 2014 They are 500 cc silicone implants. Does it seem like I need a lift now?

Jeffrey M. Darrow, MD · Answer

Thank you for your photos. From your photos it appears that your nipple/areolar complex is still slightly above your inframammary fold. Some of your breast tissue is below that fold, so you have a grade 1 ptosis. Unless the position of your nipple/areolar complex is bothering you, or the amount of breast tissue below, your inframammary fold is bothering you, no breast lift is needed at this time. The weight of 500 cc implants will tend to stretch out your tissue over time so this may be something that you will need to consider in the future, if your breasts descend more.

Semih Yildiz, MD, FEPOBRAS · Answer

A lift is usually decided by the nipple position, lower-pole skin stretch, and how much breast tissue has settled over the implant, not just by the age or size of the implants. In the photos, the breasts appear to have some lower-pole descent and skin laxity, but the nipple/areola position is partly covered, so an in-person exam is needed to judge this accurately.

If the nipple sits at or below the breast fold, or if there is a true waterfall pattern with breast tissue hanging off the implant, a mastopexy is usually needed to lift and reshape the breast. If the nipple position is still acceptable and the main issue is heaviness, size, or implant position, an implant exchange, pocket adjustment, or smaller implant may be enough. Since your implants are from 2014, it is also reasonable to assess implant integrity during the consultation before deciding on lift versus exchange plus lift.

Chet Mays, MD · Answer

Thank you for your inquiry. The best way to address your concerns and goals is to schedule a consultation with a Board-Certified Plastic Surgeon. They can listen to your goals and concerns and come up with a plan that will benefit you.

Joel Patrick Maier, MD · Answer

It appears as though you have developed some ptosis over the years. Having said that, the shape of the breast is normal and your nipple-areola complexes are centered properly over the breast mound. A breast lift will help downsize the breast and make them perkier with less breast tissue hanging off of the implant. I would not hesitate to proceed if you have these concerns. Also consider switching to a saline implant as the long term worry/cost/risk is significantly less with basically the same cosmetic outcome, I hope this helps. Thank you for the inquiry!

Moises Salama, MD · Answer

Thanks for your question. From your pictures, it seems like you would be a good candidate for a breast implant exchange with a lift. I recommend scheduling a consult for a proper evaluation. Please always consult with a board certified plastic surgeon. Take care, Dr. Moises Salama, board certified plastic surgeon.

Brian Bassiri-Tehrani, MD · Answer

This is a great question. Sometimes after many years after a breast implant augmentation surgery, the breast tissue sags over the breast implants. This is known as a waterfall deformity or snoopy nose deformity. Depending on the extent of breast sagging, different breast lift techniques can be done. If you have not checked to see if your implants have ruptured, it would be a good idea to check before surgery. It has been over 10 years so swapping out implants for a fresh pair would be a good idea. You can consider a size change too at that time too if you desire. Hope this helps!

Emre Guvercin, MD, FEBOPRAS · Answer

After breast augmentation breast tissue can fall down above the implants; this situation is called waterfall deformity. Correction is performed with breast lift surgery; implants can stay, be changed or removed according to patients desires and implant situtation.

Daniel Barrett, MD · Answer

Dear Nicky 89,

determining whether you need simply a breast augmentation versus a breast lift can be somewhat complicated. It depends on a number of factors including skin laxity and current nipple position. Generally speaking, if the nipples are lower than the inframammary line the patient will most likely need a breast lift. If the nipples are at or above the inframammary line we can generally get by with just a breast augmentation depending on the size of the implant the patient wants. I often still using implant when I perform a breast lift because it provides more upper breast fullness after the lift. To be sure a consultation with a board-certified plastic surgeon will help determine what the patient actually needs.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Leila Kasrai, MD, FRCSC · Answer

It depends on what you think. If you’re unhappy with the shape of your breasts and feel that they’ve lost their perkiness, then a lift may help resolve this issue. It is suitable for candidates whose nipples are at or below their breast fold.

Ted Eisenberg, DO, FACOS, FAACS · Answer

Lift is considered when the nipple rest at or is below the crease under the breast.From the pictures posted your nipples are not below. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Breast augmentation in 2014 - do I need a lift now? (Photos)

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