5’2, 28F, 3 BA surgeries: should I have a lift and move the implants to subglandular for a more natural appearance? (Photo)

Hi Montreal21,

I appreciate your inquiry about whether to proceed with a breast lift and reposition your breast implants to a subglandular position for a more natural look. Your history and the provided pictures have been very helpful in assessing your situation.

In cases like yours, the consensus among most plastic surgeons, including myself, is to favor moving the implants to a subglandular position. This change could potentially provide a more natural appearance and feel to your breasts. The necessity of repairing your pectoralis muscles will depend on various factors, including the condition of the muscles and your specific aesthetic goals.

Regarding the breast lift, if you choose to retain your current implants or opt for smaller ones, a breast lift would likely be beneficial. The type of lift - whether it's a doughnut, lollipop, or vertical mastopexy - will largely depend on the size of the implants you select and the degree of lift required. Going for significantly smaller implants would necessitate a more extensive lift.

When it comes to achieving symmetry and reshaping, physically removing breast tissue surgically tends to provide more precise and predictable results compared to liposuction. This approach would be key in addressing any asymmetry you are experiencing.

I hope this response clarifies your options and assists you in making an informed decision regarding the lift and repositioning of your implants to achieve a more natural breast appearance. Remember, the final decision should align with your personal aesthetic goals and physical considerations.

Wishing you the best in your journey towards achieving the look you desire.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS
Plastic and Aesthetic Surgeon

With a lift, I recommend staying under the muscle for better support. Otherwise, your once sagging breast must now support all the weight of the implant and is at higher risk of sagging again. I do think your implants should go down in profile, and I suspect your implants may still be sitting a little high and need to be released to drop down more. I also think a smaller implant, perhaps something like 275 and 325 or 300, will fit your tissue and frame better.

If you are dissatisfied with the volume of your breasts then I recommend smaller implants instead of liposuction. Also, I would not recommend subglandular as this would lead to higher risk of capsular contracture. If you want to change the position of the nipple-areola complex then you can use a circumareola approach to reposition them and correct the asymmetry.

Best Wishes,

Gary Horndeski, M.D.