2 1/2 months post op from Crescent Lift with silicone implants and my breasts are already sagging. (photo)

Question

I'm 23 years old had crescent lift with silicone gels 2 1/2 months ago and they seem saggy already (nipples are still low and not semetrical )but I'm more worried about the flatness of my upper chest? I expected them to have nice natural cleavage instead it's just not there. Any opinions are greatly appreciated!

Richard H. Tholen, MD, FACS · Answer

While some plastic surgeons may really believe that crescent lifts actually are a good operation that actually "lifts" the breast, I do not believe you get any more than a few mm actual "lift" at all. Did you pay "extra" for the crescent lift? If you did, how much did you pay? Did you have unrealistic expectation about the degree of "lift" anticipated, or did your surgeon "talk up" this lift?Unfortunately (and I'm not saying this is what happened to you), I think there are plastic surgeons who like to perform periareolar incision breast augmentations, and then decided that if they used a superior incision instead of a more typical inferior periareolar incision, they could take out a sliver of skin and sew up the same incision they would have used anyway, but now they call it a "Crescent Lift" and charge extra. Maybe even extra operating time and fees! This is a scam since a crescent "lift" takes about 10-15 SECONDS more than a standard periareolar incision, and closure is the same amount of time. If a surgeon really feels a crescent lift is of potential value, he or she should do it at no additional charge (unless it's being done separately as a stand-alone procedure or scar revision). Just saying.Your anatomy was simply filled up--implants cannot impart shaping to the breast unless they are the form-stable cohesive "gummy-bear" type implants. Standard cohesive silicone implants (and saline ones) simply fill the existing skin brassiere. Cleavage can be made somewhat closer (anatomy permitting), but I always tell my patients that cleavage is the province of a good push-up (push-in) bra, and that I just gave her something to push up!Your results are excellent, and typical for a generous periareolar breast augmentation. I'm sorry if your surgeon "sold you" on the idea that you would be high and perky, since implants ALWAYS drop (something about gravity affecting 100% of us 100% of the time) and 97% of scars soften as they mature. Crescent lifts do not really lift much at all. Your result follows that accurately. I hope your expectations were not unrealistic, because this really is a good result that you should not be upset about (except perhaps the crescent lift part of the equation). Best wishes! Dr. Tholen

Richard J. Bruneteau, MD · Answer

The crescent breast lift is a procedure that has extremely limited value. In this particular case, it might have been inadequate for the task at hand. Under these circumstances, it's probably reasonable to perform a secondary revisional procedure to lift the breasts into normal position. This procedure should be delayed at least six months to allow adequate healing and resolution of swelling.In the interim, it's important to maintain good communication with your surgeon. Your surgeon should be able to outline a plan that addresses your concerns.

Gary M. Horndeski, MD · Answer

Crescent
lifts are insufficient to lift breasts.You would have better results with a new technique called Breast
Augmentation with Mini Ultimate Breast LiftTM.Using only a circumareola incision it is
possible to reshape your breast tissue creating upper pole fullness, elevate
them higher on the chest wall and more medial to increase your cleavage.Aligning the areola, breast tissue and
implant over the bony prominence of the chest wall maximizes anterior projection
with a minimal size implant.Small round
textured silicone gel implants placed retro-pectoral look and feel more
natural, are more stable, less likely to ripple or have complications needing
revision.Implant profile is irrelevant
in the retro-pectoral position since the muscle compresses it.This is the technique you need now to correct
the problem.You would also benefit from
smaller implants.Best Wishes,Gary Horndeski, M.D.

Joe Gryskiewicz, MD, FACS · Answer

Hi Miss Moore,Keep your surgeon in the loop.  Look at other patients who have had your exact surgery.  You will note that over time, the fullness at the top of each breast will decrease.  We would all love to have a lot of fullness stay at the top, but over time this is commonly lost to some degree after a lift.  And often a bra or push-up bra is needed to achieve this despite breast implants with a lift.  It is hard to say much more without seeing preop photos.  So revisit your surgeon, discuss this, and go online and review other outcomes, as this might help you feel more comfortable.  All the best, "Dr. Joe"

Kenneth Hughes, MD · Answer

It is a bit early to make a decision on how to proceed.  A more involved lift could remove more skin to improve the lift and roundness of the breast and the areolar position.Kenneth Hughes, MDLos Angeles, CA

John Silverton, MD, FRCS · Answer

A crescent lift is really not much of a lift. It only pulls up the upper part of the areola and tends to make the areola look long.You probably need a more substantial lift for a nice shape. You may need a lollipop mastopexy. You should see your Board Certified Plastic Surgeon for a discussion and new measurements.

Khashayar Mohebali, MD, FACS · Answer

It is hard to know without seeing your pre-operative photos if you needed more than just a crescent lift.  At this point, I would wait for about 6 months after surgery to re-evaluate to see if you need a complete lift or not.

Stephen W. Gordon, MD · Answer

Fundamentally, a crescent lift does not lift the breast, or at least not very much. Think of your breasts as a container made of skin which has a breast mound inside of it.  Insufficient skin is removed with a crescent lift to give any meaningful change to the dimensions of the breast skin envelope.  A crescent lift distorts the areolar from a circular shape to an oval shape, and not uncommonly leaves patients with scars which are objectionable. If your implant is smooth , and on top of the pectorales muscle, then your implant is also contributing to the saggy appearance..If you want your areolas to be higher on your chest, and less saggy breasts, you will have to have another more substantial breast lift, like a verticle scar type lift.

Frederic H. Corbin, MD (license restricted) · Answer

Thank you for the photos and your question.  Though an examination is really need it appears that you would have benefited more from a circumareola or circumvertical lift at your initial operationDr Corbin

Brooke R. Seckel, MD, FACS (retired) · Answer

Thank you for your question.  I am sorry that you are disappointed so early after your surgery.It is very important to understand that a combination breast lift and implants cannot create a pushup cleavage that you see one you wear a bra.  I suggest you revisit her plastic surgeon and discuss your disappointment.  Your recurrent sagging does seem to have occurred early and it is usually hoped that the implant presents will add fullness above the nipple areola.

2 1/2 months post op from Crescent Lift with silicone implants and my breasts are already sagging. (photo)

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