Are my Breasts Still Sitting Low After Breast Lift and Augmentation?

You describe two separate issues:  the shape of your breast, and the presence of rippling.  Rippling is due to the palpability of the implant through the tissue.  Thinner patients will have more rippling especially with implants placed in the subglandular position.  Thinner patients are also more prone to stretching due to the lack of elasticity in their tissues. 

Your breast may have had a higher position if you had had a T-scar type mastopexy instead of a lollipop, but your results are acceptable.  Although the rippling appears to be better when you pinch your breast to simulate a higher lift, the rippling will not change much if you relift your breast.  A different style implant may help. 

I would give yourself more time for your breast shape to stabilize, then discuss the issues with your plastic surgeon.

Your results are very acceptable in my opinion. Whether or not the implant position is high enough is a matter of personal preference. If the implants were placed in the subpectoral position and the mastopexy was slightly more aggressive, the implant could look higher and more youthful. But your breast shape, scarring, and position are quite good. You have a very thin skin envelope which explains the rippling despite using the cohesive gel implants. My personal preference for you would have been a subpectoral or at least a subfascial implant pocket location. 

After 8 weeks your breasts have not yet fully settled after surgery.  You have nice results but the final judgement can only come after things have settled completely.  You should wait until at least three months after your surgery before you can tell whether or not you will be happy with your results.

Sincerely,

Martin Jugenburg, MD

 When dealing with a deflated breast like yours I have found that it is necessary to place the nipple areolar complex higher than you might usually expect for a standard mastopexy.  I think this occurs because the skin lack descent elasticity.  

Hello,

You will get different answers depending on whom you ask.  The implant position is the foundation of the breast shape so it is important to establish the optimum  breast implant position prior to determining the amount of lift needed etc.  If you look at your before photos and imagine where you would draw the position of the implant in its ideal location for your chest it would be slightly higher than your current implant position.  I am a big fan of subfascial breast augmentation but not everyone is an ideal candidate for this.  Significant breast skin and soft tissue laxity is one factor that should be weighed carefully when the implant is considered to be placed in the above the muscle position.

All the best,

Dr Repta

In my opinion you have a long chest and this makes your breasts look lower. I think the location of the implant is adequate and it would've been very difficult to raise your stress higher.

The rippling on the side of the breast may be something that would have to be treated surgically by changing the pocket to below the muscle or using dermal matrix like alloderm to support lower outer quadrant of the breast and treat the rippling.

Your breasts have a reasonable shape right now but won't maintain this long term. With your implants in a submammary pocket, you can expect that they will descend over time with elongation of your breasts and thinning of your skin (providing all other factors such as weight don't change). 

Another issue that you have noticed is the rippling which is seen both with saline and silicone (less commonly)  implants that have been place in a submammary pocket. This will be a chronic problem which worsens with certain positions and is directly related to the thinness of your skin.A submuscular position would have been a better choice.

Rippling of the breast after impalnt placement has to do with the amount of soft tissue present between the implant and the skin.

Photos indicate an acceptable result. I question the type of implant because of the "ripples". But if you are not happy than repeat lifting with a larger implant like smooth HP silicone memory gels. 

Your photos show a very good result from breast lift. The nipple should sit above the breast fold, front and center on the breast, and the nipple should be just about the mid point of the upper arm. Your result is spot on and you will not need a lift again in the future.
Best of luck, peterejohnsonmd.com