How to Get Natural Saggy Looking Breast Implants? (photo)

Question

I had breast augmentation surgery done 4 years ago, Ive got 320 cc high profile silicone implanted over the muscle. I would like to have a more natural appearence, I asked my PS if I could get that with bigger implantes with medium profile and he said no, that my skin is too thigh to get the look I want (kim kardashians or sofia vergara ones) Do you agree? If so how can i make my breast skin loosen up for a closer and lower appearence?

Rigo J. Mendoza, MD · Answer

I think that you could achieve the result you want by switching to a moderate plus profile implant instead of a high profile. Also, if you want a little more fullness on lower pole than the upper, you can have the inframammary fold lowered slightly.

Vincent N. Zubowicz, MD · Answer

I don't think you can tell from a photograph or do the implants are above or below the muscle. To me the breasts appear artificially supported which occurs of capsular contracture. Dealing with the contracture is the best way to get a natural look.

Darryl J. Blinski, MD · Answer

Result looks very good for your body type. Maybe fat grafts would increase the size and keep a "natural" look.

Joseph L. Grzeskiewicz, MD, FACS · Answer

While I agree with most of my colleagues who have responded here that you have what most might consider a "nice result," to you it is not what you really want. Thus, I think it is reasonable to explore options to change your breasts if that can be done safely and rationally and it has a reasonable expectation of producing the results that YOU really want, no matter what anyone else has to say. If I understand you correctly, what you are really looking for is more fullness in the lower part of your breasts, that is, you would like more show of the breast fullness below the nipple and areola. I agree with you. I also take it that you want your breasts to be a bit larger too. You currently have 325 cc implants over the muscle, and although we don't know your height and weight, I can say that those are relatively modest sized implants, especially with the dimensions of high profile implants. If you are looking for something like Kim Kardashian or Sofia Vergara, those probably won't get you there. I also understand that you would like a more "natural appearance," and this to me means less of a round, full look on the top of the breasts. Your existing implants are above the muscle, and high profile, and this is working against that. So, what would I do instead? I would remove your existing implants along with the capsules surrounding them, and I would extend the pockets for the implants slightly lower and toward the outside to produce just a little more fullness of the breasts in those areas. Your nipples are slightly pointed down and out, and that is because your implants are too small and narrow and not placed optimally. In addition to this change in placement of the implants I would also replace them with slightly larger moderate plus profile implants, perhaps 375 cc or 400 cc. I would also change to a submuscular placement on top to cover the top of the implant and soften the contour and give you that more natural look. I would have no reservations about doing such an operation on a lady with your appearance, and I would be confident that it would achieve the goals that I have mentioned. You should have another consultation with a board certified surgeon who has a lot of experience in revisional breast surgery and can think this way, and allow him to advise you more completely about your options. Suffice it to say that I see why you are not happy with your result even though others may think that it is good, and if you are not happy with the result, then I think there is reasonable expectation that it can be improved for you. Good luck.

C. Bob Basu, MD, MPH, FACS · Answer

Based on your photo, it appears you have a very nice result. Your PS is correct. There are some limitations of what can be achieved given your skin quality and anatomy. Shooting for a "movie star's" breast shape simply may not be reasonable or achievable. And remember, you've got a good result. Trying to make changes to your result could open up pandora's box. Best wishes.

Dr. Basu

Houston, TX

Dr. Basu

Houston, TX

Scott E. Kasden, MD, FACS · Answer

You have a very nice result.

	 

	I agree with another doctor, I am not sure that they are above the muscle.

	I also agree that another operation may make them worse not better, and that you may even suffer a complication- yes it happens. 

	If you want saggy, you may try teardrop implants.  I think if you came to me I would likely say no to you because in my opinion, I would fear that the chances of improvement would not outweigh the chance of complication and/or disappointment.  I would discourage you from more surgery at this time.  Of course, if you have the cash in hand, I am sure someone will be happy to oblige, but be careful.  Just because you can, doesn't mean you should.

Leonard T. Yu, MD · Answer

People have different ideas of what looks good, "natural", "too big", just right, etc...many women would think that you have a great result...any time you do surgery, you take a chance of making things worse...you could change to lower profile implants...this would give you less fullness in the upper part of your breast and slightly wider breasts, but be careful as this may give you too much "side boob" if you go much bigger due to your narrow chest and nipple position. My recommendation would be to leave things alone.

Katherine Feliz Camilo, MD · Answer

Most patients wish to have the results you have now !  if you really want to get " natural saggy looking breast " , you have the option of changing your implants for anatomic shape  ones ( tear drop ) , or getting smaller implants in order to have saggy skin . 

	Best wishes

Cynthia Disla, MD - Account Suspended · Answer

I do  not    think   this  a   result    of    an implant over   the   muscle   from    4  years   ago ,  they really have  the  apparence   of   being  located  under    muscle ,    

	   what    you  are  asking  for    is   very   well expectable  with a    big  implant    375 -425 implant  located   in  front of  the  muscle ,    with  a  sonomamography    you can  be claer  of   location  of   your implant ,  it  is  evident  if   it is   in front    of   mucle ,  or in the  back

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