Natural Saggy C Cup Breast Tissue "Removal" Prior to D Size Implants? Possible?

You have a very common problem that is seen daily in plastic surgeons offices.  There really is no reason to remove your natural breast tissue before adding an implant, in fact this will make your result less attractive and lead to a higher incidence of complications. What you need is a breast lift to remove the excess skin of your breast and repositioning of your nipple and an implant to give you the overall size you are requesting. When this surgery is performed correctly your breast will look natural and the nipple will sit on the mound of your breast in a normal position. You do not have to worry about your breasts falling off the implants.

Based on the description, you may be a candidate for an augmentation mastopexy.  This is a lift with implants and is very common.  Skin may be excised around the border of the areola (circumareolar lift), or you may need a vertical lift (often called the lolipop lift).  Very saggy breasts require a wise pattern mastopexy.  This results in an inverted anchor scar.  Your lift may require excision of skin and minimal breast tissue along with placement of an implant in the submuscular plane.  In my opinion, the best look is achieved with a frame appropriate implant and a lift.  A common request is to place a very large implant in order to lift saggy tissue.  As you have implied, this merely results in a large implant that is enveloped by a persistently droopy breast. A picture would allow a more conclusive evaluation.  Hope this helps.  Good luck

It sounds like you would need an augmentation and a lift.  During the lift some times there may a be a small amount of breast tissue removed to improve shape and aid in closure of the incisions.  Removal of all of your breast tissue is neither recommended or required.

Dr. ES

What you are proposing is not done commonly, unless one does a subcutaneous mastectomy for high cancer risk. The sagging breast tissue is not the problem, but the stretched out inelastic skin. If your nipple is at the level of your breast crease, you have pseudo ptosis, which can be improved to a certain degree with an augmentation only. Without the benefit of photos, I would suggest a vertical breast lift first followed by an augmentation. An alternative to an implant would be fat augmentation of your breasts. I often see significant improvement in the skin quality from this procedure.

You are essentially speaking of a subcutaneous mastectomy with implant reconstruciton. This is a technique used in patients at high risk for breast cancer but not commonly used in the typical breast enlargement/lift case.

The correction for naturally sagging breasts is not to remove the breast tissue, but rather to resuspend and reconfigure the breast tissue while also elevating the nipple to a normal position. This is known as a mastopexy or breast lift. The placement of a breast implant to increase the volume of a breast is may be performed at the same time in select patients. However, if the lift that is necessary is significant, it is often safer to stage these two operations:


First stage is to reshape the breast and reposition the nipple

Second stage to place an implant for volume increase


Concerns with performing both of these procedures at the same time is the risk of losing blood supply to the nipple. I recommend you have at least 2 consultations with Board Certified Plastic Surgeons who perform a lot of breast surgery to find out which options are available to you.

Regarding: "Natural Saggy C Cup Breast Tissue "Removal" Prior to D Size Implants? Possible?
I have a natural 34C. My own breast is soft and very saggy with the nipple at the crease. My skin has lost much of it's elasticity. I would love to have firm breasts again, but do not want implants that have my natural sagging tissue hanging off the bottom, creating an even larger more saggy look. Is it was possible to remove all my nautral tissue, and replace the volume with an implant of the same size C or slightly larger to fill the pocket? Is this too technical of a procedure to request?"

...possible to remove all my nautral (breast) tissue, and replace the volume with an implant of the same size C or slightly larger to fill the pocket? Yes, it is possible but not advisable unless you have cancer or a high likelihood of developing breast cancer.

Breast Sagging is the result of stretching of the ligaments that hold the breast to the chest wall (the Suspensory Ligaments of Cooper) and developing excess breast skin (resulting in a higher ratio of breast skin to breast volume). Unlike a breast implant, your breast will not ripple, leak or need to be replaced. Replacing it should therefore be done as a last resort.

A BETTER option would be to have a short scar breast lift like the Hall-Findlay Breast Lift in which the sagging breast tissue is flipped up and used as an auto-implant and the breast is made perkier by changing the arrangement of the breast itself followed by the removal of the excess skin. Once the breasts are made perkier and lifted, if you need more volume, only then would either fat grafting or a breast implant be called for.

Dr. Peter Aldea

Read and re-read Dr Placik's posting. What you want is not what you need. I recommend, NO PHOTOS POSTED, a Full lift + implants. But better to see 3 boarded surgeons in your area. From MIAMI Dr. Darryl J. Blinski, 305 598 0091

It osund slike you can use a breast lift with an implants. Your native breast tissue can be lifted to enhance the result of the implant.

With loose skin and nipple position at the level of the fold under the breast, a breast lift will be required to raise the nipple and tighten the skin envelope over the implant. Removal of breast tissue is another matter, and the implants will look best if all of the natural breast tissue is present to cover and hide the implant. A proper lift will tailor the skin over the implant and make them look and feel as one.

Best of luck,

peterejohnsonmd