6 months post breast lift revision, already sagging. What can be causing this and what are my options?

Question

Hello! I had a breast lift 6 months ago and my breast are already sagging. I had previous lift with implants a year and a half ago and did a revision because of the sagginess. My doctor says that it is due to the elasticity of my skin and that the solution may need to be getting multiple lifts until the skin stops giving - similar to people that get many facelifts, eventually the face stops moving. I don't want to get a third lift to have the same issue happen, thoughts?

Anna Steve, MD · Answer

Supporting a revision breast lift with an internal bra may help prevent future recurrence of droop after subsequent breast lifts. There is an absorbable scaffold made of a material called P4HB that acts like a scaffold for your body during the healing process. It's absorbed and replaced by a strong layer of collagen.

Daniel Barrett, MD · Answer

Dear Forceful850466,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Ronald J. Edelson, MD · Answer

The sagging may well be due to the loss if elasticity if your skin. You have too much excess skin in the lower portion of your breast. It needs to be tightened by cutting out the extra skin.

Farbod Esmailian, MD · Answer

Sorry to read about your disappointment. Judging by the photos, I would say you dont need to redo the entire lift but to remove the excess skin and tissue in the lower pole (the area below the nipple/areola), essentially an "inferior mastopexy". You have excessive lower pole stretch. In addition to remove the skin and tissues, a capsulorrhaphy would also be needed to support the implant and prevent future stretching of the skin.

Hope that helps.

Hope that helps.

Connie Hiers, MD, FACS · Answer

Recurrent sagging is due to the quality of your skin. Sagging stretched skin does not hold well. For your next procedure, you will need an internal bra for more support, and I would suggest going somewhat smaller so there is less weight on your tissues.

Cassie Nghiem, MD · Answer

Hi Forceful850466, great question! It's hard to give you a definitive answer without an exam, but there are maneuvers to help support your breasts. The "internal bra" is a dissolvable mesh that can help support the weight of the implant and tissue. This mesh gives an extra layer of support so your skin isn't the only thing supporting the weight of the implants. Getting a smaller implant is also an option, which would place less weight on the implant. Unfortunately, I don't see any easy fixes without surgery.

Darryl J. Blinski, MD · Answer

Based on the nicely posted photos I would recommend revision of inverted T lift only with ACM grafts. Fee $8,500+ Best to virtual consult with....

Victoria Aimé, MD · Answer

Hello! I'm sorry to hear about your experience. Yes, tissue elasticity and skin tone play a part in breast sagging/drooping (medically called breast ptosis) and this is largely determined by genetics and life experiences (i.e. more likely in patients that have had significant changes in their weight and/or have a history of smoking). Breast implants also contribute to this where the larger the implant, the heavier it weighs down on the breast envelope and more tendency for the breast to droop. It is also more likely if the breast implants are placed above the muscle as only the skin is holding the implants up and the skin has a tendency to stretch. If you decide to undergo another breast lift, I would recommend placement of mesh to help support the breast implants higher on your chest wall and a revision to the lower breast tissue to remove some of the remaining breast tissue that is sliding down with redraping of the lower breast pole to give a tighter, but still rounded breast shape. Your scars are still pink so I would suspect that your surgeon will want to wait until 1 year out from surgery for any further revision to allow everything to fully heal and the scars to mature. Wish you all the best!

Jose A. Munoz, MD - Account Suspended · Answer

Hi and welcome to our forum!From your photos, I note that your breasts are bottoming out. While the distance from the top of the breast bone to the nipples appears normal, the distance from the nipples to the fold beneath the breasts is increased. There is loss of superior breast pole volume. The nipples sit high on the breast mounds.When pregnant or overweight, the skin's dermal elastic fibers rupture due to stretch, resulting in the loss of elasticity (like an old rubber band). The skin will stretch over a greater surface area and will predispose to further sagging. You have already undergone several revisions, unfortunately with recurrence. Your skin apparently cannot tolerate implants of this size. Revisit your plastic surgeon and consider another lift with smaller implants.Best wishes...

6 months post breast lift revision, already sagging. What can be causing this and what are my options?

Answers (9)

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