How bad is my breast ptosis and how much longer can I get away with before surgery? (Photos)

Thank you for your question and photos.The answer to this question is based completely on how much the appearance of your breasts concerns you. This would be an elective cosmetic procedure as there is no medical necessity to do anything.The implants are sitting in the same place they were 10 years ago but the breast has slipped off the implant. This is most apparent in the profile view.Aesthetically we like to have the nipple at the most projecting point of the breast. Your nipple is well below that point and breast tissue has descended past the breast fold and is resting on the chest wall.The corrective procedure for this would be implant replacement with a breast lift and  lower pole breast reduction.If you are going to have children within the next year I would wait to have surgery until after having children. If there is no immediate plan for children and you want a more youthful "perky" breast you could have surgery at any time.Good luck and I hope this was helpful.

You can 'get away' with it for the rest of your life. If you want your breasts to look better, you'll need a lift. 

Thank you for your question. Most of my patients want the most attractive breasts that they can have. You have a waterfall deformity in which not only do you have ptosis but a considerable amount of breast tissue on the inferior pole of the breast. My experience has been that performing a breast lift  without removing the infrior pole breast tissue often results in recurrence of the droop and bottoming out. I developed a procedure to treat patients with type of breast problem. The technique is called reductive augmentation which includes re positioning the implant, breast lifting, and removing tissue from the bottom of the breast. You are an excellent candidate for this. Best wishes to you.

How bad things are really depends on how perceive things.  If your breast do not bother you then leave them alone.  You don't have to have surgery unless you want a lift or you need your implants changed.  If you have silicone implants then you would benefit from an MRI if your implants are 10 yrs out.If you were to undergo a breast revision surgery, I would recommend you change out the implants at the same time that you undergo a full breast lift.  A full lift would elevate your nipple and areola to a better and higher location on your breasts as well as get rid of the excess skin and tissue that is hanging of your breast implants now (waterfall or snoopy deformity).Make certain you see a board certified plastic surgeon that has experience in breast revision surgery.Hope that helps.

While you definitely have a waterfall deformity that could be corrected with a lift, how bad it is really depends on how much it bothers you. The same goes for when you should have the lift. It’s completely subjective and when something bothers you enough that you feel like you want to correct it, that’s the time to start considering your options. Hope that helps! 

You don’t have to have breast lift surgery unless you want to. Nothing terrible is going to happen. You are certainly a good candidate to have the breasts lifted and might want to look into what’s involved regarding scars and cost.

Dear Elle2127,
breast lift is an elective procedure, it is not mandatory in any case. My preferred lift is a lollipop lift when a periareolar won't do (ie greater than 2cm lift required). The lollipop technique was created by a Canadian plastic surgeon named Elizabeth Hall-Findley and treats the breast as a three dimensional structure instead of two dimensions (anchor - lift). Most importantly it does not require the horizontal component scars that the anchor-lift requires and breasts appear much more natural, lifted, and less boxy. Lastly, the lift lasts longer because the lollipop doesn't rely on the skin to hold the breast up, its actually breast tissue thats being brought together to support the breast and hence improves longevity. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

It is up to you when you choose to have elective breast surgery. However, I would suggest waiting until you have had all the children you desire. Once you are through having your children and do want an improvement, you might consider a lift. Your implants are sitting where they have always been, but your own tissue has sagged.

You have glandular ptosis (waterfall deformity)This occurs when the implant is  fixed in position and the breast tissue starts hanging over the implant .You may be able to correct this without a lift ,by placing the implant above the muscle together with mesh support

Dear Elle 2127,The question of how bad is your breast sagging now ten years after breast augmentation may be a question that only you can answer.  There is some waterfall effect occurring, but in my opinion it is not severe.  For you, it may be severe.  The other question of how long you can go until needing a lift is unanswerable.  It will be dependent on many factors, gravitional effects, hormonal changes, support bra usage.  The one thing that you can do to prolong the need for a lift will be to wear good supportive bras at all times.  Good luck!