Does breast augmentation on older female require additional periodical maintenance as the sagging continues in the breast?

Question

I am 55 year old female who had mastectomy and later implant on my right side, and now one fat grafting. My left side had been reduced to Size B, but now it started to sag. I though breast augmentation with implant should lift my good breast up and also flatten it a bit in order to get some symmetry. But my Surgeon said that I will require “maintenance” every 2-3 years because the natural sagging continues. I thought once the implant is in, no further “work” requires on it.

Christine Fisher, MD, FACS · Answer

Hello and I understand your concerns. Without at least photos, it is very difficult to assess your concerns and the best correction options for you. I can say that every woman and every breast is different when it comes to breast reconstruction and if reconstruction was only performed on one breast, it can be more challenging to ensure symmetry between the two. If you are uncomfortable with the advice given by your current surgeon, there is nothing wrong with scheduling a consultation with another surgeon to get a second opinion. Make sure the surgeon you choose is board-certified and has extensive experience in breast reconstruction procedures. Good luck to you!

Marc Pacifico, MD, FRCS(Plast) · Answer

Dear YelenaMany thanks for posting your question. One inescapable fact is that we will continue to age, and that will affect the breast as much as anywhere else. Your surgeon is right to consider how your breast will age when discussing procedures to address your asymmetry. An implant in a breast (all other things being equal) will be stable, but the breast will age, lose support and sag over time, and over the implant.Therefore, at some point, to address this "waterfall effect" surgery may be indicated in the form of a breast lift.There is no right or wrong about what do to, but I think  it was appropriate for your surgeon to ensure you considered this factor in your decision making.Good luck

F. Ryan Wermeling, MD · Answer

Thank you for sharing your excellent question!  I counsel my patients that implants are never lifetime devices as gravity and aging continue to change the breast.  Some patients may need additional surgery at some point to correct the natural aging.  However, that does NOT mean that every patient will require surgery to correct things.  Particularly in your case with an implant on one side and a reconstruction on the other your breasts may age differently.  You always have the option of a small procedure to regain some symmetry.  But if you are satisfied with the appearance of your breasts you would not need any sort of "maintenance."  
In general breast augmentation in an older patient is no different than in a younger patient but your plastic surgeon will take into account the differences in skin and breast tissue quality that will affect placement of the implant.  In any augmentation it is critical to place the implant in a precise position that can limit drooping of the implant with time.

Aditya Sood, MD, MBA, FACS · Answer

Thank you for your question! Adding an implant to your left side may indeed require 'maintenance' in terms of addressing any ptosis or sagging that forms over time. I am unclear as to whether your right side was radiated, and if it was it will remain slightly harder/flatter/higher. A reduction, as you have had on your right side, is a great way to try and match the reconstructed breast, and if you add an implant you may require either immediately or in the future a lift to help fight the gravity effect. best of luck!

Alex Senchenkov, MD, FACS · Answer

Breast asymmetry is vexing issue of breast reconstruction. You had mastectomy on the right with implant based breast reconstruction, followed by a symmetry breast reduction to B-cup size on the left.
The right (reconstructed) breast is tighter because it has less skin and is prone to development scar deposites around the implant (periprosthetic capsule). This reconstructions are likely require revisions. In fact, your chance of getting revision is around 70% within 7 years, the data showed. This will be considerably lower if you choose the breast reconstruction with your own tissue (from the tummy tuck - DIEP/free TRAM flap).
The left breast sagging is age-appropriate and cannot be stopped. Symmetry revisions are often needed. These are less frequent if you try to match to the contralateral DIEP flap reconstruction that will sag more that the one based on the implant.
The more symmetry and asthetics you desire the more revisions you may need to have and the more time the surgeon will need to work on you. That said, you should not be discouraged and the results of well-performed reconstructions are superb. We aim to make them better than the original breasts. 
I wish you best of luck.

Does breast augmentation on older female require additional periodical maintenance as the sagging continues in the breast?

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Answer: Breast Reconstruction

Answer: Breast Reconstruction

Answer: Breast asymmetry correction

Answer: Breast asymmetry correction

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Does breast augmentation on older female require additional periodical maintenance as the sagging continues in the breast?

Answers (8)

Answer: Breast Reconstruction

Answer: Breast Reconstruction

Answer: Breast asymmetry correction

Answer: Breast asymmetry correction

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Recommended reading

Everything you need to know about Breast Reconstruction

Our mission is to create a world where every investment in modern beauty is Worth It.