What can be done (if anything) to prevent lower pole from filling and stretching?

I am almost 11 weeks post op lift (inverted T) and augmentation (510 cc, mod pro, saline, sub). I had a reduction done years ago and was instantly left with no upper volume, full lower pole and very high riding nipples. New Dr raised the crease and gave me more upper volume. When he did the surgeries the distance from crease incision to edge of areola was 4 cm, now it is already 6 and 1/4 cm and the nipples are looking a little high again. I have worn a bra 24/7 since the surgeries.

Doctor Answers 6

What can be done (if anything) to prevent lower pole from filling and stretching?

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Photos will help answer this question but in general gravity is not on your side and some patients have more of a stretchable skin property.

What can be done (if anything) to prevent lower pole from filling and stretching?

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The breasts may lose their elasticity and firmness which can be caused by different factors such as pregnancy, massive weight loss, lactation and aging. To reaffirm the breasts and restore the natural look your surgeon can perform a mastopexy or breast lift. A breast lift restores a firmer, perkier, and more aesthetically pleasing shape to sagging breasts. This not only can improve a patient’s appearance by restoring her youthful, feminine proportions, but also help bras and swimsuits fit more comfortably and attractively. By removing excess, stretched out skin, reshaping the breast tissue, and raising the nipple & areola into a more forward position, a cosmetic surgeon can create a more youthful breast contour. Stretched, large areolae can also be reduced during breast lift surgery, creating an overall better proportioned, natural looking breast, Actually the perkiness on a person or another, depends on patients skin and breast tissuefor the first 3 to 4 months until your implants have settle in. I recommend you to wait and keep using your post surgical bra, that will help you with the shape and support!!

What can be done to prevent lower pole from filling and stretching

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Thank you for your question.

The good news is that after second uplift the skin usually stretches significantly less comparing to the first operation. However if your skin has a high tendency to stretch it may continue stretching a bit more.

Well done for wearing bra 24/7. In cases like yours I usually suggest to my patients to wear supportive bra 24/7 for life. It supports your breast tissue and skin from outside and partially eliminates the effect that implants are causing on the lower pole by their weight from inside. Most of the patients wear bra during the day, but during the night sleep if your breast does not have any support that is when you tissue may be stretching the most.

If even after that it continues stretching, third skin tightening should be the last one in most of cases as skin can not be stretching forever and at some point it reaches the limit and stops stretching.

I hope that helps.

Best wishes.

Elena Prousskaia

Lower Pole stretching after Mastopexy

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Hello and thank you for this question.  The problem you are having is the most frustrating aspect of breast lifts or reductions.  We call that 'bottoming out'.  It occurs because the skin and underlying tissues that support the weight of the breast (and implant) are thin and have lost their elastic strength.  Sometimes, this occurs also because of the swelling associated with the recent surgery.

In your situation, you seem to still be in the normal range of distance from nipple to crease.  I would wait minimum of six months to see if it continues to stretch.

There are some remedies for improvement.  The simplest is to re-excise some of the stretched skin.  I do this at times under local anesthesia in my office.  Other more involved treatments include placement of Strattice under the skin from edge of the pectoralis muscle to the infra-mammary crease for internal support.

Hope this helps.

Bottoming out

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  •      Six and a quarter cm is still acceptable, but I understand your concern over the rapid stretch.  I believe that most of the stretch has already occurred as your body by this time developed a capsule around the implant which hopefully should give it some support.
  •      I dont believe that that you can do anything at this time to prevent any stretch that might occur.
  • I would wait a full year and see where you settle.  If at that time you find that distance excessive then you may want to consider another revision.  I would consider using silicone rather than saline.. Saline stretches tissues more than silicone due to the "hammer effect."  This describes the fast movement of saline as opposed to the more viscous silicone which does not move as rapidly.  Additionally, the actual lift technique that you should have should not rely on the skin, but rather, on the internal fascial strucure of the breast.  Finally, there are products such as ADM's (Acellular Dermal Matrix) grafts or biologic meshes, such as Galaflex or Seri that can be used internally to help support the implants and or within the actual breast tissue to help support the lift.
  • Good Luck,
  1. Ary Krau MD FACS


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After having large breasts initially, your skin may not have the best support and be more prone to stretching. Large implants do have weight and tend to sag more. If you sag too much, you might consider going smaller or using a dermal graft for internal support.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.