Is it a good idea to have a lift with preservation of 8 year old implants because my breasts sag & I have tenting? (Photo)

My PS recommends I don't go much smaller with my implants but I feel they are too heavy and I have a lot of natural tissue now as I'm 22 months post partum. I have tenting between my breast and the weight currently keeps the skin down. Will lift the breast make the skin lift more? I want smaller implants but my doctor said thats not a good idea. He said I shouldnt go down much, he advised against removal of implants, and he said we should just keep existing implants in. Does this sound right?

Doctor Answers 10

A breast lift with implant removal may be what you want

You know, the decision should really be yours. If your breasts are too large for comfort, sizing them down is completely appropriate. As you have said things have changed since those implants were put in 8 years ago. Your own breast tissue, increased by pregnancy may be enough volume. I can't really tell from your photos how low your breasts are and where your nipple is in relationship to the crease underneath the breast, but it does appear that the implant is much higher than the breast tissue. Is it possible that you have some hardening of the scar around the implant or capsular contracture?

I do not recommend switching out implants that are not causing problems simply because they are 8 years old, but it would also be only in unusual circumstances that I would not switch out 8 year old implants if we were already going to the operating room for surgery on your breasts.

I think your questions are good ones. You know your body and your breasts better than anyone else. You can likely have a nice result with a breast lift with smaller implants or with no implants at all.


Bay Area Plastic Surgeon
4.9 out of 5 stars 50 reviews

I Want a Lift and Smaller Implants But Told That Is Not a Good Idea? Should I Keep Existing Large Implants?

No, if you want smaller implants, that is your choice. The pictures shown illustrate significant drooping and large implants, as well as unfavorable scarring from a periareolar incision, presumable done for a lift in the past.  All of this can be improved with an inverted-T mastopexy (lift) and smaller implants. This procedure would elevate the breasts on the chest wall, give a more aesthetic round shape and decrease the size of the stretched-out areola as well as revise the unfavorable scar.  I have no explanation for why your plastic surgeon thought you should keep the same size implants if you want smaller breasts.  The combination of breast tissue and implants you have could be altered downwards by choosing a smaller implant and removing some breast tissue if you so desired.

Robert M. Lowen, MD
Mountain View Plastic Surgeon
5.0 out of 5 stars 43 reviews

Revision Breast Surgery

Hello,

No, this doesn't sound right.

I believe you've posted on this before. If you are contemplating a breast lift, then you can do anything you want with your implants, including going smaller or entirely removing them. 

Please do as we suggest and see a few surgeons that specialize in revision surgery. 

Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 79 reviews

Smaller implants and lift

Depending on the size of the implant you already have I would either take the implants out completely if they are small and reduce them significantly if they are large. I do think a full vertical left is warranted to lift the breast back up on the chest wall and make the areola smaller. I wouldn't recommend leaving eight-year-old implants in place either way. Good luck. 

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 43 reviews

Breast augmentation and lift

I appreciate your question.
It appears that you have implants that have slid down your chest wall into the breast itself. 
Not knowing your size, most women with this issue would benefit from a smaller implant and internal support with capsulorrhaphy or dermal matrix.
I personally like the anatomic implants for this as well. 
A lift would then bring the breast on top of the now stabilized implant
The best way to assess and give true advice would be an in-person exam.
Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.

best of luck!

Dr Schwartz

Change of Implants and a Breast Lift

I feel that you should obtain additional opinions with Bd Certified (ABPS) plastic surgeons to discuss your options.  It appears to me that you need a full anchor uplift with reduction in size of your current implants.  This should enhance your shape and reduce the stretched skin "volume" of your breasts.   Best of luck with your choices and result.

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 30 reviews

Going For Smaller Breast Implants

It looks like you had a breast augmentation with a periareolar lift prior to your recent pregnancy. At this time you have more breast tissue and more sagging. Going smaller with increase your sagging, so a lift is needed to maintain the breast shape.

The periareolar lift you had before will most likely not provide enough lift, and will cause your areolae to remain large. Switching to smaller implants and changing to a vertical (or anchor) lift will reshape your breasts and reduce the size of the areolae in the most predictable way.

The above is based on your photos. An in-person consultation will provide more information and may result in a change in plan. Other than cost savings, not sure why your plastic surgeon advised keeping current implants, but they know more about your case than any online expert. Seek a second opinion to truly learn your options.

Joseph Mele, MD
Walnut Creek Plastic Surgeon
4.5 out of 5 stars 16 reviews

Breast uplift and eight year old implants

Since you are planning a breast uplift and are also interested in having smaller implants, this is actually the perfect moment to replace your 8 year old implants going down in size. While you have no current problems with the implants, it would seem wise to take the opportunity to replace them with new ones anyway, and much more so because you may want to get a smaller size. The only questions that you should discuss with your surgeon are how small the implants should be, and what would happen if you removed the implants altogether, going for a simple uplift without replacement. This may be an option, depending on your expectations in terms of shape (fullness at the top) and on the amount of breast tissue that you already have.

Ciro Adamo, PhD, MD
London Plastic Surgeon
5.0 out of 5 stars 17 reviews

Is it good to have a lift and preserve 8 year old implants?

Based on your photos, you already had a lift with your augmentation(periareolar?). I would recommend placing new implants with your lift at the time of your surgery or not placing any and do a vertical lift, since you want to be smaller. It looks like you might have some deformity superiorly from the implants, consistent with a capsular contracture. Seek a second opinion from a board certified plastic surgeon for an in person evaluation. Good luck.

Is it a good idea to have a lift with preservation of 8 year old implants

You do not say how large your implants are, but by your photos they do appear to be quite large in addition to your own ample tissue. They also look like they may be above the muscle, and thus could have even more of a stretching effect on your skin. You look like you had a prior "donut" or Benelli periareolar breast lift, but are still quite sagging and with very large areolae. You know better than your surgeon whether you feel that your breasts are larger than you want them to be. My recommendation, not knowing your implant size and not being able to examine you, would be to reduce your implant size as much as you need to in order to get a proper anchor breast lift and reduce your areolar size. A smaller implant with a somewhat smaller breast (and smaller areola) that is lifted and pleasing in shape would be a good goal.

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.