Are breast implants a realistic solution for lifting saggy breasts? (Photo)

Will breast implants improve my slightly sagging breasts without a lift or will I Need a lift as well ? My chest lacks volume because I have lost alot of weight And my breasts are far apart, deflated and saggy. I'd like to be a full C-D cup again. ( this was my cup size when I was heavier)

Doctor Answers 14

Are breast implants a realistic solution for lifting saggy breasts?

Thank you for the question and pictures.   Congratulations on your successful weight loss! Based on your photographs, it is most likely that you will benefit from breast lifting plus/minus breast augmentation surgery.  Breast augmentation surgery alone will not achieve an outcome that you will be pleased with.

You will do best by seeking consultation with well experienced board certified plastic surgeons. Ask to see lots of examples of their work and communicate your goals clearly. 

Generally speaking, patients who are considering breast augmentation/lifting surgery should understand that this combination surgery is significantly more complex than either one of the procedures done separately. In other words, the combination breast augmentation / mastopexy surgery differs from breast augmentation surgery alone in that it carries increased risk compared to either breast augmentation or mastopexy surgery performed separately. Furthermore, the potential need for revisionary surgery is increased with breast augmentation / mastopexy surgery done at the same time. This revisionary rate may be as high (or higher) than 20%. 

Personally, I find that the breast augmentation/lifting procedure to be one of the most challenging of the breast operations I perform, even compared to somewhat complex revisionary breast surgery. On the one hand, when performing breast augmentation/lifting surgery we are increasing the breast size with breast implants; on the other hand, we are reducing the breast “envelope” in order to achieve the breast lift. These two “forces” must be balanced as perfectly as possible in order to achieve the desired results. Removing too much skin/ breast tissue is problematic; removing too little breast skin/tissue can also be problematic. Remember also that patients presenting for breast lifting surgery and general have lost some skin elasticity/thickness making potential incision line healing problems and/or recurrent drooping/sagging important concerns to communicate. 

To achieve a surgical result where the breast implant and breast tissue “come together” and behave like a single breast is one of my goals but can be difficult to achieve. Essentially, we are trying to create a breast implant/breast tissue interface that feels and behaves as naturally ( as a single unit) as possible. Generally speaking, making sure that the breast implant has some sub muscular and some sub glandular component ( dual plane) and tailoring the overlying skin/subcutaneous tissue/breast tissue as precisely as possible over the underlying breast implant is key.

Despite these efforts, breast implants are after all a foreign body that don't necessarily stay where we wish they would; therefore, breast implant related problems such as positioning ( too high, too low, lateral displacement etc.) can occur and may be a reason for returning to the operating room for revisionary breast surgery. I use a “tailor tacking” technique that allows a determination of what breast implant should be used to SAFELY produce the results the patient is looking for. This technique involves use of a temporary sizer and temporary “closure” of the overlying breast skin over the sizer. The use of the tailor tacking technique is very helpful. Breast lifting involves removal of skin ( and tightening of the breast skin envelope) while breast augmentation involves expansion of the breast skin envelope. These 2 forces are counteracting each other. Again, despite these efforts, breast implant and/or tissue/skin complications may arise causing minor or significant complications. 

Generally speaking, it is difficult to achieve the “perfect” result with breast augmentation/lifting surgery, despite best efforts. Patients should be aware of the complexity of this combination procedure, achieve REALISTIC EXPECTATIONS prior to proceeding, and understand that additional surgery ( along with the additional recovery time, stress, expenses etc) may be necessary in the short or long-term. Patients should understand that the results of the procedure will not necessarily match aesthetically the results of patients who have undergone breast augmentation surgery only.

For example, some patients who wish to maintain long-term superior pole volume/"roundness" may find that this result is not achieved after the initial breast augmentation/lifting operation. An additional operation, possibly involving capsulorrhaphy, may be necessary to achieve the patient's longer-term goals ( with superior pole volume/roundness). It is helpful if patients understand that this breast implant capsule used to provide the support for the breast implant is not present during the initial breast augmentation/lifting operation. The capsule (layer of scar tissue) forms around the breast implant and may be a good source of supportive tissue during revisionary breast surgery, Including correction of breast implant displacement/malposition problems ( such as bottoming out, symmastia, lateral displacement etc). 

Potential risks associated with breast augmentation/lifting surgery include infection, bleeding, incision line healing problems, loss/change of nipple/areola complex sensation, and blood flow related issues to causing skin or tissue necrosis. Poor scarring, pigment changes, areola/nipple asymmetry etc. are also potential problems. Again, patients may experience implant related problems such as encapsulation, leakage, displacement problems ( too high, bottoming out, lateral displacement, asymmetric positioning etc.), rippling/palpability of breast implants etc. Patients may also be dissatisfied with breast size, shape, and/or how the breast implants and overlying breast tissues “interface” with one another. Occasionally, a breast implant may even have to be removed and the patient will generally be “implant free” for several months at least. Obviously, this situation can be quite physically, emotionally, and psychosocially stressful to the patient involved.

Given the complexity of the combination breast augmentation/lifting operation and the greater risk of revisionary breast surgery needed, there are good plastic surgeons who will insist on doing the procedures separately. For me, if I see a patient who needs a great degree of lifting, who has lost a lot of skin elasticity, or whose goal is a very large augmentation then I think it is best to do the procedures in 2 stages (in order to avoid serious complications). However, doing the procedure in one stage does increase the risks of complications in general and the potential need for further surgery. This increased risk must be weighed against the practical benefits of a single stage procedure (which most patients would prefer).

Conversely, if I see a patient who requires minimal to moderate lifting along with a small to moderate size augmentation (and has good skin quality), then doing the procedure one stage is much safer. Nevertheless, the potential risks are greater with a 1 stage procedure and the patient does have a higher likelihood of needing revisionary surgery.

Having discussed some of the downsides and potential risks/complications associated with breast augmentation/lifting surgery, most patients (If properly selected and who are doing the operations at the right time of their lives psychosocially) accept the scars associated with breast augmentation/breast lifting surgery as long as they are happy with the improvement in contour, size, and symmetry. I hope that this summary of SOME of the issues surrounding breast augmentation/lifting surgery is helpful to you and other women considering this procedure in the future. The attached link may also be helpful. Best wishes.  

Implants and saggy breasts?

Since your breasts are sagging (or ptotic), the best option for you to lift and restore volume would be implants in combination with a lift (also known as a mastopexy).  This will recenter your nipple areola complex over the central portion of your breasts -- based on your current photographs, your breast tissue is currently below your nipple areola complex.  I would suggest that you consult with a board certified plastic surgeon to further discuss what options would be best for you.  Good luck!

Anureet K. Bajaj, MD
Oklahoma City Plastic Surgeon
5.0 out of 5 stars 17 reviews

Implants or lift

Thank you for your question. Based on the pictures both implant and lift will give you optimal results. Please consult with a board certified PS for evaluation and to discuss your goals.

Treating Sagging Breasts

Implants only fill or enlarge breasts, they do not lift breasts.Therefore, if your breasts sag, you will need a lift in addition to the implants.

Robert T. Buchanan, MD
Highlands Plastic Surgeon
5.0 out of 5 stars 5 reviews

Are breast implants a realistic solution for lifting saggy breasts

Implants will make you breast larger, that is all. There is no lift that comes with the implant. Implants alone will leave the new mound exactly where it is now

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.7 out of 5 stars 21 reviews

No. Implants do not substitute for breast lift

Based on your photos you should consider breast lift and tightening without breast implants. You will get great results. Size is not everything.

Vasdev Rai, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 21 reviews

Breast lift

Thank you for your question, this is always a contentious topic. However in your particular situation I would save it a breast lift is needed to give a proper shape.  If you have saggy deflated skin, putting in a large implant will only contribute to this and make it worse. This is what I have to tell patients in discussion. Certainly nobody wants extra scars on their breast , however in my opinion the benefits far outweigh the risks. A lift can be a very satisfying procedure in which reshaping the breast and lifting the nipple. Good luck!

Kailash Narasimhan, MD
Sherman Plastic Surgeon
5.0 out of 5 stars 14 reviews

Breast implants cannot lift sagging breasts

Breast implants alone cannot lift sagging breast skin. Once the breasts have begun to droop, a breast lift can return them to a more youthful position. Breast implants will increase the volume, but can't correct droop. For some women, implants combined with a lift is the perfect solution. It's really important to meet with a board-certified plastic surgeon as you make this decision. An in-person consultation with a surgeon you trust is the only way to make an informed decision. 

Adam L. Basner, MD
Baltimore Plastic Surgeon
4.8 out of 5 stars 35 reviews

Lift without implants

Implants can lift your breasts some and restore volume and fullness.  Whether you want a lift will depend upon your goals.  It may be possible for you to be happy without a lift.  A thorough consultation with an experienced board certified plastic surgeon is very important and is the only way you will know for sure.  The surgeon needs to have a very clear idea of your goals as well as a very good examination of your tissues to say for sure.   Implant type and size will also play a role.  I hope this helps.

Justin M. Jones, MD
Oklahoma City Plastic Surgeon
4.9 out of 5 stars 42 reviews

Implants versus lift

Congratulations on your weight loss!  Unfortunately placing implants will only make your breasts bigger, not lift them up.  To lift them up, you will need some type of mastopexy which will require additional scars.  With an implant alone, the tissue will hang off of the implant without a nice result or they will be placed too low leading to further ptosis/pseudoptosis (sagging).  Be sure to see a Board Certified Plastic Surgeon for an in person examination who can show you before and after pictures.

Andrew Freel, MD
Baton Rouge Plastic Surgeon
4.9 out of 5 stars 12 reviews

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.