Extremely saggy and larger silicone implants after two pregnancies, breastfeeding/ engorgement. Any suggestions?

I am 30-yo and I had breast aug in Nov 2008. High profile silicone implants under the muscle, 425 cc's each side. 6 years later, I had my 1st baby. During lactation, my breasts got engorged -- very hard and gigantic! Then I had my 2nd (and last) baby in May 2015. The exact same thing happened! Now, I can actually place 3 fingers under my saggy breasts! They've lost their vol and are very much larger & separated from each other. What should I do? How much would it cost me here in FL?

Doctor Answers 12

Saggy after two pregnancies

Hello, I'd suggest seeking consultations with several experienced local plastic surgeons to discuss your options.  In some cases a bigger implant might be sufficient to restore volume lost after pregnancy, but if there is significant sagging, a lift might be recommended as well.  

Breast Augmentation and Pregnancy

Don't do anything until you are done having babies so the breast changes don't undo any surgical improvements.

Your skin has been stretched with the pregnancy breast engorgement.  One aspect of your surgical treatment would be a mastopexy, or breast lift.  This procedure removes excess skin through incisions that area inconspicuously placed.  I don't know what to make of your statement "They've lost their vol and are very much larger..." which seems to be contradictory.  Other possibilities would be a change in the implant size to accommodate your size desires.

Be sure to find a Board Certified Plastic Surgery with cosiderable breast lift experience.

Very saggy breasts with large implants after babies??

   This is a great question and one that I get asked all the time. There is no one right answer, but the key is to have an expert consultation and examination. It sounds to me that you are very reasonable and understand that now, because of the stretching of the skin, you will certainly need skin removed to achieve the best result. For what you are describing, it would be best to perform a lift with high or moderate profile silicone implants for added fullness in order to restore a nice breast shape and volume. Spend time with a board certified plastic surgeon discussing this, and looking at various sizes before you settle on surgery.
    These surgeries are not inexpensive. To be done safely, with board certified physician anesthesiologists, in a certified surgery center you are going to pay between $7-9,000 all included. Some surgeons may even do this type of procedure in two separate stages. Don't be tempted to choose the least expensive physician, as there is no substitute for a well done procedure.

Erez Sternberg, MD
Jacksonville Plastic Surgeon
4.8 out of 5 stars 28 reviews

Post Pregnancy Saggy Breast

This is probably the most common question asked by my cosmetic breast patients with any droopiness or ptosis of their breasts. There is no absolute or correct answer. It depends on your (the patient's) expectations and desires. Just remember the implant needs to be centered directly behind the nipple, so wherever your breasts/nipple sit currently this is approximately where you can expect the implant to be positioned/settle. Breast implants alone simply add volume to your breasts. They do not lift or shape your breasts. If you are happy with the look of your breasts and just want them to be a bit fuller then a breast augmentation alone may work. In my practice, my patient's generally expect superior pole fullness/cleavage and a youthful, perky breast appearance without wearing a push-up bra so I tend to offer more lifts. Most of these patients are initially hesitant about the scarring, when in fact they should be more concerned about breast shape, contour and nipple position. I educated them that scars mature and fade over 6-12 months, when breast shape, contour and nipple position generally don't improve and, may in fact, worsen over time. In my experience you could certainly have an augmentation alone and end up with a "natural" or "matronly" result. You may be perfectly happy and satisfied with your result. However, many of my patients who chose this route then will come back with a horizontal tan line across their chests (above the top of their implants) from a sundress or tube top, asking why when they wear a sundress or top without a bra, their breasts sit low, or do not have superior fullness. I re-explain that the implant must be centered behind their nipple and that generating this superior fullness would require a larger implant combined with a lift. Some elect to have the lift, and others chose to push their breasts up in a bra to generate superior fullness and cleavage. Finally, attempting to avoid a lift by using an extremely large, high or extra high profile implant is a nothing more than a short term Band-Aid, and does not address the root cause/problem (i.e. stretched/lax and excess skin/tissue). This does nothing but postpones the lift for a short period of time and will only lead to further tissue stretch and thinning requiring an even larger lift to fix. Ultimately, this approach generates a much more complex (and expensive) surgical problem just months to a few short years down the road, so I never encourage patients to go with this approach. Some of you may then ask why some surgeons you've seen offer this approach to droopy breasts, typically without discussing the other abovementioned options and each options pros and cons. The truth is that it's far easier and quicker for a surgeon to place a large implant without regard for the durability, or lack thereof, than perform a more technically challenging, and longer, lift procedure.

Saggy post preg

It sounds as though you would at the very least need a lift and perhaps an implant exchange.I would go see a board certified plastic surgeon to get an evaluation.

Robert Brueck, MD
Fort Myers Plastic Surgeon
5.0 out of 5 stars 54 reviews

Breast changes after pregnancy: Extremely saggy and larger silicone implants after pregnancies, breastfeeding/ engorgement.

I concur with my colleagues that a breast lift and exchange of implants would be of benefit given your description. Choose only a board certified plastic surgeon. Meeting with a few surgeons will provide you with the most accurate pricing information. Best wishes. 

Karen Singer, MD
Tampa Plastic Surgeon
4.0 out of 5 stars 5 reviews

Extremely saggy and larger silicone implants after two pregnancies, breastfeeding/ engorgement. Any suggestions?

You will need a breast lift to get rid of your saggy skin and an implant exchange to smaller implants. That is the only solution to your dilemma.  Please see a board certified plastic surgeon for evaluation and to discuss your options.

Thomas Guillot, MD
Baton Rouge Plastic Surgeon
4.7 out of 5 stars 12 reviews

Post pregnancy breast changes

It sounds as if you have developed fairly significant breast changes after the engorgement during pregnancies and breast feeding. You will likely need a breast lift (mastopexy) with breast implant exchange. The breast  implant sizing depends on your expectations.  It is important that you be evaluated only by a Plastic Surgeon certified by the ABPS with an extensive experience in all aspects of cosmetic breast surgery and can show you a comprehensive gallery of his/her results with this type of procedure. The cost varies from surgeon to surgeon. I recommend that you make the decision based on experience and abilities, not cost alone. Best of luck!

Extremely saggy and larger silicone implants after two pregnancies, breastfeeding/ engorgement. Any suggestions?

It sounds like you have developed sagging of your breast off of the implants. You should see a plastic surgeon for evaluation, but it sounds like you will need a breast lift with possible implant exchange.

Extremely saggy and larger silicone implants after two pregnancies, breastfeeding/ engorgement. Any suggestions?

Go see a few in person consults in PS for implant exchange and lifting operation combinations.........

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.