5 months post op, my breast tissue is sagging down below implant, which treatment would you recommend? (photos)

365 silimed textured dual plane. 5 months post op. My breast tissue has sagged down below implant. Doc has recommended two options: - peri-areolar lift under local anaesthetic. -fat grafts to add volume in bottom part of breast. The fat grafts sound a bit Frankenstein. He also said there's no guarantee I'll get the result I want. But I've also read that peri-areolar lifts don't give great results. I'm 100% sure I don't lollipop lift as scarring is too much. What would you all recommend?

Doctor Answers 6

Implants riding above breast tissue

  • You 100% don't want a vertical lift - so don't have it done.
  • If you wait a full year, you may change your mind.
  • If you must do something now. positioning the implant lower makes sense,
  • If money is not a concern, consider switching to a smooth implant as it can settle, a textured can't.
  • Then if that is not good enough, have the perio-areolar lift under local anesthesia.
  • Fat grafts may make the breast look bottom heavy.
  • Best wishes.

Atlanta Plastic Surgeon
4.6 out of 5 stars 43 reviews

Third option would be to have the implant sit a little lower


A third option would be to have the implant sit a little lower on your chest.  This can be done alone or in combination with a slightly larger implant.  The reason for a larger implant would be to maintain upper pole fullness while giving you more lower pole expansion.

All the best,

Dr Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 162 reviews

Sagging breast tissue following augmentation

Hi, I agree with my colleagues that you really would benefit from a vertical incision mastopexy (the "lollipop" incision).  I'm not sure that fat grafting is necessary in your case.  If you decide on just a peri-areolar incision, my concern is that you won't have enough of a lift of your tissues.  You appear to have some extra skin in the lower pole of the breast, and this is the tissue that would be excised with a vertical lift.  I suggest having a frank discussion with your surgeon about your goals and what you are willing to trade off to achieve them.  Good luck, /nsn.

Nina S. Naidu, MD, FACS
New York Plastic Surgeon
4.7 out of 5 stars 13 reviews

5 months post op

If you do not care for your nipple position a breast lift will improve this. You will need to decide if the resulting scars are worth the improvement though. It does look like you will need a vertical mastopexy if you do decide on a lift.

Lee E. Corbett, MD
Louisville Plastic Surgeon
4.8 out of 5 stars 25 reviews


If you really want your breast tissues to sit on the implant a lift is what you need.  A periareolar lift will usually move the nipple a few centimeters.  A full vertical lift will move it more.  In addition placement of a larger implant may provide a minor amount of lift.  Good luck!

Adam Saad, MD
Atlantic City Plastic Surgeon
5.0 out of 5 stars 4 reviews

5 months post op, my breast tissue is sagging down below implant, which treatment would you recommend?

Thank you for the question and photos!  It does appear in your postoperative photos that your breast tissue is drooping over the implant giving you such a deformity.  At 5 months postoperatively, it is unlikely that this will improve with time, and certainly may worsen.  I am unsure what your preoperative discussion with your surgeon included, but your preoperative photos do demonstrate significant ptosis (sagging) of the breasts with the nipple-areolar complex at an already lowered position prior to your procedure.  A breast lift certainly would have been indicated at that time, with an implant alone unlikely to correct that much of a ptotic breast.  

I do agree that a breast lift should be considered to provide you the most aesthetically-pleasing breast shape, in order to reposition your nipple to a more appropriate position, and at the most projecting part of your breast.  With as much ptosis as you still have and what appears to be some laxity of skin, a vertical mastopexy (such as a "lollipop") would give you the best result.  Scars on the breast do heal very well and the vertical incision is well-concealed.  Otherwise, a periareolar lift to purse-string the areola would also be reasonable to improve the shape, but may not yield the same result as a vertical lift.  I do not believe fat grafting would correct the appearance that you have.  Hope that this helps!  Best wishes and good luck with your decision!

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 26 reviews

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