4 year old implants - Do I look like I need a lift or new implants? (Photos)

From the pictures posted, results seem ok. You can always review with your original surgeon. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

You probably have different options, but it is hard to give you any guidance without an exam. It seems new implants would not help. It may be a little early to consider a lift, but depending on the exam, perhaps you have in excess of breast tissue at the lower pole which may be repositioned or removed with a lift. Your nipple position is relatively good but may also be managed with a lift.

Thanks for your question! Based solely on the photos, if you are happy with the size, cleavage, etc., I might just recommend a lower pole mastopexy to tighten up the lower part of the breast. It seems that your breast tissue is falling off the implant. However, if you would like bigger, a more projecting implant may help correct that a bit too. Good luck!

A waterfall deformity occurs as the native/natural breast ages and descends with time while the implant remains in a more elevated position. This can lead to a loss of alignment.

A mastopexy/lift can be helpful in re-suspending the tissue. You do not necessarily have to change the implants (as they are not the problem). However, it is important to remember that the lift will shrink the native breast somewhat and you may choose to offset the loss with a larger implant.

As always, discuss your concerns with a board certified plastic surgeon (ABPS).

From the photos it appears you are a good candidate for a lift. This would remove excess skin and reshape the breast for a refreshed look. You can elect to keep the current size implants or exchange them. Simply exchanging the implants without a lift would not be recommended. I've included a video I hope you find helpful.

It seems you may have a waterfall deformity, where the breast tissue has descended over the implant, causing sagging. This can be corrected with a breast lift (mastopexy). However, as with any lift procedure, the breasts will become slightly smaller due to the removal of excess tissue.
If you wish to maintain your current size or increase it, the lift can be combined with larger implant replacement during the same surgery.
Best, Süleyman Köken

Based on these photos, breast lift with or without removal of implants should be considered. In person consultation with a board certified plastic surgeon is recommended. Good luck.

Your implants are too large for your chest wall and you can see your breasts are touching in the midline. I recommend smaller implants, plication and a lift procedure.

Best Wishes,

Gary Horndeski, M.D.

Thank you for your question. Deciding upon new implants or a mastopexy requires a little more background. For example, patients entertaining this idea may have lost weight, had children, breast-fed, different size implants were placed, etc. Knowing how the breasts appeared prior to augmentation is helpful as well. The best thing to do is to discuss these options with your surgeon and if the answer is unsatisfactory, getting a 2nd opinion may be needed. Good luck with your journey!

It looks like the soft tissues are being stretched out from the gravitational pull from your implant, which is on the large side.
Having used a smaller implant may have protected you from this happening.
A breast lift and tightening the skin envelope may improve your situation.
Some plastic surgeons may also opt for securing the implant position by placing an internal bra, made out of mesh or cadaver dermal products.
Follow up with your provider or schedule a few in person consultations with other plastic surgeons in your community.
Best,
Mats Hagstrom MD