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

Question

I had implants placed 4 years ago, shape has always been a little off but seems to be progressing. Should I get a lift or new implants?

Semih Yildiz, MD, FEPOBRAS · Answer

From the photos, the main issue appears to be implant position and lower-pole skin stretch, with some asymmetry. That can look like bottoming out or a stretched implant pocket rather than simply an implant that needs to be changed. If the implant pocket has widened or dropped, exchanging the implants alone may not correct the shape and could allow the same problem to recur.
A breast lift is usually considered when the nipple and breast tissue have dropped too low on the breast mound. In your photos, the nipple position is an important part of the decision, but it is hard to judge perfectly without an exam and measurements. If the nipple is at or below the fold, a lift may be needed for the best shape. If the nipple is still in a reasonable position but the implant pocket is low or loose, pocket repair, capsulorrhaphy, and sometimes internal support may be more important than a lift.
New implants may be part of the revision if you want a different size or profile, or if the current implants need to be changed, but they are not usually the whole solution for progressive shape change. An in-person revision consultation should assess implant position, capsule, skin quality, nipple-to-fold distance, and whether a lift, pocket repair, implant exchange, or a combination would give the most stable result.

Chet Mays, MD · Answer

Hi, Thank you for your inquiry! We here at Mays Plastic surgery would love to sit down for a consult to discuss your concerns.  A breast lift, and adding volume, whether its fat transfer to your breasts or implants.  Schedule a consultation with a Board Certified Plastic Surgeon to help you reach your goals.

Daniel Barrett, MD · Answer

Dear Polite710069,

I understand your concern. However, without a proper assessment, it would be difficult to determine what is wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Guray Yesiladali, MD, FEBOPRAS · Answer

When the breast shape continues to change years after augmentation, it is usually related more to skin and tissue laxity than to the implants themselves. In this situation, simply replacing the implants does not correct the issue and may even add more weight.
A breast lift is typically the most effective solution, as it reshapes and supports the breast tissue, repositions the nipple, and allows the implants to sit in a more natural position. If you are otherwise happy with your implant size, a lift alone may be enough. If you also want a size or profile change, a lift can be combined with implant exchange.
A lift, with or without implant adjustment, is the option that will give you the most balanced and lasting improvement
&mdash; Güray Yesiladali, MD

Ted Eisenberg, DO, FACOS, FAACS · Answer

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

Ira H. Rex III, MD · Answer

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.

Brian K. Reedy, MD · Answer

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!

Donovan Rosas, MD · Answer

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).

Suleyman Koken, MD · Answer

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

Zoran Potparic, MD · Answer

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.

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

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