What Results Can I Expect if I Replace my Periareoler Lift and Implants with a Traditional Lift and Explant?

After weight loss my breasts shrank from a 34DDD to a droopy 34C. I had a periareolar lift w/400cc sub-pectoral implants to avoid anchor scars. After swelling I was left with a misshapen breast (implant high), noticeable implant wrinkling, continued sag, stretched nipples, wrinkly skin and stretch marks. Are the look of my breasts and pectorals damaged permanently? I’d like to have these giant implants removed with a normal lift but am afraid it’ll look bad. My surgeon says he can fix them but doesn't recommend explant. Any advice for my situation?

Doctor Answers 6

What Results Can I Expect if I Replace my Periareoler Lift and Implants with a Traditional Lift and Explant?

In my opinion, this will create the appearance of a nipple that is well positioned but the gland will drop within the confines of the breast skin and likley leave a slighlty scooped appearance to the upper portions of the breast over a 6-9 month period. Implants or fat grafting are used to restore upper breast fullness.

Chicago Plastic Surgeon
4.9 out of 5 stars 81 reviews

Weight loss and redo breast lift

Without examining you it would be difficult to say. However, most weight loss patients need volume and you probably need the implant with some form of breast lift procedure.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

Correct your problem with a different type of lift and repositioning your implants

Your present problem is a product of the type of lift performed for the amount of loose breast skin that resulted from your weight loss. You had too much redundant skin to be effectively treated with a periareola lift. In addition the placement of the implant beneath the muscle is also part of the problem. The implant by itself is not the problem and is part of the solution.

The entire solution is to perform a lift that provides more skin removal while also repositioning the implant in a space above the muscle. There a two possible lift choices, One would result in a lollipop scar and the second in anchor shaped scar. The former will result in less overall scarring then the latter. A side benefit of these lifts will be to reduce the size of your stretched areolas. You will have to rely on your surgeons expertise as to which of these two is most appropriate for you skin excess. In addition, you will probably meet some resistance to the repositioning of the implant above the muscle.

But maintaining the implant below the muscle makes it difficult to lift the nipple areola complex into the right position in relationship to the implant. This is the reason your present implant is positioned too high. Furthermore, you do not need the implant below the muscle since you naturally have a C cup breast that will adequately cover the implant by itself. I have encountered many patients with your exact problem and have successfully corrected this problem with the steps I have outlined. If your surgeon follows these you will ultimately be happy with your results.

David A. Ross, MD (retired)
Chicago Plastic Surgeon
4.6 out of 5 stars 89 reviews

Consequences of having the Wrong Breast Lift (Mastopexy) Operation

It has been said repeatedly but it needs to be repeated -

- A Breast Implant is a lousy long-term substitute for the right Breast Lift (Mastopexy) procedure and a large breast implant is a huge screw-up substitution for THE right Breast Lift operation.

- Misguided efforts trying to "avoid breast scars" continue to screw over hundreds of thousands of women needlessly

- Chief among them - the Periareolar ("around the nipple") and Benelli Breast lift techniques are usually grossly inappropriate in women with sagging breasts associate with large weight losses. POOR choice of lift.

- Only a small percentage of women "need" Anchor / vertical T Breast Lift / Breast Reduction scars these days

The attractive Breast is not necessarily big or perky. We have all seen big and perky breasts which are far from attractive. The attractive breast is proportionate. Its nipple complex is situated in the center of the breast (directly across the the breast fold). The ratio of breast skin envelope surface to the breast fill volume are such that they are in balance.

When looking at a sagging breast, the surgeon needs to educate the woman to view how the breast SHOULD look. In massive weight loss cases, the excess breast skin MUST be removed and a distended, stretched out nipple complex needs to be made smaller. This means that there MUST be a scar around the areola and at least another scar down the breast. The ? need for a scar across the bottom of the breast would depend on which breast lift technique is used and the volume and type of implants used.

Without a photograph it is hard to advise you. But generally speaking, you may be best advised to leave the implants alone and undergo the lift you should have had ; either a lollipop or another real breast lift operation.

Peter A. Aldea, MD
Memphis Plastic Surgeon
4.9 out of 5 stars 108 reviews

Getting the lift you needed all along

From weight loss, and losing substantial breast volume you will have too much breast skin in most cases to get a good result with just a periareolar lift.  In that case you are relying on the implant to drape the lax skin rather than removing it and at best you will wind up with a baggy lower breast which is flat in the front.  

The anchor scar lift is usually needed because of the excess skin envelope.  Whether or not you can do without an implant would depend on your current breast volume and whether you desired upper pole fullness.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

Full Mastopexy and Removing Implants

Without seeing you, it is hard to tell you what the best course of action is.  A full mastopexy is a very powerful procedure, and can really reshape/ lift the breast, while removing excess skin.  It can also help correct asymmetry between the breasts.  If you take out the implants, this will result in alot of excess skin that will need to be tailored.  Without the implants, you will lose most of the upper pole fullness you have now, so downsizing the implants may be a better option.  This will decrease your size, but still provide a good shape. I hope this helps. 

Christopher V. Pelletiere, MD
Barrington Plastic Surgeon
4.8 out of 5 stars 73 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.