Breast Sagged 3 Year After Breast Augmentation?

Question

Hi,  I got my Breast augmented 3 years ago, with Saline implants, my breast were not sagging before the surgery. I just wanted to have the bigger look.Now 3 years later, my breast are sagging real bad and I called my Dr. and he told me that I would need a Breast lift and another implant. But the lift will leave me with an unwanted diagonal scar from the bottom of the breast to my areola. Why this happened only 3 years later? Is this normal? I am only 22 Years old, 5'10", 132 lbs. I went from B to a large C.

Jerome Edelstein, MD · Answer

Sagging can be caused by inadequate support (provided by a bra), larger implants, and the general aging process. You may have also had some sagging before your breast augmentation as well, which should have been addressed at that time. I am sorry to hear about your experience but it sounds like a lift may be the most suitable option for you at this point.

Lewis Albert Andres, MD · Answer

Hello!  Thank you for your question!  The mastopexy (breast lift) procedure raises the breast, which ultimately provides a more 
youthful and perky breasts.  This is done by 
removing the extra loose skin and rearranging the surrounding breast 
tissue in order to reshape and support the newly formed breast.  At
 the same time, the nipple-areolar complex (NAC) is raised to the ideal position above the fold beneath your breast (the 
inframammary fold) as well as being placed at the most projecting portion.  Oftentimes with age or following pregnancy, the NAC 
becomes widened and enlarged.  This may be reduced in size during the 
breast lift procedure.
It is common for the breast to lose its firmness and uplifted appearance over 
time, which is also accentuated with age, pregnancy/breast feeding, 
weight gain/loss, and gravity.  This results in breast ptosis, or 
sagging of the breast, with a “deflated” appearance.  Women seek the 
mastopexy procedure to regain the previous youthful appearance of her 
breasts and women report increased confidence, self-esteem, and 
femininity once achieving this desired shape and fullness.  Breast lifts
 may or may not be performed with implants – the implant would add 
increased size but also greater fullness in the upper pole of the 
breasts which creates more cleavage.I would discuss your 
concerns with your plastic surgeon.  Increased size of the implants as 
well as laxity of the native skin do cause increased stretching 
inferiorly.  Revisions certainly may be considered - allow your surgeon 
to examine and evaluate you and then go over which procedure(s), if any,
 will be the right one for you.  Best wishes for a terrific result!

Otto Joseph Placik, MD · Answer

This is difficult to explain and Ihave no specific answer for why you would observe rapid swelling and ptosis in a milld breast enlargement

Sugene Kim, MD, FACS · Answer

Although it is hard to comment without photos, I agree with my colleagues. You probably had sagging breasts or loose skin prior to your breast augmenation. Unless you had a large weight fluctuation, it is not likely that you breasts would sag 3 years after breast augmentation. Often times, patients ask large implants to just fill the loose skin. It is better to have appropriate sized-implants with lift than large implants to avoid lift. Th scars on breasts normally heal very well.

John P. Di Saia, MD · Answer

Hello,
You probably were in the condition that a breast lift in your first operation could have been helpful. Was this discussed at all?
I discuss this with some patients who indicate that they do not want the lift and may opt to go without it. I will discuss it before surgery when it seems indicated however just to be complete.

Michael C. Edwards, MD, FACS · Answer

Depending on your natural breast tissue laxity you may have benefitted from a breast lift with your first augmentation. I have cared for 18-20 year old women who had not had children who needed a lift with augmentation simply because of their anatomy. In somone who did not need a lift to start with and did not have large implants, it would be unusual to need a mastopexy only 3 years post-op. 
Dr Edwards

Richard P. Rand, MD, FACS (retired) · Answer

Unless you had children or significant weight gain and loss in the meantime, the only way I can imagine your needing a breast lift now is that you probably needed one in the first place.  If you go back to your original preop photos, your nipple areola complexes were probably lower than ideal and the doctor tried to get by without the lift then.  Your current implants haven't caused you to need a lift, it comes from laxity of the tissues.
The scars are necessary to get the best shape and they improve with time.

Michael A. Marschall, MD (in memoriam) · Answer

Perhaps you could provide a picture as the degree of ptosis, "sag" as it were is variable.  Sometimes confining the scar to around the areola is possible, sometimes not. Here again all would depend on the type of problem that you have.
As far as sagging after mammary augmentation, yes implants react to gravity as do the breasts themselves. Sometimes, though, the breast tissue drops over the implant and creates a "snoopy" look.  A breast lift would still be possible although, implant exchange not necessarily mandatory.
Hope this helps!

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