Sagging Breasts After Breast Implant Exchange

I recently had implant exchange. I also had a capsular contraction in one breast. Before the surgery, my breasts were sloped, but not hanging. After surgery, to my horror, my breasts were hanging much lower on my chest. I'm still not satisfied and my surgeon claims he can't do anything about it. Now, I must always wear a support bra to lift my breasts. Another surgeon agreed to do a breast lift. But I am wondering, what happened? Could the doctor have removed some of my own breast tissue during the implant exchange, causing my breasts to hang lower now?

Doctor Answers 8

Whatever the cause, it sounds that at this point you need a breast lift

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It's difficult to comment without seeing your before and after photos, but a couple of thoughts come to mind:

First, I doubt your surgeon removed any breast tissue or did anything improper. What he likely did was remove the old implants and capsule and replace them with new implants. Now, these implants may be a bit too small for your breast pocket that was left after the old implants were removed, but this is tough to know without photos.

Second, at this point, it sure does sound like you need a mastopexy, or breast lift. If done well, it should give you a nice, durable result. The cost of this is of course, extra fees, another surgery, and new scars, but certainly this would be the best choice at this point.

My recommendation would be to now look forward, pick the surgeon in your area that you are comfortable with, and have the lift when the time is right for you-- there is no rush from a medical standpoint.

Good luck!

Dr. Salemy

This is very unusual.

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To Jewel1,

Hi! I don't agree with my colleagues here. This is not common, and I have done hundreds of implant replacements over more than 20 years, so I hope I know what I am talking about.

I don't know what happened. A capsulectomy alone wouldn't do this. If you had smaller implants put in, you might see this problem. I can really understand your being upset, but for your future, it doesn't matter what happened. Look forward. It sounds like you need a lift.

HOW a lift is done is very important to get good long term shape. You should end up with either a circular scar around your nipple, or, if you have more sagging, a lollypop scar. These scars fade pretty well. Ask to see lots of before and after pictures, ang get more than one consultation.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Sagging breast after implant removal

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Discuss this with more than one surgeon. IF your implants were textured and you had capsular contracture, your surgery could have released your breast tissue and unveiled a sagging breast.

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Sagging breasts after implant exchange

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The breasts may appear sagging after the capsule was removed because you most likely needed a breast lift also. I would talk with your surgeon.

Could be several things

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It's not uncommon for breasts to look differently after an exchange. First, the fact that your surgeon removed the capsules is significant. With capsular contracture the capsule is firm and actually providing support. With this gone there is less support for the new implants.

Next, if the replacement implants are smaller than the original implants than sagging will definitely happen.

Finally, if the position of the implants was changed, i.e. from subgandular to subpectoral this can result in the overlying breast to hang low and a "double bubble" deformity could occur.

With all that said it sounds like a lift is very necessary and should allow you to regain that youthful appearance.

I agree with Dr. Beraka

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I have been doing breast surgery for over 20 years and can't think of a patient who had what you are describing. If your breasts were already sloped, however, you probably needed a lift at the time of the implant exchange or you certainly were going to need one at some point. Now, you know that for sure. If it is properly done, you will gain a youthful, elevated, conical and projecting breast at the expense of some incisions whose scars should fade well over time and would be worth the trade for the shape improvement. Good luck!

Normal response

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The capsule of the breast implants was providing some support and hold. When this hold was released the breast will then show their true laxity. There probably was not any breast tissue removed. This can happen even with the same size implants. The best thing to do is to get a breast lift.

These type of changes can be hard to predict. It doesn't sound like your surgeon did any thing wrong. You just need to give it a little time, about three months, and then see what needs to be done.

Marcus L. Peterson, MD
Saint George Plastic Surgeon

Not uncommon

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Hello Jewel

We find that many patients who have capsular contracture and have had their implants in for more than a few years are surprised to see what their breasts look like after implant exchange.

The capsular contracture artificailly raises and hardens your breast. Once this contracture is released and the implant allowed to be where it should be, then the patient feels like their new soft breasts are too low.

Many patients will even tell us they prefer their hard breast because it was "higher." Of course, hardness of the breast is not normal and the proper thing to do is to remove the hardness and leave you with a soft breast.

You may indeed need a lift, but it is not because your surgeon did anything improper at the time of surgery.

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.