Sagging Breasts After Breast Implant Exchange

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

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.

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.

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.

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.