6 months post breast implant procedure - Do I need a lift? (Photos)

Question

UTM L:445cc R:415cc Natrelle Inspira soft touch , 5’1 148llbs A see from the pictures, I’m happy with my breasts when they’re lifted with bras, but I don’t like how they “waterfall” without the bra. When I went to my 6 month PO meeting with the doctor, he said they are unlikely to change any further.

Donovan Rosas, MD · Answer

Patient concerns regarding the appearance of their breasts can typically be divided in two pools: volume, ptosis (droop). The procedures to address these issues are as different as the issues themselves. However, these concerns are not mutually exclusive. Many patients, whether they are aware or not, will benefit from both.
There are two factors which can help to answer the question of which surgery will deliver the most satisfying result: mastopexy, augmentation or both. Patients must first consider the position of the NAC (nipple areolar complex i.e. the pigmented portion of the breast) as it relates to the inframammary crease. If the nipples are at or below the level of the crease the patient may benefit from a lift or mastopexy. The breast lift is designed to elevate sagging breasts to a more youthful position. It also helps to reshape and tighten the skin of the breasts. This is typically accomplished via a periareolar (around the nipple) incision with or without a vertical incision. 
Mastopexy is an effective way to address sagging breast, however, the changes which accompany weight loss or pregnancy can also decrease volume of the breasts. When a woman wants the volume restored, or increased, a breast augmentation will also be needed in conjunction with mastopexy. Augmentation can help restore the volume loss which is well known to women following children. There are a number of options available to women considering augmentation ranging from size and implant type to access incision.   
A breast augmentation alone may also be appropriate if ptosis is mild. If the patient is comfortable with the natural appearance of the breasts but desires them to be larger, a breast augmentation alone is the right procedure.  Augmenting significantly ptotic or sagging breasts tends to magnify the problem. In these cases, a mastopexy performed in conjunction with an augmentation is preferred.
Based upon your photos, you appear to have a very reasonable result. Nipple position seems good as well. There is some mild asymmetry which may be amenable to lift. Ultimately it is important to understand, any appreciable sagging is minimal thus the gain from a lift is more limited. Patient in similar situations need to decide whether the improvement is worth the increased scar burden.
There is a procedure for every problem. To determine which technique is right for you, consult with a board certified plastic surgeon Patient should discuss their concerns with their physicians in order to make an educated decision.

Finny George, MD · Answer

Hi, thank you for sharing your question. It appears that you may benefit from a lift to correct the position of the gland over the implant.

Daniel Barrett, MD · Answer

Dear melmels2001,

breast revision surgery is the most difficult plastic surgery procedure performed. Botched breast surgery alters normal tissue planes and laxity, the ability of breasts to heal properly, and leaves scar tissue that dramatically affects the level of difficulty of the corrective surgery.
Many patients come in to correct poor outcomes from their initial surgeries. The most common problems are due to implant malposition, bottoming out of the implant, poor scarring, and incorrect implant size.
While the type of revision required will depend on the result of the previous surgery and the desired result of the patient, some revisions involve extensive pocket repair that may or may not need specialized external bras.
If you are considering breast surgery revision, you should speak with a board certified plastic surgeon and have yourself properly assessed. Only after a thorough examination you will get more information and recommendations. Also, you have to make sure that your surgeon understands your breast augmentation goals.

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

Mauricio Castano, MD · Answer

Hi thanks for your question, there won't be much change after 6 months, a lift will improve the appearance, as well the asymmetry, I would advice as well to go with a smaller implant, that really suits with your chest wall frame and breast mound/footprint.

Camille Cash, MD · Answer

From the photos you will need to consider a lift in order to improve the shape, especially on the side with more ptosis.  At six months post op they are not likely to change further without surgical intervention.

Connie Hiers, MD, FACS · Answer

Your implants are large for your frame and will not settle down anymore. You do need a lift, especially on the lower breast, to raise it back up.

Mats Hagstrom, MD (license on probation) · Answer

Breast augmentation outcomes are usually mainly based on three variables.
The first is the patient’s candidacy for the procedure.
It looks like your left breast has some ptosis (droopiness) 
The second variable is implant selection.
And your case implants are a bit on the large side.
The third variable is the surgeon‘s ability to put the implants in the correct anatomic location.
In your case, the implants are sitting somewhat high.
A high position implant that has a large diameter is going to give you fullness above your breast up on your chest Wall just like you show.
For your right breast, the implant can be lowered and this would give you a fairly ideal outcome.
For the left breast, the implant should be lowered and you need a lift to get the ideal shape because of left sided droopiness. 
 On the left breast if you opt for lowering the implant only you’ll still have some of the breast hanging off the implant look(waterfall aka ‘rock in the sock’ aka double bubble etc) 
If you had slightly smaller implants, they wouldn’t show so much in the upper chest.
Follow up with your provider or schedule a few in person second opinion consultations with other providers in your community.
Best,
Mats Hagstrom MD

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