Did my implants not drop and fluff at 9 months post-op? Why do they look so long and not perky? (photos)

Question

I am 35 years old with a lift and implants after years of breast size fluctuations and extreme sagging and Lack if fullness up top, I always had larger breast. 9 months post operation wanted a lift and fuller cleavage. I am afraid something isn’t right.

Miguel Mota, MD · Answer

Hi and thank you for posting. The good news is your implants and their placement seem to be perfectly fine. They have dropped and settled nicely. The issue is the breast lift.

A breast lift is essentially the repositioning of the nipple-areola complex plus tightening the lower pole. This is hard to do when adding implants, especially if they are large implants. It is challenging because some patients don’t want to reduce their size. But in reality, this type of lift requieres a reduction (excising tissue, mostly from the lower pole), as well as an augmentation (adding implants), and then a lift. 
 
I believe your have still have too much lower pole tissue and your areolas should be higher. If your are unhappy with your results you will need a breast lift revision. This is actually easy to do now that everything has settled so you will have excellent results!

Best of luck,
Dr. Miguel Mota

Casey Anderson, MD, FACS · Answer

The implants appear to be in appropriate position. What looks amiss is the breast tissue has begun to sag over the top of the implant. This can be corrected with a revision to the lift.

Michele A. Shermak, MD · Answer

Hello!
It looks like you have a good volume of breast tissue combined with a full implant. It also looks like you had large areolae prior to this surgery since you have pigment on your vertical incisions. 
What is done next depends on your goals for volume and look. Implants provide cleavage in the upper part of your breasts. If you like the cleavage then it looks like you would benefit from a revision of your breast lift with removal of breast tissue which is making the lower aspect of the breast heavy. The revision will also help remove the pigmented skin from the vertical aspect of the mid breast. If you are looking for a remarkably smaller size then you can downsize and narrow the implants. These revisions require an experienced board certified plastic surgeon. You can find one at plasticsurgery.org. 
Best of luck to you!

Gerald Minniti, MD, FACS · Answer

This is common problem women have when they undergo a breast augmentation and lift with very heavy and large breasts. This is also more common when a high profile implant is used as well. The over -projecting implant acts like a ledge and the breast tissue begins to weigh down on the skin of the lower breast, causing tissue stretch and descent of the breast tissue. You'll need a revision surgery that involves re-lifting and REDUCING breast tissue, as well as replacing your current implant with a moderate profile device, possibly larger to make up for volume lost in the lift.

Daniel Barrett, MD · Answer

Dear Creative141984,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

Measurements are needed to be sure, but you may need the lift revised or lower the implants. Go back to your surgeon and discuss your concerns.

Darryl J. Blinski, MD · Answer

Based upon the very nicely posted photos, though no before photos are included, you had a very conservative lift. Revision of your lift is needed.

Did my implants not drop and fluff at 9 months post-op? Why do they look so long and not perky? (photos)

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