Saline implants (550cc) in right now, considering shaped silicone and possibly a little larger instead of a lift? (Photos)

I had my breasts done in 2012 and since had another child. After 8 months of nursing and thinning out, I'm extremely unhappy with my breasts. Wondering if I need a lift to fix the bottoming out of the breasts? They are also uneven and fall into my armpits when I lay down. I'm very self conscious about how far apart they are especially when I am working out they look crazy sometimes. Saline implants 550cc in right now, considering shaped silicone and possibly a little larger instead of a lift?

Doctor Answers 6

Lift vs larger implants

It is important to seek consultation from a board certified plastic surgeon. Your breasts appear droopy but it is difficult to tell you exactly what kind of lift would work best for you. If you get larger implants, gravity will also pull them down because of the greater volume.  So you have to determine exactly what you want to achieve.


San Diego Plastic Surgeon
5.0 out of 5 stars 4 reviews

Saline to shaped silicone implants

It is hard to know whether you need a lift from your pictures. Based upon your description you will need to have the pocket closed laterally and perhaps along the bottom of your breasts. If you need a lift you should get a lift instead of trying to put in a larger implant. In the long run you will be better off as the larger implant will almost guarantee the need for a lift down the road.  Silicone implants will help some with the rippling

Robert Kearney, MD, FACS
La Jolla Plastic Surgeon
5.0 out of 5 stars 31 reviews

Saline to Gummy Bears

Hello,
Unfortunately, all your selfies are with your arms lifted, so a good determination of the need for a lift is impossible. What is certain is that if you need a lift, larger implants are NOT going to help. Guaranteed. You'll definitely need a pocket closure, which is pretty standard anyway when converting from round smooth to shaped and textured devices.  Be sure to visit only ABPS certified/ASAPS member surgeons expert in using shaped devices. Hint: there are not a lot of us, as most American surgeons (90% +) do not recommend shaped implants, and have no experience using them, only misguided opinions. 
Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 79 reviews

Revision to Shaped Silicone?

When photographs are taken with your arms raised it artificially raises and distorts your breast shape/position and makes if difficult to get a good idea of what is actually going on. However, based on your description of your concerns, we can understand some of the problems you are experiencing.

Your situation is not unusual. Over time larger saline implants tend to stretch out and thin your tissues. They also displace downward and outwards resulting in the kind of situation you find yourself in. An additional pregnancy will also tend to accelerate the problem of thin tissues, and with a saline implant this will often result in visible rippling. It also sounds like you have a quite a bit of animation change which is displacement of the implant upwards and outwards with contraction of the muscle.

So you have a constellation of problems that are related to a certain type of implant, thinning of your tissues and submuscular implant placement. What is not clear from your photos is whether or not you need a lift. It is important to remember that implants do not lift your breast. Putting in a larger implant will only add weight to your breast and tend to drag it southwards over time. It's not possible to tell from your photos whether it is the implant that is pulling your implant downwards and outwards (most likely scenario), or whether you have loose skin and breast tissue that is sliding off the implant. If it is not a skin and tissue problem then you will probably not need a lift.

What you do need is to have your implant repositioned upwards and inwards so they are not bottomed out and falling into your armpit. This is done by suture tightening and reshaping the internal implant pocket or capsule which is called a capsulorraphy. This is generally an effective technique but is more likely to fail with a larger implant. Switching to a new generation highly cohesive silicone gel implant will also reduce or eliminate the problem of visible rippling.

I would suggest swithching to a textured surface gel implant because the textured surface allows for microscopic tissue ingrowth and results in implant adherence to your tissues. Along with tightening of the capsule, this will help prevent recurrence of the downward and outward displacement of tissues that you currently are seeing. The textured surface implant will also help to reduce the animation problem that you are experiencing as well. All shaped silicone implants have a textured surface, so switching to a shaped implant would be useful. A shaped implant will have a somewhat more subtle or natural look which you should take into consideration.

Breast surgery

It appears that you need a lift as well as exchange of implants.  Your breasts are too low down and going with larger implants will only make them sag more.  The saline implants call be deflated prior to surgery to help in the planning and decision making process.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 25 reviews

Revision breast surgery

It is not uncommon after having another child that your breasts can change.  You probably need a lift but at minimum you need pocket tightening to help get your breasts closer together and prevent them from falling to the sides.  Seek in person consultation with a Board Certified Plastic Surgeon who performs a lot of revision breast surgery.  Best of luck to you

Milind K. Ambe, MD
Orange County Plastic Surgeon
4.8 out of 5 stars 36 reviews

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.