400cc over the muscle in November 2022. Are my breast implants sagging? (photos)

Question

I had 400cc over the muscle in November 2022. Are my breast implants sagging or is my chest wall naturally low? I feel like my nipples are low down. Thanks

Daniel Barrett, MD · Answer

Dear Ann12398,
I understand your concern. However, without a proper assessment, it would be difficult to determine is there 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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Celal Alioglu, MD · Answer

Hello, 
The breasts are sagging, and the implants are positioned too high. This is called a "waterfall deformity". In a waterfall deformity, the implant is positioned much higher compared to the nipple-areola complex, and the loose breast tissue sags over the implant like a waterfall. To prevent this complication, implant selection and planning before surgery are important. It's essential to check whether the skin between the nipple-areola complex and the lower breast has been efficiently filled by the implant after surgery.

Azita Madjidi, MD, MS, FACS · Answer

If you had breast implants over the muscle, the only thing holding the implants up is your skin. With age and gravity, your skin will relax and implants, especially the large and heavy ones will sag. On these pictures, your nipples are still in a good position but in a few years they may go lower.

Connie Hiers, MD, FACS · Answer

You are not sagging, but you may sag over time since breast tissue itself does not support the weight of implants. Placing the implants behind the muscle does give some support. Your breast naturally do sit somewhat low on your chest and your bases cannot be moved. You are fine for now.

Camille Cash, MD · Answer

It appears that your surgical result is good and represents an augmented version of your pre op photos.  The nipples appear to be in approximately the same position.  They were a little asymmetrical before, and remain the same post op.  It doesn't appear the breasts are sagging any more than before surgery.

Mats Hagstrom, MD (license on probation) · Answer

I think your breast augmentation is a very good representation of the larger version of your preoperative breast.
The outcome looks like an augmented version of your previous self. 
I don’t see any inherent problems, complications, or need for surgical, intervention or revision.
Breast augmentation outcomes are based on three variables.The first is the patient candidacy for the procedure. The second is the choice of implants in regards to size shape, and type.
The third is the surgeons ability to place the implant in the correct anatomic location.
It looks like your surgeon did a good job with the procedure.
The outcome is the product of implant selection and your candidacy for the procedure.
Best,
Mats Hagstrom, MD

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