I had saline implants placed 3 years ago and a lift since then I've had a pregnancy and the fullness on top is no longer there. It seems as though I have ski slop breastwork. What should I do to correct this? I was thinking to get larger high profile implants.
I'm Wanting to Get New Implants What Do You Recommend? (photo)
Doctor Answers 17
Thank you for your question. I would recommend that along with an implant exchange, you should have some skin removed from the lower aspect of your breast along the fold. The skin on the lower aspect of your breast seems to have stretched out either from the implant or pregnancy or both. If you just get a larger implant, this will get worse and the nipples will be pointing to the roof. So some skin needs to be removed. Please consult with a board certified plastic surgeon.
What do you recommend to fix my breasts?
Thank you for providing the photo. On review, your implants appear to have bottomed out somewhat and increased the distance from the nipple to the fold. When this happened, the implant shifted down and you lost volume to the upper pole of your breast.
To correct this, you may want to consider the following:
- Conversion from saline to silicone gel implants
- Mild upsizing
- Revision of your breast lift (focusing mainly on reducing the vertical distance from the nipple to the fold)
- Possible use of Strattice along the fold to provide good reinforcement/support
I would be very careful going too much bigger because this simply will accelerate stretching of your tissue and, ultimately, may lead to recurrence of this appearance.
I hope that helps!
I do not think that larger high profile implants are the correct choice. If you can accept the scars then a lift is appropriate
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From the photos, it appears you have inferior pole ptosis. I would recommend repeating the mastopexy, and at the same time tighten the scar capsule around the implant to keep the implant higher. Change implants only if you want a different size. I do not think a high profile implant will give you more fullness superiorly.
I'm Wanting to Get New Implants What Do You Recommend?
Redo full lifting with possible fat grafts and/or implant exchange to your breasts. Best to seek in person evaluations.
Implants bottoming out
Thanks for your question and photos. The photos demonstrate a phenomenon called "bottoming out" where the large implants have stretched the skin out and the pocket where the implants sit is too low. This is the reason why you have no upper pole fullness. Exchanging these implants for larger implants is not the solution. Rather, this will likely make the problem worse. The correction for this is often to reduce the size of the implants and perform a breast lift. There are many other "tools" that can be used to help support the implants, but the downside is that these tools cost additional money for the patient. Material called alloderm or strattice are biologic "tools" that can help. This is something that can be discussed with your plastic surgeon. Good luck!
Breast implants can lead to sagging
Thank you for your question and for the photos. Of all the types of breast implants, saline are the least compressible and therefore stretch the tissues the most. Anyone having a breast lift is, of course, already prone to sagging and implants add to this and saline implants affect sagging the most. High profile implants also stretch the tissues more than moderate or midrange profiles. If you use a high profile implant, you will have the upper pole fullness you want for a short period of time and then it will drop, probably faster than if you have a mid-range profile. I would suggest subpectoral textured silicone implants, midrange profile with revision of the lift. Textured implants can allow the tissue to "lock" onto them and hopefully help fight the tendency to sag. Please have a consultation with a plastic surgeon Board Certified by the American Board of Plastic Surgery.
Tracy M. Pfeifer, MD, MS
I'm Wanting to Get New Implants What Do You Recommend?
You need a revision mastopexy with internal support with either acellular dermal matrix or mesh
Implant exchange and breast lift for upper pole fullness
From the look of the picture, you have bottomed out and you have thinning of the breast tissue. I would recommend downsizing to a silicone implant with the breast lift procedure. This will correctly position the breast and give more upper pole fullness.
Your photos show that you have bottoming out where the bottom half of your breasts have stretched out significantly resulting in low breasts with no upper pole fullness. Exchanging implants alone will not help as the new implants will drop into the stretched breast and essentially give you the same look. The lower part of your breast needs to be tightened. That is what is done in a breast lift, Therefore augmentation mastopexy would work best for you. The use of Strattice or any other dermal matrix graft certainly will give your breast a bit more support and perhaps help in preventing bottoming out in the future, However, they are quite costly and bring on their own set of potential problems. I do not feel they are necessary. Increased support in the lower part of your breasts can be achieved with the lift along with the use of the capsule that you currently have surrounding your existing implant.
Ary Krau MD FACS
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