Downsized Breast Implants with a Lift, but Still Sagging

Just had my 800cc implants reduced to 425cc due to back problem. had a round block lift done in case of sagging. 2 days p/o and sagging! Surgeon says my skin will make them higher with time. Used to seeing high implants when new these are saggy from day 1. Not very comforting. Should I get redo?

Doctor Answers 9

Downsized Breast Implants with a Lift, but Still Sagging

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I have not been impressed with the amount of lifting a round block can achieve, in my opinion. It is true that decompressing your breast by removing an 800 cc implant will result in some skin contraction but how much is unknown. Give it 6-9 months and consider a revision at that time.

Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Minor lift for significant downsize

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I would wait it out at this point.  It is my opinion the is unusual to have a periareolar lift when you have had a significant downsize.  Usually, the lift in that situation requires a periareolar and vertical lift ("lollipop" lift).

Dr. ES 

Persistent Breast Sagging after "Downsizing" with small implants and the wrong Breat Lift Operation

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Sorry to hear of your predicament. Your experience however is quite common and could have been prevented.

Every breast implant acts as a breast skin expander. It stretches the skin of the breast, creating more of it, thereby increasing and tilting the ratio of breast skin to breast fill resulting in sagging. The bigger the implant the faster the process. For this reason rather than picking the biggest breast implant one could shove in the breast (and you picked the biggest), it is best to think long term and pick the smallest implant you could tolerate.

A Benelli or Round Block lift is best reserved to minimal lifts in small breasted women. It is wholly inadequate for large breast lifts and often results in a flattened breast and tension on the areola resulting in its slow outstretching and poor scarring.

I'm not sure WHY this operation was picked in your case. I am guessing that you insisted to your surgeon that no scar be placed on the breasts, as many women do, without understanding that the results are never the same and often poor.

If you want natural looking perky breasts you will require a revision with conversion to a lollipop type scar.

Peter A. Aldea, MD
Memphis Plastic Surgeon

Circumareola lift and implant reduction

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It sounds like the circumareola lift may not have been sufficient enough. You may need a more formal lift using either a vertical lift or traditional Wise pattern.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Breast Lift and Implant Reduction

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A circumareolar lift is likely not a powerful enough lift to tighten the loose skin that you have after downsizing your implants.

At this point there is not much to do but to wait and see how things shape up.  Later on, like 6 months after the initial surgery a more powerful lift can be done to tighten the skin.

Good luck.

Farbod Esmailian, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 88 reviews

Vertical breast lift with lollipop scars is most effective.

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1)  The round block (circular scar around nipples) breast lift was probably not powerful enough for you, since you got much smaller breast implants.

2)  You should get much better correction of sagging with vertical lift.  Women accept these scars if they love their new perky shape.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Your outcome was unfortunately compromised at the planning stage...

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Hi there-

One of the things I find myself saying to my own patients quite often is that it is a mistake to think that all breast lifting techniques are appropriate for all patients.

Similarly, not all breast lifting techniques can achieve similar changes/improvements in a woman's breast shape and position.

Unfortunately, this idea that all breast lifts techniques will equivalently improve and lift the breasts is pervasive among patients, and hasn't been appropriately discouraged by surgeons... 

What I always ask women if I believe they are asking me for an operation that will not result in beautiful breasts is, "If after surgery your breasts are ugly or funny looking, but you have a cute scar, will you be happy?"....

Unfortunately, most women end up deciding on a breast lift technique because they think it will give them the cute scar they would prefer, or worse, because it is less expensive.

The very most unhappy women I see in my Orlando Plastic Surgery and Skin Care Center are those who underwent a breast lift technique (in another office) for the wrong reasons....

It sounds like you had an operation ill-suited to your situation. In going from a huge implant to a large one, there was too much excess skin of relatively poor elasticity to deal with- and the minor improvement possible through the technique used was inadequate.

Without seeing you it would be impossible to know for sure, but it sounds like you are going to need a revision of your breast lift, with better dimensional tightening/restructuring of the breast tissue and skin, and possibly with repositioning of your implant pocket.

I'm sorry I couldn't be more positive, but I think it's more important that I give you my most honest opinion- while I personally do all of the short scar breast lift techniques myself, I believe very strongly that it is imperative to choose the technique very carefully...

I hope you are able to achieve the breasts you dream of, and wish you the best.

Round block lift wasn't enough

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Halving the implant size from huge to pretty big will leave you with more loose skin than what can be handled by a periareolar lift alone.  That's one of the big problems with big implants - namely that if and when you downsize, there is too much skin to handle without a full lift.

Down-sizing with a lift

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Although we do not have the benefit of a photo I thinkk down-sizing from 800cc to half that volume may require more lift than be provided with a round block or peri-areolar lift. I would allow proper time to heal prior to any additional surgery but continue to follow up closely with your plastic surgeon.

I wish you well.

Dr Edwards

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.