Had full anchor uplift and round 225cc implant 5 months ago under the muscle, feel they are drooping and have ski slope effect.

Will having another uplift give me perkier boobs or what else would I need to do to get this effect

Doctor Answers 4

Another Lift Necessary?

It's unfortunate that you find your self in this situation. Providing both before and after photos is very helpful in allowing us to deconstruct what has gone wrong, and can help determine what might be done to correct the situation. Fundamentally this is a problem that is seen far too often on this site, which is the unacceptably high occurrence of poor outcomes when a lift and implant are performed at the same time. Several studies have shown that the revision rate is 30% or higher when both operations are performed at the same time, and trying to correct a problem after the fact is much more difficult than avoiding it in the first place.

Your before photos show that you had a significant amount of breast tissue and great deal of ptosis or sagging. In addition your areola is quite enlarged. All of these factors indicate that a major lift will be needed to return your nipple and breast tissue to a more normal or youthful position.Trying to accomplish this kind of lift while at the same placing an implant under the muscle is fraught with risk and poses major difficulties. The essence of the problem is that the two operations are working directly against one another. When doing a lift the nipple and breast is repositioned upwards and excess skin is removed which shrinks and tightens the skin envelope to help hold the tissue in position. When placing an implant, the breast tissues are expanded and the skin is stretched to accommodate the increased volume. At a certain point, when a significant amount of lifting is required, it simply becomes impossible to accomplish both goals at the same time and consistently achieve a good aesthetic outcome. Both procedures are compromised and predictably the patient ends up with a result that is in need of a revision.

Your after photos demonstrate that your surgeon clearly had a difficult time trying to do both the lift and implant at the same time because your breast was insufficiently lifted, your areola is excessively large, and you have poor scars. All of this results from trying to stuff all of your breast tissue plus an implant into an excessively tight skin envelope. The problem now is that you have a very difficult situation to correct. Simply revising your lift is not going to fully correct the problem because the same set of obstacles are still present, namely trying to achieve an adequate lift while attempting to accommodate your breast tissue and implant within a reduced skin envelope. Either a significant amount of breast tissue will need to be removed, which can distort your breast shape and increase risks for tissue necrosis, or you will need to remove the implant, complete the lift, and have the implant replaced at a later date. Neither of these are good options and will require significant additional surgery and expense.

In my opinion your surgery should have been planned to be done in two stages from the beginning. Many surgeons on this site have indicated that they always approach a breast lift and implant as a single stage operation and are willing to accept a high revision rate of 30% or more. Their argument is that if the operation is planned in two stages then there is actually a 100% revision rate. I think this a false logic and it is serious disservice to patients. When it is needed, an operation that is planned for two stages has a revision rate of zero and will much more consistently deliver high quality results. This is not to say that every lift with an implant must always be done in two stages because there are many patients that can end with very nice results in a single stage operation. It is the job of the surgeon to appropriately decide which approach will most consistently deliver a high quality result with a low risk of revision.

It is understandable that patients would prefer to have their surgery performed in a single operation if at all possible, but patients don't have the skill and knowledge to decide which approach will provide them with the best outcome. I think it is a disservice to patients to tell them that they "can" have both procedures performed at the same time, when in reality there is a high likelihood that the combined operation will fail to deliver a high quality result and revision therefore will frequently be needed. The revision process commonly will be more complicated and more expensive than if the surgery was approached in a two stage process from the beginning.

Breast lift and implants - what do I need to fix them?

Thank you for asking about your breast lift and ipmlants.

  • Your photos do suggest that your breasts are drooping again -
  • The implants appear to sit higher than the breasts.
  • You need to return to your plastic surgeon to discuss a revision.
  • A second lift, probably with some kind of synthetic mesh to support them and the implants would be the likely next step.
Always consult a Board Certified Plastic Surgeon.
Hope you find this information helpful. Best wishes.

Had full anchor uplift and round 225cc implant 5 months ago under the muscle, feel they are drooping and have ski slope effect.

Thank you for the question. Your concerns are not uncommonly encountered after breast augmentation/lifting surgery.  Revision of the breast lift will likely achieve an outcome closer to your goal photograph.  This procedure will likely involve further tightening of the breast skin envelope, probable tightening of the breast implant capsule (capsulorraphy),  and possibly the use of a different size breast implant (if necessary).

Best to discuss your concerns/goals directly with your plastic surgeon for in front of a full-length mirror and with the help of goal photographs. Best wishes.

Less than desirable results

following an augmentation lift procedure.  Dr. Stridde certainly didn't mince any words about his opinion.  I am on the other side of the fence and can and have accomplished excellent results starting out with what you did.  BUT you would have been presented different options, depending on what your goals were.  In my patients who are like, they offered a lift using an inferior based flap to help hold the implant in place and the implant is filled to make up for whatever tissue is removed. 

At this point it is water under the bridge and if you're wanting more fullness on top, you will need a lift.  Make sure the revision isn't just another version of what was done the first time or your results will eventually be disappointing.  Hopefully your surgeon has a good revision policy to minimize your costs for this.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 32 reviews

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