Failed breast lift - Do I need bigger implants and/or repeat lift to achieve my goal? (Photos)

Question

I am 1 year post op lollipop breast lift with 310cc implant. My breast still seem to lack upper pole and seem some what saggy to me despite having a lift. Do I need bigger implants and/or repeat lift to achieve my goal? I like the appearance of my breasts when my arms are raised as shown in my second picture

Donovan Rosas, MD · Answer

Patient concerns regarding the appearance of their breasts can typically be divided in two pools: volume, ptosis (droop). The procedures to address these issues are as different as the issues themselves. However, these concerns are not mutually exclusive. Many patients, whether they are aware or not, will benefit from both. There are two factors which can help to answer the question of which surgery will deliver the most satisfying result: mastopexy, augmentation or both. Patients must first consider the position of the NAC (nipple areolar complex i.e. the pigmented portion of the breast) as it relates to the inframammary crease. If the nipples are at or below the level of the crease the patient may benefit from a lift or mastopexy. The breast lift is designed to elevate sagging breasts to a more youthful position. It also helps to reshape and tighten the skin of the breasts. This is typically accomplished via a periareolar (around the nipple) incision with or without a vertical incision. Mastopexy is an effective way to address sagging breast, however, the changes which accompany weight loss or pregnancy can also decrease volume of the breasts. When a woman wants the volume restored, or increased, a breast augmentation will also be needed in conjunction with mastopexy. Augmentation can help restore the volume loss which is well known to women following children. There are a number of options available to women considering augmentation ranging from size and implant type to access incision. A breast augmentation alone may also be appropriate if ptosis is mild. If the patient is comfortable with the natural appearance of the breasts but desires them to be larger, a breast augmentation alone is the right procedure. Augmenting significantly ptotic or sagging breasts tends to magnify the problem. In these cases, a mastopexy performed in conjunction with an augmentation is preferred. With regards to your specific question, if you are seeking greater upper pole fullness an implant is needed. You have a very nice result but your disappointment is not a unction of what was done but rather what was not done. It is important to remember that a lift will reshape the breast and reposition the NAC. It will not create fullness in the upper pole. The common misconception is that the fullness of the upper pole descends over time and needs to be lifted. It actually atrophies and is no longer there. It needs to be replaced (via an implant), not repositioned. If you are seeking greater upper pole fullness a lower profile/wider device will help. There is a procedure for every problem. To determine which technique is right for you, consult with a board certified plastic surgeon Patient should discuss their concerns with their physicians in order to make an educated decision.

Emre Guvercin, MD, FEBOPRAS · Answer

Hi there &mdash; this is a very common concern after a lift + implant, and your photos describe a pattern we see often. The issue is not the size of your implant. A 310 cc implant is more than enough to create upper-pole fullness if the breast tissue is properly supported and repositioned.
What you’re noticing &mdash; lack of upper pole and a slightly saggy appearance &mdash; typically comes from how your own breast tissue is sitting over the implant, not from implant volume.
Do you need bigger implants?
No.Increasing size won’t fix this pattern and may even make the breast heavier and saggier over time.
What you actually need
A revision lift focused on re-orienting your natural breast tissue upward is the correct approach. This is exactly what the Push-Up Lift technique is designed to do: • Re-center and tighten your own tissue over the implant • Direct the breast volume toward the upper pole • Remove the excess lower or lateral skin • Create a rounder, perkier shape without changing implant size
Why your breasts look better with your arms raised
When you lift your arms, the breast tissue is temporarily pulled upward &mdash; this mimics the effect of what a proper re-suspension (Push-Up Lift) does surgically.This is why the implants themselves are not the problem.
You can absolutely achieve that lifted, upper-pole fullness look you see when your arms are raised &mdash; it just requires the right type of lift, not a bigger implant

Tyler Frew, MD · Answer

Hi there,
You can get more upper pole fullness with a larger implant and/or a lift revision. I would prefer to revise the lift in order to tighten things again, maybe adding a scar under the breasts converting your lollipop lift to an anchor lift. All the best

Ronald J. Edelson, MD · Answer

Your result is not bad but could be improved.  Measurements would need to be done to determine if the nipples were lifted enough.  You may also want larger implants. I would get other opinions and realize that you will get different recommendations from different surgeons

Camille Cash, MD · Answer

From the submitted photos it does appear you will need a revision to your lift to achieve the goals you stated.  If you are happy with the size of the breasts there is no need to increase the volume.  It will not help you to achieve a look more similar to your "wish" pic.  Visit with a board certified plastic surgeon in your area for a consultation and discussion of your desired look.

Failed breast lift - Do I need bigger implants and/or repeat lift to achieve my goal? (Photos)

Answers (5)

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