39, 120lbs, 5'5 - breast implants 7 years after lift without implants, would they cut into the scars I already have? (Photos)

Hi, thank you for sharing your question. Breast implants will give you the desired outcome and can be done through existing scars. You have a small amount of pseudoptosis which should correct with implants but can also be addressed at the same surgery if needed.

While lift and augmentation are commonly performed together. They can be staggered.

If staggered, I will typically use the transverse limb of the prior limb along the fold for augmentation access.

As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Dear TampaFLgirl,

I tend to prefer the periareolar incision because its the most well hidden. There is a natural border between the areola and the rest of the breast skin the hides the incision extremely well. You have to be completely naked to see it vs other incisions like transaxillary and inframammary are visible in clothing such as sleeveless shirts and bikini tops when extending your arms up. I've also noticed increased rates of bottoming out with inframmary incisions that is not reported. Transaxillary implants are always wide in appearance because the surgeon is not able to dissect medially enough to provide better cleavage. Ultimately, I can perform any of the incisions but I recommend the periareolar. There is no difference in sensation because the nerves that control nipple sensation come in laterally from the back and injury to them occurs when surgeons dissect to far laterally which is why transaxillary incisions have the highest nipple sensation disruption. There is no difference in breast feeding ability. One study did show a slight increase in capsular contracture with use of periareolar but that study was small and did not incorporate modern techniques such as below muscle placement, keller funnel usage and triple antibiotic irrigation.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Yes , the implants would be placed through the old incision under the breast. After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what size and style breast implant is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

The answer to this question is that you will first want the old mastopexy operative note to allow your surgeon to find out what surgery was performed previously and where the remaining blood supply to your nipple/areolar complex lies. Once the surgeon knows where the blood supply to the nipple is coming from, she/he will be able to safely place an implant without reducing the blood supply further. A transaxillary breast augmentation may be safest but that would of course use an armpit incision. An argument to use the old scars is that you may want your surgeon to revise the lower pole as the nipple position is on the high side and placement of the implant may stretch the lower pole further, lengthening the nipple to inframammary fold distance.

Hello, adding implants will give you more upper pole fullness it sounds like you are seeking. Your surgeon will likely use an incision you already have. From the photos and your nipple placement it does not look like a full lift would be needed. As always in person consultation with a board-certified plastic surgeon is recommended.
- Dr. Joe

If your nipples are above your breast fold then another lift may not be suitable. Implants alone may be sufficient in give you fullness in the upper pole. Incision placement depends on the surgeon, as it may be in the breast fold (inframammary) or through the areola (periareolae). Some surgeons may also do it through the armpit. Your surgeon would need to examine you to determine whether the incision can be placed in the same location as a previous one.

Thanks for your question! I don't think you need another full lift because your nipple is in a good position. Perhaps just a lower pole mastopexy to tighten that with an implant would be sufficient. I would suggest an in-person consultation. Good luck!

At this time, I recommend The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained if not injured during your previous surgery. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best way to manage issue: placement of an appropriate sized implant through a portion of your inframammary incision, then revise the inframammary and vertical scars for the dual purpose of tightening up breast tissue envelope and to get finer scars.