BA done 5 years ago and now breast implants sagging. Can my nipples be centered again without a lift? (photos)

If your implants are under the muscle then you can undergo a mini lift. Using a circumareola incision, your breast tissue is reshaped, elevated higher on the chest wall and more medial to increase your cleavage.

Best Wishes,

Gary Horndeski, M.D.

An in person examination assessing the softness and position of your implants as well as measurements to assess nipple position relative to the suprasternal notch, inframammary fold and breast base will help determine if a breast lift is necessary and worth the additional scaring. However, it may be possible to achieve better nipple positioning if your exam suggests capsular contracture. In this instance, a revision augmentation with capsule management techniques, a new implant pocket and different implants may be able to achieve improvement.

Dear Txjlalva,
determining whether you need simply a breast augmentation versus a breast lift can be somewhat complicated. It depends on a number of factors including skin laxity and current nipple position. Generally speaking, if the nipples are lower than the inframammary line the patient will most likely need a breast lift. If the nipples are at or above the inframammary line we can generally get by with just a breast augmentation depending on the size of the implant the patient wants. I often still using implant when I perform a breast lift because it provides more upper breast fullness after the lift. To be sure a consultation with a board-certified plastic surgeon will help determine what the patient actually needs.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

You need a lift and have two options for a lift. One, you can have the surgical lift to raise your nipples and center your breasts. You can also consider minimaly invasive skin tightening with radiofrequency like ThermiTight. the amount of lift obtained cannot be determined, but scarring is very minimal and so is downtime.

I am assuming you would rather avoid the scars, but I think that a circumvertical mastopey would be necessary to lift you nipples.
I would need to see your preop photos to see what your breasts used to look like. It is possible that the additional weight of the implants has led to some of the sagging. If you want to reduce the fullness in the side of the breast, you would probably need a narrower / smaller implant