4 years post op - breasts are sagging. How can this be fixed? (Photos)

n cases of large and sagging breasts, it’s possible to achieve a lifted and well-shaped result by reducing and reshaping the existing breast tissue. If, instead of working with your natural tissue, an implant is added to create fullness in the upper pole, this only adds unnecessary weight — which may lead to further sagging over time, both of the breast and the implant itself.
In your case, if you’re not satisfied with the current volume, the implant can be removed or replaced with a smaller one. If you are happy with your existing size, a lift alone may be enough to restore a youthful and balanced breast shape.
With the Push-Up Lift technique, we’re able to explore all treatment options in a personalized and tissue-preserving way.

Dear SRM0095,

my preferred lift is a lollipop lift when a periareolar won't do (ie greater than 2cm lift required). The lollipop technique was created by a Canadian plastic surgeon named Elizabeth Hall-Findley and treats the breast as a three dimensional structure instead of two dimensions (anchor - lift). Most importantly it does not require the horizontal component scars that the anchor-lift requires and breasts appear much more natural, lifted, and less boxy. Lastly, the lift lasts longer because the lollipop doesn't rely on the skin to hold the breast up, its actually breast tissue thats being brought together to support the breast and hence improves longevity.

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

Thanks for your question. From your pictures, it seems like you're a good candidate for a breast lift or a breast implant exchange with a lift. I recommend scheduling a consult for a proper evaluation. Please always consult with a board certified plastic surgeon. Take care, Dr. Moises Salama, board certified plastic surgeon.

It looks like the weight of the implants, gravity and aging have accelerated the rate of sagging. This is natural, especially with larger breasts and implants. Another lift can help improve perkiness.

Thank you for your inquiry! Several reasons could cause this: large implants without support, skin laxity. We would love to meet with you to discuss your concerns. Schedule a consultation with a Board-Certified Plastic to help you reach your goals.

Everyone will have some sagging to their breasts after four years. The extent of the sagging is directly proportional to the weight of the breasts and genetics. You cannot control your genetics, but should you have additional surgery you have some control over the weight of the breasts. You may want to consider going smaller and/or adding support through some type of internal bra. It is also recommended that you wear a bra as much as possible, at least during the day.

Thank you for your pictures and questions. Let me first tell you this is not a complication. It is an expected outcome of surgery. But it can be fixed in the right hands with the right plan. Without reveiwing your operative reports or examining you, it is hard to say for sure, but what this looks like to me is the expected outcome of a surgical plan with lack of long term thinking about soft tissue support. A heavy glandular breast with signs of already poor soft tissue support was reduced and an implant was placed. Not sure of implant details (CC? over/under muscle? profile?) but that new implant started immediately putting strain on the soft tissue envelope (superior pedicle? inferior pedicle?) and without support, that tissue did exactly what I would expect it to do over time which is give way to the implant, stretching the lower pole of the breast and allowing the implant to continue to sink deeper and deeper on the chest until you are at where you are today. The correction for this would be a revision (possible with newer more cohesive gel implants), revision of the lift to reduce the stretched tissue, and placement of soft tissue support (I use GallFLEX for this). This would restore things back to a more youthful position and maintain them there for a longer period over the future. Hope this helps!
Dallas Buchanan, MD
VIVIFY plastic surgery
Tampa, FL

Your implants took your soft tissue envelope for a ride and dragged them down. The fix, unfortunately, is more than just tightening up the implant pockets and reinforcing with resorbable mesh; you'll need another breast lift. When done correctly, your risk of recurrence would be very low.

In your pre-op photograph, your breasts were quite low. At that time, implants were probably not necessary but what was more important was the lift. Unfortunately, you had a vertical lift technique that only lifts the areola but not the breast tissue. At this time, I recommend explantation and lift using The Bellesoma Method. The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated 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.

The weight of the breasts and poor skin elasticity has caused the breasts to sag. The correction is a lift. You can consider an exchange for smaller implants and/or adding bioabsorbable mesh to better support the tissues. I've included a video I hope you find helpful.