Background: Breast augmentation patients present with a variety of breast shapes that may necessitate additional procedures other than just the placement of an implant.Such is the case with sagging of the breasts. While many patients think that an implant will lift a sagging breast, this is not so. While it is true that nipple positions can be elevated by breast implants, that only occurs when the nipple is at or above the inframammary fold. (no breast sagging)
Women that have had breast implants for a long time often present for implant exchange/replacement. This is due to a variety of reasons such as implant failure and the desire for larger or smaller implants sizes. It is common that at the time for new breast implants the breasts have changed from the first time the implants were put in. Due to weight gain/loss, pregnancies and gravity, breast tissue that was once on top of the implant has now slide off of it. This creates a unique form of breast sagging known as implant sagging.
Thus breast implant replacements may necessitate the need for a concurrent breast lift procedure. Whether the implants size is the same, bigger or smaller a breast lift is needed to get the breast mound and nipple back up over the implants.
Case Study: This 47 year-old female had saline implants placed 14 years previously. (400cc size) While her breast implants remained intact, she was not happy with the appearance of her breasts. Her breasts had become saggy as the mound tissue had fallen off of them. She also wanted larger breast implants.
Under general anesthesia she had vertical breast lifts performed as well as replacement of her implants. Her saline implants were replaced with 550cc moderate plus profile silicone implants.
Depending upon how much breast tissue one has at the time of the original breast implant placements will determine to a large degree how the breasts will ‘age’. The more breast tissue one has initially the more likely subsequent tissue sagging will occur. Implant replacments years later may then require a simultaneous lift.
Highlights:
- The combination lift and implant operation is a challenging breast reshaping procedure that its associated with a high risk of revision.
- There is a delicate balance between the size of the breast implant desired and the amount of lifting needed.
- Many breast implants over time will have the natural breast tissue slide off of the implant creating the secondary need for a lift at the time of their implant replacement.
Dr. Barry Eppley
Indianapolis, Indiana