Background: Breasts that are either deflated or have developed sagging are prime reasons to pursue breast augmentation surgery. Pregnancy and weight loss are the most common culprits for causing this type of breast shape change. Breast augmentation surgery is the solution to these breast shape concerns.
With loss of the supporting breast volume combined with stretched out skin, the breasts not only get smaller but that likely will develop some sagging as well. While breast sagging occurs in a variety of degrees of magnitude, these degrees of sagging are definjed by where the nipple sits relative to the inframammary fold. The relevance of this to the breast augmentation patient is whether their breast sagging will require some type of lift with their implant placement or not.
The most difficult breast sagging patient is the one whose nipples are right at the level of the inframammary fold. This makes them marginal for whether they can just have breast implants alone. Will the implant volume create enough of breast mound and nipple elevation to avoid the need for a breast lift? Two factors play into whether this is possible, the implant volume’s and the potential for lowering the existing inframammary folds.
Case Study: This 24 year-old female wanted breast implants. She was very small framed and thin and had two pregnancies. As a result, she had lost all of her breast tissue and the stretched out skin had a little sag.
Under general anesthesia, she has smooth round high profile silicone breast implants of 400cc size placed. Through an incision placed lower than her existing inframammary folds, a dual plane partial submuscular position was made which also lowered the fold levels as well.
Women who are marginal candidates for needing a breast lift can avoid this undesired possibility by a combination of an adequately sized implant and dropping down the level of the lower breast folds. There is also some risk of developing bottoming out of the breasts but this must be balanced with how much one wants to avoid the scars from a breast lift procedutre.
Highlights:
- Breast implants can adequately ‘reinflate’ breasts as long as they do not have appreciable breast sagging.
- In many mild cases of breast sagging, the inframammary folds must be lowered to get the implants adequately centered behind the nipples.
- The size of the breast implant chosen will determine how well any breast sagging and excess breast skin is filled out.
Dr. Barry Eppley
Indianapolis, Indiana