Background: Breast sagging can be treated by either the use of a lift or an implant. A lift works by removing sagging skin and physically moving the nipple upward. Any lifting effect of an implant comes from tissue expansion with an outward and upward push. In many cases of breast sagging both a lift and implants are used because an implant can not really push the nipple up very much.
Many women understandably try to avoid the need for a breast lift by using a large breast implant. While this would seem to be an effective approach, the reality is that unless the nipple is at or above the level of the inframammary fold a large implant will push the nipple further down. Thus it becomes important to get the nipple moved upward by some form of a breast lift even if it is not a complete one.
Case Study: This 44 year-old female had lost some weight and had breast implants placed years ago. She was never completely happy with their small size and how they did not lift up her breasts. Since she has lost weight her breast sagging had become worse.
Under general anesthesia, vertical breast lifts were performed as well as breast implant exchange. Her existing 450cc saline implants were replaced with 900cc saline implants (700cc base size filled to 900ccs) Given her large and taller body size, this size of breast implant did not look too big.
Even with a larger breast implant size, a sagging breast may still not be sufficiently lifted. Only a formal lift through tissue excision and nipple-areolar relocation can a breast be lifted. With larger breast implant sizes the type of breast lift can be affected. With larger breast implant sizes, the need for skin to accommodate that volume may eliminate the possibility of any horizontal skin excision. This leaves the vertical or the lollipop breast lift as the only breast lift of choice.
Highlights:
1) Many women want to lift their sagging breasts by implants alone but this rarely is successful.
2) Even with the use of larger breast implants some actual lifting of the breast is usually needed.
3) The size of the breast implant chosen affects the type of breast lift that can be used. (vertical vs anchor pattern)
Dr. Barry Eppley
Indianapolis, Indiana