After Breast Augmentation, Worried About Sagging—Should the Implants Be Removed and a Lift Performed?

Hello.

We are Moms Surgery & Plastic Surgery.

Today, we would like to discuss cases in which sagging develops years after breast augmentation, or in which patients consider removing their silicone implants and undergoing a lift because of concerns about the implants.

People undergo breast augmentation for reasons beyond simply lacking volume.

Some people originally had a certain amount of volume but consider augmentation to improve sagging caused by childbirth or aging.

However, it is now widely understood that improving sagging often requires a breast lift rather than augmentation alone.

Characteristics of Sagging Breasts

When you are young, sufficient skin elasticity and tissue support help maintain a naturally full shape.

However, over time, as the skin loses elasticity and the tissue shifts downward, overall sagging develops.

This is especially true when there was originally a significant amount of volume; the breasts may become loose and elongated, much like a balloon after the air has been let out.

Because of these changes, many people think that restoring the volume will bring back the firmness.

Changes That May Occur When Only Implants Are Inserted

However, adding implants without addressing the sagging may lead to a result that differs from the desired shape.

For example, the nipples may remain positioned low while only the upper breasts appear prominently bulged.

From the side, this may be described as resembling Snoopy’s nose.

Ultimately, rather than creating a firm and natural shape, this can result in an awkward appearance that seems filled out only at the top.

In addition, as the weight of the implants is added, the sagging may progress further over time.

For these reasons, some people visit us after several years to consider removing the implants along with a breast lift.

The Condition of the Tissue Must Be Considered After Implant Removal

When implants have been in place for a long time, the tissue in the lower part of the breast is often very thin.

If this condition is not carefully considered and the sagging tissue is removed as in a conventional breast lift, the lower breast may lack volume.

In particular, this may result in a change in which the lower central area appears sunken.

To reduce these issues, it is important to organize the skin while preserving and making the best possible use of the mammary gland and fat tissue.

How to preserve and use the tissue that remains can be an important consideration.

A Conservative Approach Is Also Needed When Removing the Capsule

The capsule must also be considered when removing implants.

In general, because of the possibility of a seroma or inflammation, removing the capsule may be considered.

However, when a breast lift is performed together with implant removal, the lower tissue is often insufficient, so a conservative approach to the capsule may also be necessary.

This is especially because attempting to remove the capsule too thoroughly can also damage normal tissue in many cases.

“​​How much tissue to preserve is also an important surgical consideration.”

A Surgical Approach That Considers Nipple Blood Flow

In a breast lift, the direction of blood flow to the nipples is also very important.

This requires particular consideration in patients who have undergone augmentation, as the blood vessels in the lower part of the breast may already be damaged.

If this condition is not considered and an inferior flap is used as in older techniques, it may place greater stress on the nipple tissue.

In the past, when understanding of breast blood flow was limited, cases of nipple necrosis sometimes occurred because of these issues.

This also led to the mistaken belief that breast lifts or reduction surgery were dangerous.

Today, it is considered important to develop a surgical plan that takes both blood-flow preservation and the condition of the tissue into account.

How to Choose Surgery Appropriate for Your Age Group

Breast surgery is not simply about creating a particular shape; it is important to consider a balance suited to your current condition and age.

Especially when sagging has progressed, organizing the position and elasticity of the tissue may be more important than simply adding volume.

After implant removal, a breast lift is also not merely a matter of removing the implants. An important consideration is how to use the tissue that remains to create a natural shape.

We hope today’s information was helpful to those considering a breast lift.

Thank you.