What do I need to do if my breasts sag after breast implant augmentation?

Some of you might be getting married or are planning to give birth before breast augmentation. Today, I would like to share about what to do in case your breasts sag after breast augmentation due to aging or giving birth / breastfeeding.

One thing that you should recognize is that not one same pattern applies to everyone. The things that can happen to you after breast augmentation varies from one person to another. Therefore, I would like to share some different types and what you can do with you face such problems.

1) Losing skin elasticity

This is when you breasts look like that they lost volume in the upper side, and sag a little. This is not complete sagging but the breast skin has lost some elasticity..
There are those who require a change to a larger implant in such case. The larger implant would pull on the skin making the skin tighter. This makes the breast skin more elastic.

If you have used small size implant more so than what should have been used considering your physical body, it could be better to increase the size of the changing implant. But in general, your skin is thin and weak therefore, larger implant used could only lead to more sagging of the breast.

If the size of the implant was appropriate in the first surgery, it is better to maintain that size in the surgeries after. If you do increase the size of the implant, then it is recommended that you use form stable implant.

The 5th generation silicone gel, i.e. form stable implant was introduced 5 years ago in our country. All of those patients who got breast augmentation before that time used unstable implants. Such implants are not helpful in avoiding the sagging therefore it is better to replace such implants for better shape and elasticity.
One thing that you should keep in mind when changing to larger implants is that there is more possibility of suffering capsular contracture.



I have experienced this many times and I think this is what happens in the re-surgeries. If the original implants did not cause any problems then it means that the implants have no effect on the surroundings., that the implant matched well with the breasts. But if the new set of implants come into the body, the body may react by attacking rather than adapting. Therefore, such activity could end up in capsular contracture in some cases.
Also, you would have to make the size of the pocket larger for the larger implant. We cannot take this lightly and just make the pocket larger. We must remove the capsule as much as possible. For such reasons, I recommend areola or inframammary fold incision rather than the axillary incision for re-surgeries.

2) Low degree of capsular contracture holding up the implant at the upper part and the skin losing some elasticity (fake sagging)

If you have a severe case of capsular contracture, then you would have visited the hospital before you came in for the problem of sagging breasts. If you have low degree of capsular contracture, you tend to stay as you are. (You might not even think that you have capsular contracture) The implant is caught up by the capsular contracture and when you give birth and sagging is caused, an elephant shape is caused because the upper breast only has implant and the lower breast is only composed of your breast tissue.



This is not real sagging but a fake sagging of the breasts. The nipples are facing downwards and the implants are captured at the upper part of your breasts.

Patients think that they have the upper bulge in the breast after giving birth or breastfeeding. Such problem can be solved by opening up the capsule. You would not need general anesthesia in some cases.


But if you have a severe case of capsular contracture then you might need re-surgery that requires shifting of the implant to lower spot or applying dual plane procedure. This would require general anesthesia.

3) Severe case of capsular contracture

If you have a severe case of breast sagging then this would require correction (breast lifting). But the problem is that there already are implants in your breasts. We need to decide on what to do with these implants.

At times, we just remove the implants and conduct the correction surgery. This would apply to those patients who had large original breasts or have had the implants for a very long time. Some might perceive the implants to be bad for them due to many pregnancies or even some might want to remove the implants due to the complications that they have suffered.



Such cases would result in rather simple correction surgeries. But if the implants have been in the body for a long time, these implants make the breast tissue cells contract and thin. Such outcome could limit what we can do during the correction surgery.

But most of the patients want to continue to use the original implants or even use larger ones for re-surgeries. This is a problem. The more severe the lifting surgery is, the blood circulation to your skin and areola/nipple gets cut off. Lifting requires desquamation of much tissue cells and replacement therefore there are a lot of bleeding. Such activity limits the blood supply into the nipple.

Therefore, if we have to replace the implants and correct the sagging breasts, we need to forego some greed on trying to do too much lifting. We should correct the breasts to only some degree, not perfect. But, if you want aggressive correction done, then we need to do the lifting first then place the implants back into the breasts after much time.

The new implants should be form stable implants and we need to remove the capsule as much as possible. Also, we need to use the suction drain.


It is better to do as little incision as possible when conducting the correction for sagging breasts. It is better to do the incision around the areola rather than conducting vertical incision of inverted T incision.

There is nothing dangerous about conducting correction surgery and using the implant in the very first breast augmentation. This is conducted with normal, usual state of blood circulation/supply. But the environment changes in the re-surgery. The implants have made the breast skin thinner and the blood circulation is already somewhat damaged.

Therefore conducting surgery could limit the blood circulation and leading to complications.

The correction should not be too aggressive and if the sagging is very much severe, then the whole process can be conducted in two procedures.