There are those who just want to take care of the sagging or there are those who want to take of both sagging and volume. There are also some who want to take care of sagging and contraction.

Those who are interested in correcting the sagging and increasing the volume have had to deal with breast sagging after giving birth as they lose volume in the breasts as well. There are those who go on a severe diet that leads to loss of volume as well.



Pretty looking breasts need both rich volume and shape therefore sagging correction and implant augmentation are both necessary.

But of the patient has much volume and sagging breasts, she would only be interested in the correction.

Let’s look at the various cases that may arise.




If you have a small volume, you would consider implant, not concerning the sagging degree. If the sagging is not severe, we can make the breasts look less sagging with the use of the implant.

I think that I have stated this before. If you use just the implant (stable implant, dual plane), you cannot lift up the breast. The implant can help the skin stretch out so that there are no wrinkles on the breasts. But is the sagging is severe, the implant does not provide any visual help. You would need correction (that result in wound) and you would only need to use the implant.

 
If you have large volume breasts then there is no need to use the implant and the patients also do not want to use it. Contraction is done and at the same time lifting is applied. In most cases, contraction leads to the lifting of the breasts.

It is not easy when the volume is moderate. In this case, the patients do not know what they need to get. If the volume is moderate, and you have minor case of sagging breasts, then it is better to use the implant. Lifting causes wounds therefore, using implant is less resistant by the patients and it is also cheaper.

 
What if you have minor level of both volume and sagging breasts. We need to decide whether you would need both enlargement and correction or you would just choose one of them. There is not one right answer. If you want large volume, then you would need the breast augmentation. If you just want the sagging to be correction, then you should just get the correction done. If you want both so much, then you can get both.

So the key question that I raised, is using the implant meaningful or not, is not something that is easy to answer.




But the breast augmentation and correction methods are different on those with sagging breasts and on those without. There are more things to consider when we conduct breast augmentation on sagging breasts. We have to improve on the sagging with the usage of the implants. This is where we apply dual plane procedure. We removed the point of interaction that becomes loose and make contact with the implant. The new interaction with the breast cell and the implant would avoid the sagging. But this is not applicable on the severe sagging breasts.



Also all sagging breasts do not have volume on the upper side. The implant needs to fill up this upper side of the breasts therefore, the implant needs to be stable in shape. We all this “shape stability”. Allergan’s Style 410 is one of the most shape stable implant. There is also Mentor’s anatomical type, Silimed’s both anatomical / round type that are stable in shape. All these productions have FDA approval as well.

There are also many sagging corrections according to the degree of sagging. Simple incision around the areola or incision on the bottom of the breasts, T-shape incision on the bottom of the breasts, and etc. There are various methods that could be applied.

Today, we looked at how implants can be used for the sagging breasts and somehow we got to cover more than necessary. This is all for today. Thank you for reading. Have a great day.

Q. Which is better for the sagging breasts? Round type implant? Or the anatomical type?

I have shared before in the old post. Dual plane surgery is conducted for the sagging breasts.

Dual plane should be done through inframammary fold.
 




Implant put under the pectoralis muscle in a sagging breast looks like a lump on the breast. If the implant is put in through the dual plane, then the sagging breast would look natural and good with the implant.

If the implant is put on top of the pectoralis muscle, it would make the implant expose more because of the less amount of skin and its thin layer.
In answering today’s question, it is better to use anatomical type implant for the sagging breasts.

The image below is one that I shared in the past.



Round type implant when standing up looks smaller than anatomical implant that has the same volume. The top part of the implant is crushed downwards.

If you ask whether or not the round type implant maintains its round shape when put into the body, it does not.
As you see in the image above, the upper part crushes downwards. The same applies for the textured type as well. All the round type implants that are sold today are the same.
But a form stable implant maintains its shape eventhough it is standing up. Natrelle and Polytech anatomical implants have such stable form.

Sagging breasts means that there is not much volume on the upper breasts therefore patients with sagging breasts want to fill up the upper part.
There are many who think that the anatomical type implant is too thin to fill up the upper volume and want the round type.

However, this is not true in reality.
Round type when lying down is round as its name says so. But when it stands up, the implant crushes down.





If there are two implants with same volume, the one that fills up the upper volume of the breast is the anatomical type implant.  (Full height, ie. high standing anatomical type implant)

If a round type implant has a strong exterior surface that helps maintain its form, this might be better that the anatomical type implant.
However, the round type implant in the market today are produced with less stability than the anatomical type implants.



Today, we looked at which implant, round or anatomical, to choose for sagging breasts. Thank you very much.

Breast Ptosis Surgery, KIES-U Plastic surgery Korea

How do your breasts change after you give birth or as you get older?

First, is when most of the fat on your breast drops down and the lower part of the breast stretches.

Second, is when you lose volume in the upper breast. We call this glandular ptosis.
Please refer to the image below.

Glandular ptosis that is formed after giving birth

The glandular ptosis formed after giving birth is different from the real ptosis.

In the real ptosis, the upper breast skin stretches causing the nipple to droop also.

As you get older, both your nipple and ptosis droop downwards.

Those patients who come to the clinic to talk about the ptosis do not know if they have loss of volume, glandular ptosis, or real ptosis. Let’s look at each with an aid of the images below.

1)     Normal breast

Normal breast without any ptosis

Your skin has good elasticity and your ptosis along with subcutaneous fat are all in good condition before giving birth. (Although your breasts may be small) Your nipples are always above the lower breast line. This is very important for aesthetical good look.

The 2 images below are of a patient who gave birth to two children and thought that she had a severe case of sagging breasts. The word “sagging” is rather subjective but from a doctor’s point of view, I don‘t think that there is any droopiness.

The ptosis tissue dropped down a little and there is a loss of volume on the upper breasts so basically there is less volume on the breasts. Breast augmentation would lead to positive results for her.

Loss of volume on the upper breast after giving birth

After breast augmentation through areola incision and areola reduction

 
2)     Glandular ptosis

We can see the glandular ptosis in the image below. The nipple is positioned lower than the bottom breast line.

Droopy breasts with loss of volume after giving birth (Glandular ptosis)

But the tissue on the lower breast is stretched out, and there is a loss of volume on the upper part. Therefore, much of the skin has fallen below the lower breast line. (Glandular ptosis)

You cannot put implants on the breasts with glandular ptosis as you would on the normal breasts. You must conduct biplane breast augmentation.

Biplane requires the implant to be positioned below the pectoral muscle but the lower part of the implant has to be on top of the pectoral muscle.

Biplane breast augmentation is conducted on those patients with glandular ptosis

3)     Real ptosis

Real ptosis is caused when the skin on the upper breast loses elasticity and droops downwards below the nipple – areola.

Drooping breast with loss of elasticity due to aging and giving birth (real ptosis)

You would need breast ptosis surgery in order to aesthetically fix the drooping breasts (real ptosis). Many patients already know this but breast ptosis surgery does not require implant but involves periareolar lift.

This leads to a lot of wounds / scars therefore you need to talk with your doctor and make a careful decision.

At times you can use implant for the breast ptosis surgery as well.


This may seem awkward but ….
Whenever I conduct breast ptosis surgery I feel that the beautiful looking breasts can change after giving birth meaning that a woman needs to sacrifice her beauty for a birth of a baby. If a woman does not sacrifice her beauty, no baby would be born.…..

So I try to meet my patients with drooping breasts with most respect. I think that all mothers need the utmost respect.


Thank you.