Sagging breasts: Inevitable after breast-feeding?

"My breasts.. were a little sagging.. but they became worse after breast feeding my second child. My breasts became wrinkled. My friends were amazed at what they saw and they wanted to touch my breasts. They say that they will never breast feed their children. I didn’t know that this would happen because I didn’t breast feed my first child but after breast feeding my second child, my breasts have become like that of an old woman. "

This is a content written by a housewife in an internet community. This was something that I could not neglect. It is sad to know that one needs to give up beauty for pregnancy and breast feeding.

But there is something unscientific here. It’s not just the content but there are many who think similarly. As a cosmetic surgeon, I would like to point this out. Sagging breasts are closely related to pregnancy but it is not related to breast feeding.
Of course, I have medical reasoning behind.



In conclusion, breast feeding does not lead to sagging breasts therefore, you can relax and carry on with breast feeding

I would like to refer to a research conducted by Dr. Brian Rinker from Kentucky University, USA.

The research was conducted on 134 patients with sagging breasts. The research covered various factors such as age, weight change, high BMI (body mass index), bra size, number of times begin pregnant, smoking, breast feeding, weight increase while pregnant, regular exercise, etc.

The factors that lead to sagging breasts are
1) Age
2) Smoking
3) Sudden loss of weight (20 kg or more)
4) Obesity
5) Large sized original breasts
6) Number of pregnancy

Factors that do not influence sagging breasts are

1) Breast feeding
2) Increase in weight during pregnancy
3) Not exercising upper body

The surprising fact here is that the breast feeding is not a factor that leads to sagging breasts. Also, a common happening of increase weight during pregnancy does not make your breasts look bad.

Upper body exercise that a lot of fitness trainers recommend, also does not help out prevent the sagging breasts.

Pregnancy can lead to sagging breasts, so if you get pregnant number of times, this might worsen the sagging breasts. However the breast feeding does not. Breast feeding does not have any influence on how your breasts shape.
 
This research needs more work in the future, but it is defining that the result shows that breast feeding does not have any relations with sagging breasts.
There is no scientific fact that sagging breasts and breast feeding are related to one another. We call this superstition. It’s like saying that there is a goblin on that mountain that moves around the hills whenever it rains.

Another problem is that fashion or fitness related websites or magazine advertisements show contents that have absolutely no relationship with the cause, prevention, and treatment of sagging breasts. There are contents such as some healthy food, exercise, or a certain type of clothing help improve on sagging breasts.
This is kind of funny.

Breast tissue are close to Cooper’s ligament. It is not closely stuck to the pectoral muscle. Exercising in a fitness center does not help improve the breast tissue. Also fitness training contracts the muscles often therefore making the fibrous tissue larger. The training does no pull up the muscles. It is same as saying that if a person uses his face muscles a lot such as smiling a lot, then he should not have any wrinkles.
There is no scientific fact that sagging breasts can be improved with exercises. I do not want my patients to believe something like this as a doctor.

It is not good to gain and lose weight frequently. If you lose weight all of a sudden, you will lose much energy and your breasts will fall down as well. Sudden change is weight is not good for you.

There must be some genetic reasons as well for the sagging breasts. Age or the large size of the original breasts are some factors that you cannot control
But there are factors such as smoking, sudden weight change, obesity and others that you can control.

In 2003, 32.8% of women breast feeded their babies in US. There is not much difference in Korea.

There was a survey for the high school girls in Italy and 30% of these students though the breast feeding leads to sagging breasts.

There were survey result in Dominican Republic in which the mothers stopped breast feeding quickly because they thought that their breasts looked weird or abnormal because of it.

Breast feeding is a great source of health for the babies. There needs to be more women who breast feed their children. There is no scientific proof that breast leading badly influence the shape of your breasts.

Sagging breasts after pregnancy and giving birth can be solved with simple cosmetic surgery.

Breast augmentation Before & After

You need to quit smoking, not lose weight suddenly, and control so that you do not become obese. These are things that you can control. But you do not need to control breast feeding. As of what we know today, breast feeding does not have any effect on sagging breasts.

All mothers are beautiful. Breast feeding mothers are more beautiful.

This is all for today. Thank you very much.

Q. What underwear(bra) can I wear after breast augmentation? 

A. Underwear such as bra have a lot of functions.
Normally, bra is used so that a woman feels comfortable in doing breast related activities. In our country, all women need to wear it and it has become one beauty fashion product.




It is difficult to say that the bra is a mandatory clothing for the breasts. Also there are some people who think that the bra limits the blood circulation in the breasts there is having a bad influence.
I would like to share few things that you need to be careful about after breast augmentation.


First, you will be wearing bandage or pressurized bra after the surgery. Such clothing is a functional one and is used to stop the bleeding.
After you loose the bandage, you need to be careful so that the breasts do not get any harm and you need to know that you need about 6 months for your breasts ‘to get in shape”.




As the swelling gets better, the implant needs to press on the skin tissue making a good looking shape and also preventing itself from moving into another location or position. This can be helped with the use of correction bra.

However in my case, I have felt that the correction bra has a lot of inconveniences and there are some patients who can never get used to it, therefore I do not always recommend the correction bra to my patients.

Breast augmentation through axillary crease can make the implant move to upper location therefore one uses a band on the upper part so the implant cannot be moved.
The implant tends to move downwards in case of inframammary fold incision, therefore you need to wear sports bra so that the bra can withstand the weight of the implant.



Therefore, in the first month after the surgery, you need to use a bandage of Surgi-bra. In 2 ~ 3 months of the surgery, you can use upper band if necessary, and wear various type of other bras if necessary.

Younger patients have tight skin therefore the skin itself are pressurizing the implant. So it is recommended that these young patients do not wear bra that are too closely pressed on.

Older patients have loose skin with less elasticity therefore the implants are not pressurized. Therefore, it is recommend that they wear bra that will help the implants be stationed at the required location quickly.

Most patients can wear wired or wireless sports bras within the 6 months of the surgery.
If you get breast augmentation through fat transplantation, it is recommended that you use correction bras that are fitting with the inframammary fold as the fat used is half liquid therefore it gets absorbed or extinct as the liquid slips downwards.



Wearing what type of underwear depends on case by case. You should check with your doctor frequently on what kind you clothing to wear. The bra that you wear in the first 6 months of the surgery are strictly for functional purposes therefore it is not wise to wear tight bra to cosmetic reasons.

Today we looked at what bra to wear after the breast augmentation.
Thank you for reading. Have a great day.

Revision surgery for saline bag implant rupture

There are cases of saline bag implant collapsing and leading to revision surgeries.
When the cohesive gel implant collapses, the volume is not completely lost. You might or might not feel that the shape of your breast changed a little. But if the saline bag implant collapses, you will be able to know right away as the volume shrinks a lot.



Usually the saline bag type does not tear off and leak. There would be a very small hole when the water leaks making the size shrink.

When we use the saline bag type implant in the breast augmentation surgery, we try to makin the incision spot very small therefore we fold up the implant, put it into the pocket, and then fill up the implant with the hose. Many think that the connecting part between the hose and the implant is where there is a leakage (Refer to image above)

We do not know exactly why the saline bag type collapses or gets damaged at all times.
I think that if there is not enough water at the time when you fill up the implant, then there is a high possibility of rupture.

Whatever the type of the implant it is, whether it is saline bag type or cohesive gel type, if the implant is folded and put into the body, there will be a lot of friction on the implant and this causes damage and leakage. This happens often if the saline bag type implant is not filled up properly.


The MRI shows wrinkled surface of the silicone gel type implant that is not filled up properly. ( Hammond, Aesthetic Breast Surgery, 2009, Saunders, Elsevier)


If this happens, there is a high possibility of capsular contracture.
So if there is a collapse or you need a revision surgery, one would have to cover up the initial pocket, find a new one for the new implant. If the first surgery was done below the pectoralis muscle, the revision would be donve above the pectoralis muscle, vice versa.

A completely new environment for the new implant would help avoid the development of capsular contracture!!





If a patient had ‘very bad shrinking’ experience of the saline bag type implant, then she would not want to use the saline bag type again.
Usually, she would want to use silicone gel filled implant. Both round and anatomical type would be possible to use. (Revision can be done by the the anatomical implant)

Saline bag type implant can be used in the first and revision surgery. This is not a bad thing. But this would be similar to getting non-incision method for double eyelid that results in the eyelid resulting in becoming loose. Then, you might want to get double eyelid surgery with incision to avoid this.



The reason why many people choose cohesive gel implant over the saline bag type is because of the sense of touch. You can know just by touching, how close a silicone gel can replicate a huamn skin. Everyone can know that cohesive gel is close to the skin and is not comparable.
Cohesive gel is a must in the revision surgery.

Is there a high possibility of complications such as capsular contracture when changing from saline bag type to the cohesive gel type? There is no accurate answer to this question. There is no accurate data. I think that if the doctor does the surgery accurately then there would not be any differences from the first surgery.
Whatever implant is use, the most important factor is how the doctor conducts the surgery.

The core choices that you need to make is that the pocket plane of the implant needs to be changed and the incision should be done on the inframammary fold. This would lead to harmless revision surgery.

Most patients who come in for breast augmentation focus on the size, implant type, and the incision part. They are not aware of the ‘plane’. The depth of the plane is most important factor in the breast agumentation surgery.

Today’s content was on the saline bag type implant users who used the implant before the cohesive gel implant was approved in 2007 and needed a revision surgery. If you have any questions, please leave them on the homepage or send me notes. I will get back to you.

Thanks a lot.

Revision of anatomical breast augmentation _ Implant collapse

Today I would like to continue on the breast revision due to implant collapse.
What are the chances that the cohesive gel implant would collapse?
What causes the implant collapse?
How can you know the there is an implant collapse?
What do I need to do in such case?

Cohesive gel implant does not collapse even if a 5 ton truck goes over it. There are soft substance inside that makes the implant itself very flexible. The stimulant such as pressure, accident, and impact cannot cause the implant collapse.



But the product can still break down or collapse. It is very rare to see a cohesive gel implant break down. I have not seen any case like that on a cohesive gel.
It’s sad that there is no gathered date on the collapse rate of cohesive gel implants of different companies.

If a saline bag type implant collapses, it starts to leak quickly. The saline liquid leaks out therefore, the implant constracts and becomes simiilar to a ballon that lost air. The shape of the breast changes quickly and others would be able to notice it.
But, one cannot identify that easily with the silicone gel implant.

The inner substance leaks very slowly. It may take years for you to notice that something is not right.
If there is a leakage, most of the inner susbtances from the cohesive gel silicone implant reamin near the epithelium.
There is no evidence or proof that this leaked substance from the silicone causes damage or harm on the body. So you do not need to be worried if there is a silicone gel implant leakage.

You would need to take a MRI in order to know if there is an implant collapse or not. If you think that the new breasts are shaping differently, then you could be suspicious about the implant collapse.
It is not like the busting tire but air leakage through a small hole. “Cohesive” means sticky therefore, this highly dense substance do not leak easily through the hold and even can maintain its original shape.



Most of the reasons for implant collapse are due to the insertion of the implant during the surgery. The implant may be a defect but the status of the implant is checked byt the doctors before the insertion. So this is not likely. The implant collapse happens as this large implant gets squeezed in into a small insertion hole. If you are concerned about safety the, inframammary fold incision is the best approach.

Therefore, it is important that you choose a safe implant and secure breast augmentation procedure when using the implants that will be in your body for a life time. This surgery can lead to a very long period of complications.

If you are confirmed by the MRI that there is an implant collapse, the best thing you can do is to remove the collapsed implant. This removal is done usually through the inframammary fold approach. You need to move not only the implant but also the leaked substance therefore, you need good visibility.



Today, we reviewed on the cohesive gel implant collapse and breakage.
In conclusion, the fifthe generation cohesive gel implants that have been sold in the market since 2007 have very low incidence rate of collapse, breakage and leakage. If there is a collapse, there would be very low possibility of leaked substance harming the body.

But there are any complications such as capsular contracture that you could be worried about. This is not something that you should take lightly when deciding on the cohesive gel implant breast augmentation. You would need to get this surgery from a highly experienced surgeon who would take care of the safety as well.

Have a great day. Thank you.