Do implants sag?

Breast sagging after lift and implants

In this blog post, I’m looking at how breasts change over time and what implications those changes have for people with implants.
You may be interested in my previous post that discusses if breast implants need to be replaced.

It’s important to think about the long-term implications of any kind of breast surgery – whether this involves implants or not – before making a decision on what procedure to have. Talk to your surgeon about this at your initial consultation, so you know what issues you’re likely to face in the years after your surgery.

The impact of ageing on breasts

As we get older, our bodies change, and a woman’s body is not exempt from the natural ageing process just because she has had plastic surgery.

There are many changes that happen to breasts through age and these changes mean that all women will experience some sagging of the breast.  This is true for women with AND without breast implants.

Changes we experience include:

• skin becoming loose
• tissue deteriorating
• muscle wastage
• reduction in breast tissue
• development of fatty tissue

Fluctuations in weight, breast-feeding and pregnancy all affect breast tissue, but the single biggest cause of breasts sagging is significant weight change. If you put weight on, the breasts will get bigger; if you lose weight, then the large stretched breast will get smaller and inevitably sag.

Some patients simply have poorer quality skin, which is thin and has stretch marks; these breasts will sag more than others.

Pregnancy and breast-feeding

It’s a myth that breast-feeding causes breasts to sag!

Good, reliable studies have shown that it’s the number of pregnancies, not breast-feeding, which impacts breast sagging.

During pregnancy, a lot of women find their breasts get bigger.  After pregnancy the breast tissue often shrinks back to its original size – or often it becomes smaller.

Sometimes there is enough elasticity for the breasts to spring back to a nice shape. But sometimes – as the breasts shrink – they become saggy and can appear ‘emptier’ or ‘sunken’ in the upper part of the breast.

This is often a time when women decide they would like a breast augmentation – to return their breasts to their more youthful, pert appearance.

Breasts with implants

So how do breasts with implants change over time? And there is anything you can do to minimise the effects of ageing on your implants?

The simple answer is that breasts with implants behave very much the same as normal breasts! All breasts will sag, and certain breasts will sag more than others – regardless of whether they have implants or not.

But, the inevitable changes to breast tissue that occur over time will have additional implications for women with breast implants.

The implications will vary, depending on the size of the implants and the placement of them. 

Let’s look at each of these situations in turn.

Implant size

Bigger breasts generally sag more than smaller breasts anyway. So – the bigger the implant, the more likely the breast is to droop.

The weight of the breast implants – especially larger implants – may cause the muscle and fatty tissue to deteriorate more quickly than if no implant was in place. This would cause the breast to sag more quickly than the same breast without an implant.

Your surgeon should help you choose implants that will give you the breasts you want, whilst also bearing in mind how your breasts will change over time and how the implants will respond to those changes.

Having this conversation is an important part of the consultation process, so don’t be afraid to ask your surgeon about the long-term aspects of breast surgery.

Follow this link to find out more about my practice and breast augmentation in Birmingham.

Implant placement

The location of the implant also affects how that implant behaves over time.

Behind the muscle placement

If the implant is placed underneath the pectoral muscle, that muscle acts like an internal bra and will hold the implant up.  This helps to achieve more fullness in the upper part of the breast in the longer term.

Sometimes, the breast droops but the implant is held up in the pocket behind the muscle.

In cases like this, you are often faced with the rather odd situation where the implant sits high up on the chest wall, but the breast ‘falls off’ the implant. This creates the circumstance where the implant sits above the natural breast tissue and is sometimes (rather unkindly) known as a ‘Snoopy’, or ‘double bubble’ deformity.

In front of the muscle placement

Implants placed in front of the muscle don’t benefit from the support of the pectoral muscles, so they are likely to droop more quickly than those placed behind the muscle.

In extreme cases, for a small number of patients, where the implant is in front of the muscle, if the implant drops with the breast, you can get a ‘rock in a sock’ type of appearance, which is very unattractive.

Implant Surface

The surface of silicone breast implants can either be smooth or textured. Textured implants significantly reduce the risk of capsular contracture, but recently there has been a trend back to using smooth implants. Textured implants also tend to ‘grip’ the surrounding soft tissues and stay in place much better. Smooth implants are much more ‘slippery’ and have a tendency to droop lower and move sideways.

Some patients look to have further surgery to address this kind of problem.

Not all problems can be completely resolved through subsequent surgery, although breast uplift can help in some cases. You can find out more about breast uplift (also known as mastopexy).

Tips for avoiding sagging

There are certain things you can do to help your breasts stay pert for longer – whether you have implants or not.

Avoiding serious weight fluctuations is the single best way to maintain the elasticity of the breast tissue and avoid sagging.

If you do decide to go ahead with augmentation or mastopexy, it’s always best to wait until you’ve had your family. This way, your surgeon can deal with the breast tissue knowing how it has recovered from pregnancy. This will give them a much clearer idea of how your breasts will behave over time.

If you choose to have large breast implants, it’s good to support your breasts in a well- fitting bra for most of the time.

But don’t despair, it’s perfectly safe to leave your bra off occasionally. So, if you need to go braless in your favourite dress from time to time – go ahead and enjoy how you look with your new, fuller bustline!

If you’re thinking about having breast implant surgery, get in touch with my friendly team:

Telephone: 0121 405 0660
Drop me an email: enquiries@guysterne.co.uk

Mr Guy D. Sterne
MB, ChB, FRCS, MD, FRCS (Plast)
Consultant Plastic Surgeon