I have a very large cosmetic breast surgery practice in Henderson and Las Vegas, Nevada. I specialize in breast augmentation with implants, breast lift surgery, breast lift with augmentation or also called Augmentation-Mastopexy, and Breast Reduction. Basically, women want what they don’t have. Most women with a natural B cup bra size or larger will naturally and expectedly sag at some point. GRAVITY. There is no escaping it.
It always is interesting to hear a woman describe her appearance. Perceptions of one’s self are across the board so to speak. I always ask patients on an initial consult if they have breast sagging and whether or not it is an issue for them. Some patients explain how incredibly saggy they are, and then upon examining them, the breasts are perky and high. Other women swear that their breasts are not sagging AT ALL, and upon examination we see that their breasts are pancakes hanging to the level of the belly button. Regardless, women of all shapes and sizes present to my office for breast contouring surgery. Most patients are intelligent, well spoken, and many are professionals or busy mothers. So I don’t understand why there is this common misconception that breast implants treat sagging. The larger, the better. How would a large breast implant be expected to defy gravity and lift a breast? Magic? Breast implants ADD volume and INCREASE bra cup size. The increased weight would pull things down, correct?
Here is a typical scenario: Smart, intelligent, attractive female comes in for consultation to treat breast sagging. She is a natural 34 D bra and does not want to be larger, if anything, wouldn’t mind being a bit smaller. I discuss breast lift surgery and she is confused. “No, I think I need a breast implant. I really want a breast implant.” Really? But if I heard you correctly, you didn’t want to go from a 34 D to a 34 F?
Let me clarify: Breast implants DO NOT treat sagging. They DO NOT lift a breast. They DO NOT defy gravity. Gravity always wins. Breast implants increase cup size, not just a little, but a lot. At least one cup size or larger. Think of 200 cc as one cup size. Practicing in Las Vegas, I can’t remember the last time I used a 200 cc implant. (My most common implant size range is 350-400 cc, which creates a roughly full C/ small D bra size in a relatively small-chested woman)
Larger breasts are heavier. Larger breasts will sag more. This is normal physics, laws of nature. So I don’t understand why the concept is so confusing?
Breast lift surgery (Mastopexy) surgery treats sagging! Keeping the breast size normally proportioned or slightly smaller will increase the longevity of the lift results. Decisions to increase breast size with the addition of an implant can lead to recurrent sagging over time. This is normal and expected. We will never win the battle with gravity. If your breast is large enough, you neither need nor should want an implant. Not only is it expensive, but also it adds a realm of unpredictability, a future of maintenance surgery for potential ruptures, and in the end aggravates sagging.
Women almost never regret breast lift surgery and wish their old saggy breasts back. But there are many women who regret their decision to add a breast implant, when in the future they have to deal with large, saggy, and stretched-out breasts. It certainly keeps us plastic surgeons busy.
There are many women who are small breasted and sagging and do require an implant for volume, shape, and bra cup size increases. Breast lift with implants is a commonly performed procedure with excellent results in these individuals. Also termed Augmentation-Mastopexy, silicone or saline breast implants are typically placed under the chest muscles and a simultaneous breast lift is performed. The results are gratifying, long lasting, and life-changing in these individuals.
Hayley Brown MD, FACS
Desert Hills Plastic Surgery Center, Henderson and Las Vegas, Nevada