If you have decided to have breast augmentation, you need to realize that if you have a certain amount of sagginess, this needs to be corrected at the same time during your breast augmentation. Many patients come to the clinic thinking that they are just going to need a breast augmentation, but a physical exam will determine if the relationship between the nipple and the breast mound is appropriate. During your consultation, I put my hand under your breast folds and transfer this location onto the breast mound. The nipple needs to be located in the event that you have breast sagginess at the level of the inframammary folds.
If you have breast sagginess, there are a lot of things that we can do. It is universally accepted that if your breast sagginess is just about 1 cm, using the breast implant to augment the breast will correct this problem without any additional surgeries. This is because whenever you insert an implant, the breast pocket gets expanded and then the difference of 1 cm would be corrected by stretching the breast pocket with the implant. But, if you have a sagginess that is more than 3 cm, you are going to need what we call a periareolar lift, where the skin is cut around the areola and the nipple-areolar complex is lifted to a more appropriate place. If your sagginess is more than 4 cm, your breasts will require what is called a lollipop lift, with a scar around the areola and going down toward the bottom part of the breast.
What happens if you do not want to have a breast lift? You do not want a scar around the areola. You do not want to have a scar around going down like a lollipop. Well, essentially, what is going to happen is that even with a big implant, your breast tissue is not going to expand enough and you are going to have a big saggy breast that looks horrible. For example, in this video, I had already placed an implant prior to lifting the breast. While the patient is sitting, the breast looks big, but notice that the nipple and areola look saggy and the relationship between the implant and the breast mound is incorrect. Trying to cut corners just because you are not willing to accept a scar around the breast is not the best idea to get a nice result. If you come to my clinic to have a breast augmentation and you require a lift, but you are not willing to accept the fact that you need an implant with a lift, then I am not going to do your surgery, because you will look horrible and I am not going to put my name on a bad job.