May 2024

Will My Breast Implants Sag Over Time?

Getting breast augmentation is an exciting and life-changing procedure. No matter what, over time your breast implants will respond to gravity. When breast implants are first placed they sit high and firm. In most cases, the implants are placed under your chest muscle, which is initially very tight. The positioning can cause the implants to sit artificially high. In plastic surgery, we refer to this as “riding high.” Over time the muscle relaxes and the implants fall into place and generally look great for years. As time passes gravity affects the implants and natural breast tissue, much like aging skin, weight changes, pregnancy, and breastfeeding.

 These processes can increase the distance from the nipple to the breast crease so that the implant appears to sit low. In most cases, implants look great for their duration but they will respond to gravity to varying degrees.

How Long Do Breast Implants Last?

Saline Breast Implants

Because saline implants are filled with IV saline, a deflation is obvious as one breast implant will go flat leaving the breasts dramatically asymmetric. In the event of an implant rupture, the saline is reabsorbed by the body while the deflated breast implant is easily replaced in a breast revision procedure.

 *The average lifespan of saline implants is about 10 years although they can last much longer.

Silicone Breast Implants

New-generation silicone implants are cohesive, meaning that the gel inside the implants is semi-solid and should not leak if the implant is compromised. These implants are sometimes called “gummy bear” implants after the popular candy that bears similar characteristics.

If silicone implants rupture the result is not as obvious as the gel stays put. This is called a “silent rupture” and requires a radiographic study such as an MRI or ultrasound to diagnose any rupture. For this reason, it is prudent to more carefully monitor silicone implants with yearly visits to your plastic surgeon and radiographic studies when appropriate.

The average lifespan for a silicone implant is not well-defined because these implants are relatively new and last a long time. Most surgeons advise replacing silicone implants every 10 years. This accounts for a common occurrence with aging silicone implants called gel bleed where the gel can permeate the implant coat in microscopic amounts.

When considering how long implants last, it is important to remember that many women choose to replace their implants for different reasons other than failure or aging of the implant. Many patients desire a change in size or want a different shape. Some have lost or gained weight which affects the look and size of their breasts. For some, pregnancy changes in the breasts require new implants with or without a breast lift.

Regardless of the reason, it is important to know that implants are not permanent medical devices and will require removal and replacement at some point.

Do Breast Implants Get Droopy?

Gravity is the most powerful force in the universe and will affect the breasts. Implants add some weight to the breasts which ultimately puts more force on the breast tissue and skin over time.

Implants may initially sit high if placed under the muscle, but they will eventually settle into place as the muscle relaxes. The implants can also stretch the skin and lower pole of the breast over time. Factors like implant size, skin quality, and tissue quality play a role in how much the implants will sag. Smaller implants and better skin quality will sag less than larger implants and poor skin quality.

What Should I Do If Breast Implants Sag?

Prevention is the best solution when planning for your breast augmentation. It starts with choosing implants that are in proportion to your anatomy and not too large.

  • Once healed from breast augmentation surgery, it's best to always support your implants with a form-fitting bra, especially when exercising. Good external support will help more than anything in preventing sagging and stretching of the tissue.
  • Finally, nurture your breast skin with daily application of a hydrating moisturizer and sunscreen at the decolletage.

When implants cause the breast tissue to stretch it happens primarily at the lower pole skin and soft tissue. This results in an increased distance between the nipple and breast crease. The implant sits low and is termed “bottoming out.”

To fix an implant that has “bottomed out” sutures are placed to raise and reinforce the breast fold or inframammary breast crease. Oftentimes, Dr. Burns will also place laterally if he observes that the implants migrate to the sides of the chest wall while the patient is lying down. These sutures are placed internally.

In some cases, Galaflex or Durasorb internal mesh is added as an extra layer of support for the implant and breast skin. The mesh acts as an “internal bra” that hugs the bottom of the implant, reinforcing the sutures. If the amount of breast tissue sagging is more significant some skin and tissue may need to be removed. This can be done with a traditional breast lift or by removing skin from the lower pole in a wedge excision.

In some cases both the implant and breast tissue sag; typically after weight loss, weight fluctuation, or pregnancy. In those cases, breast lift surgery is necessary to reposition the nipple/areola and lift and shape the tissue.

Complimentary Consult

Scheduling Breast Revision with Dr. John Burns

Even with a well-executed breast augmentation, at some point breast implant revision will be part of the journey. At some point you will either need to replace your implants or have them removed altogether. Making the decision to select implants that fit your goals, your body frame, and fit your lifestyle are considerations you can make prior to your surgery that position both you and your breasts for maximum success.

If you have already have implants and are looking to make a change to your breast aesthetic, we invite you to get in touch with our team to schedule your complimentary consultation with Dr. John Burns MD.

Learn More: Time For An Upgrade? 3 Signs You Need New Breast Implants

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