Drooping of breast tissue after breast augmentation—"ptosis"—can create a very displeasing visual deformity. Most often the deformity is due to ptosis that pre-existed the augmentation. Many patients were told they needed a lift but they did not want the scars. They then received a relatively large implant, and this heavy implant exacerbated the ptosis. Sometimes large implants alone are enough to cause ptosis. In other situations, a high-riding implant can cause an upper bulge, and the natural breast tissue will slide off to the bottom of the implant and the nipple will point down.
This illustration from one of Dr. Teitelbaum’s book chapters demonstrates the difference between three closely related problems: fold malposition, stretch, and rippling.
Some type of breast lift will need to be done if there is too much breast skin or if the nipple is too low. This does involve scars—but if loose skin or a low nipple is the problem then a lift (mastopexy) is the only solution. There are various types of lifts with different lengths and scar locations. Dr. Teitelbaum will discuss the scar options for your situation.
If a pre-existing implant is too high, then the implant and, often, scar tissue are removed surgically. Then, a new implant is placed a bit lower so that it pushes what was the drooping breast tissue outwards and upwards.