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24 year old woman (32DD) wanting a breast lift, am I a good candidate? (photo)

I'm a 24 year old woman who hasn't had children, but am unhappy with the droopiness and asymmetry of my breasts, size of my nipples and lack of upper fullness. I've been thinking about having a lift for some time, and don't foresee having children until my early 30s. I'm wondering what you would recommend as far as type of lift as well as whether you'd recommend an implant. I also have fairly veiny breasts- could this be problematic in surgery? Do you know of any procedures for reducing these?

Doctor Answers (8)

Breast lift with/without implant is a good option

+1
Thank you for your question and photos.  Based on your photos, you look like an excellent candidate for a breast lift at the minimum.  I would recommend at least a vertical mastopexy with scars around the nipple/areola and running vertical down the breast, sometimes combined with a transverse scar under the breast to remove excess skin and tissue inferiorly.  This will improve the shape of your breasts, decrease your areolar size, and place your nipples higher on your chest.
With regard to an implant, this is really up to you.  An implant can really enhance the upper pole (cleavage) area of the breast, and combined with a mastopexy is a very powerful operation.  The complication rate increases when combining those two operations, so if you are on the fence about a breast implant, I would recommend that you proceed with a lift first. You can always come back and augment the breast later.   Keep in mind that you may have some decreased ability to breast feed in the future with any sort of breast lift/reduction type procedure.  This is not an absolute, but some women are concerned about future breast feeding ability.  Find a board certified plastic surgeon and make sure to have all of your question answered.  Best wishes.


Fort Worth Plastic Surgeon
5.0 out of 5 stars 36 reviews

You're a good candidate for a vertical breast lift

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Based on your photographs you do appear to be an excellent candidate for a breast lift.  Based on your photograph I believe a breast lift with a vertical component, not a circumareolar lift will give you the best possible result.

You have plenty of breast tissue so you may not need an implant.  However if you want more fullness above the areola you may need an implant as well.

Brooke R. Seckel, MD, FACS
Boston Plastic Surgeon
5.0 out of 5 stars 26 reviews

Breast lift

+1
From your photos, you are a good candidate for a circumvertical lift (scars round the areola and vertically on the breast). This itself will give you more upper fullness and you have adequate breast tissue to achieve a good shape and volume without implants. I would only recommend an implant if you want to be much larger than you are currently. "Veiny" breasts, as you describe, are fairly common and will not be a problem in surgery. The veins tend to be too large to treat with a laser, so you may have to consider sclerotherapy.

Roy Ng, FRCS(Plast)
London Plastic Surgeon
4.5 out of 5 stars 5 reviews

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24 year old woman (32DD) wanting a breast lift, am I a good candidate?

+1
Hello!  Thank you for the question and photos!   Your photos do demonstrate a degree of ptosis (sagging) in which you nipple-areolar complex lies below the inframammary crease of your breast.  Aesthetically, you could certainly benefit from raising of your nipple-asreolar complex to a more appropriate position, decreasing the size of your areolae, as well as providing more upper pole fullness - all things accomplished with a breast lift.  

Addition of an implant is your decision.  The implant itself will serve to increase the size and provide you even more upper pole fullness, improve shape and provide more perkiness, as well as likely increase cleavage.  

Think about your desires for your breasts.  Then, I would recommend consultation with a board certified plastic surgeon well-versed in breast procedures who will assist you in deciding which procedure(s) are the is the right one(s) for you, given your examination and concerns.  Best wishes for an excellent result!  

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 10 reviews

24 year old woman (32DD) wanting a breast lift, am I a good candidate?

+1
If you are happy with the size of your breasts, I would recommend only a vertical breast lift.  Implants can be placed to improve superior pole fullness or increase overall size and projection.

Find a board certified plastic surgeon who performs hundreds of breast lifts each year. Look for great reviews and great before and after pictures.

Kenneth Hughes, MD

Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 177 reviews

24 year old woman (32DD) wanting a breast lift, am I a good candidate?

+1

Thank you for the question and pictures. Yes, you will benefit from breast lifting surgery. This operation will serve to elevate the position of your breasts on your chest wall.  Whether or not you choose to have breast implants placed as well will depend on your specific/personal goals when it comes to breast size and concerns such as “superior pole fullness”. For some patients considering breast lifting surgery the necessity of additional scars is a “dealbreaker” ; for these patients it is better to avoid breast surgery altogether.
 On the other hand, many patients (If properly selected and who are doing the operations at the right time of their lives  psychosocially) accept the scars associated with breast augmentation/breast lifting surgery as long as they are happy with the improvement in contour, size, and symmetry. This acceptance of the scars is the essential “trade-off” associated with many of the procedures we do in the field of plastic surgery.

  Patients who are considering breast augmentation/lifting surgery should understand that this combination surgery is significantly more complex than either one of the procedures done separately. In other words, the combination breast augmentation / mastopexy surgery differs from breast augmentation surgery alone in that it carries increased risk compared to either breast augmentation or mastopexy surgery performed separately. Furthermore, the potential need for revisionary surgery is increased with breast augmentation / mastopexy surgery done at the same time.  This revisionary rate may be as high (or higher) than 15-20%.  

 Personally, I find that the breast augmentation/lifting procedure to be one of the most challenging  of the breast operations I perform, even compared to somewhat complex revisionary breast surgery. On the one hand,  when performing breast augmentation/lifting surgery we are increasing the breast  size with breast implants;  on the other hand, we are reducing the breast “envelope” in order to achieve the breast lift. These two “forces” must be balanced as perfectly as possible in order to achieve the desired results. Removing too much skin/ breast tissue is problematic;  removing too little breast skin/tissue can also be problematic.  Remember also that patients presenting for breast lifting surgery and general have lost some skin elasticity/thickness making potential incision line healing problems and/or recurrent drooping/sagging important concerns to communicate.  The analogy I use in my practice is that  of a thinned out balloon,  being expanded with additional air; I hope that this analogy helps patients understand some of the issues at hand when performing the combination breast augmentation/lifing operation.
To achieve  a surgical result where the breast implant and breast tissue “come together” and behave like a single breast is one of my goals but can be difficult to achieve.  Essentially, we are trying to create a breast implant/breast tissue interface that feels and behaves as naturally ( as a single unit)  as possible. Generally speaking, making sure that the breast implant has some sub muscular and some sub glandular component ( dual plane)  and tailoring the overlying skin/subcutaneous tissue/breast tissue as precisely as possible over the underlying breast implant is key.
Despite these efforts, breast implants are after all a foreign body that don't necessarily stay where we wish they would;  therefore, breast implant related problems such as positioning ( too high, too low, lateral displacement etc.) can occur  and may be a reason for returning to the operating room for revisionary breast surgery.
I use a “tailor tacking” technique that allows a determination of what breast implant should be used to SAFELY produce the results the patient is looking for. This technique involves use of a temporary sizer and temporary “closure” of the overlying breast skin over the sizer. 
The use of the tailor tacking technique is very helpful.  Breast lifting involves removal of skin ( and tightening of the breast skin envelope)  while breast augmentation involves expansion of the breast skin envelope. These 2 forces are counteracting each other. Therefore, it becomes important to remove the appropriate amount of breast skin and to use the appropriate  size/profile of breast implants to balance these 2 forces appropriately and to allow for achievement of the patient's goals while minimizing risks of complications.  Again, despite these efforts, breast implant and/or tissue/skin complications may arise causing minor or significant complications.
 Generally speaking, it is difficult to achieve the “perfect” result with breast augmentation/lifting surgery, despite best efforts.  Patients should be aware of the complexity of this combination procedure, achieve REALISTIC EXPECTATIONS prior to proceeding, and understand that additional surgery ( along with the additional recovery time, stress, expenses etc) may be necessary in the short or long-term. Patients should understand that the results of the procedure will not necessarily match aesthetically the results of patients who have undergone breast augmentation surgery only.
For example, some patients who wish to maintain long-term superior pole volume/"roundness" may find that this result is not achieved after the initial breast augmentation/lifting operation.  An additional operation, possibly involving capsulorrhaphy, may be necessary to achieve the patient's longer-term goals ( with superior pole volume/roundness).  It is helpful if patients understand that this breast implant capsule used to provide the support for the breast implant is not present during the initial breast augmentation/lifting operation.  The capsule (layer of scar tissue) forms around the breast implant and may be a good source of supportive tissue during revisionary breast surgery,  Including correction of breast implant displacement/malposition problems ( such as bottoming out, symmastia,  lateral displacement etc).
 Potential risks associated with breast augmentation/lifting surgery include infection, bleeding, incision line healing problems, loss/change of nipple/areola complex sensation, and blood flow related issues  to causing skin or tissue necrosis.   Poor scarring,  pigment changes, areola/nipple asymmetry etc. are also potential problems. Again, patients may experience implant related problems such as encapsulation, leakage, displacement problems ( too high, bottoming out, lateral displacement, asymmetric positioning etc.), rippling/palpability of breast implants etc.  Patients may also be dissatisfied with breast size, shape, and/or how the  breast implants and overlying breast tissues “interface” with one another.    Occasionally, a breast implant may even have to be removed and the patient will generally be “implant free” for several months at least.  Obviously, this situation can be quite physically, emotionally, and psychosocially stressful to the patient involved.
Given the complexity  of the combination breast augmentation/lifting operation and the greater risk of revisionary breast surgery needed, there are good plastic surgeons who will insist on doing the procedures separately.
For me, if I see a patient who needs a great degree of lifting, who has lost a lot of skin elasticity, or  whose goal is a very large augmentation then I think it is best to do the procedures in 2 stages (in order to avoid serious complications). However, doing the procedure in one stage does increase the risks of complications in general and the potential need for further surgery. This increased risk must be weighed against the practical benefits of a single stage procedure (which most patients would prefer).


Conversely, if I see a patient who requires minimal to moderate lifting along with a small to moderate size augmentation (and has good skin quality), then doing the procedure one stage is much safer. Nevertheless, the potential risks  are greater with a 1 stage  procedure and the patient does have a higher  likelihood of needing revisionary surgery.
Having discussed some of the downsides  and potential risks/complications associated with breast augmentation/lifting surgery, most patients (If properly selected and who are doing the operations at the right time of their lives  psychosocially) accept the scars associated with breast augmentation/breast lifting surgery as long as they are happy with the improvement in contour, size, and symmetry.
 I hope that this summary of SOME  of the issues surrounding breast augmentation/lifting surgery  is helpful to you and other women considering this procedure in the future.
 The attached link may also be helpful.
 Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 680 reviews

Breast Lift?

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I believe you are a candidate for breast lift. To achieve more projection especially in the upper part of the  breast, an implant can also be considered. This will also increase the size of your breast if that is what you wanted. You should discuss with your plastic surgeon the consequence of the lift and it's effects on breast feeding.

Jake Lim, MBBS, FRACS
Sydney Plastic Surgeon
5.0 out of 5 stars 40 reviews

24 year old woman (32DD) wanting a breast lift, am I a good candidate? (photo)

+1
Looking at the picture: You have Grade II-III ptosis (advanced droopiness). In my personal opinion, a Wise lift "anchor lift" will serve you best without removing any breast tissue. That will take you to a "D' Cup using your own breast tissue without having to worry about a foreign device.
Better to be examined and evaluated in person. Good luck.

Maan Kattash, MD, FRCS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 8 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.