Breast Augmentation: Q&A

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500 Cc or Go Lower? Do I Need a Lift?

I am 25, 5'4", 135 lbs, bwd 15.5, and ribcage measures 33". I have recently lost 40 lbs. I thought I might need a lift, but my ps said I could get good results with just an implant. However due to the extra skin I would need 500 cc's (silicone over muscle). I'm afraid they will be huge and cause even more sagging. But I have a very wide bwd, so will they really look that big? Is there a small enough difference between 400 & 500 cc's that I could go smaller? Should I go ahead and get a lift?

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19 Doctor Answers | Asked by Paloma1 in Missouri

Doctor Answers (19)
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Lift?

I think that, with your frame and current shape, a lift will be necessary to avoid a look of an exaggerated upper breast. Your nipples are low and your breast volume is almost completely behind your nipple. If you are against having a lift then I would use a smaller implant.

Do I need a Breast Lift or not

Using a larger breast implant to substitute for a breast lift may achieve your desire goals in the short term, but will not result in a long-term excellent outcome. The increased weight of the implant will continue to cause your breast to sag over time and will result in you needing a breast lift in a short period of time, but with thinner tissue and therefore, a compromised outcome. You should strongly consider a smaller implant and either a circumareolar or doughnut mastopexy or a vertical... more

Deciding Whether or Not a Breast Lift is Necessary...

Hi there- While I have seen just as many photos of ugly breast lift scars as you have, and therefore definitely understand when a patient expresses a desire to avoid a lift if possible, there are a few critical points to understand: Not all surgeons are created equal, and so therefore not all breast lift scars/outcomes are equal either It is possible to achieve a lovely breast lift with scars that are very inconspicuous Placing large implants above the muscle in... more

Implant Cannot Mask Need For A Lift

Based on your photographs, I do not think that a simple breast augmentation would work for you. Your breasts appear to sit lower on your frame naturally. Along with the ptosis present in your breasts already, an augmenttaion would just give you larger, low breasts. I would recommend a dual-plane breats augmentation with some sort of lift, ranging from a periareolar ( benelli or donut lift) to a full wise pattern ( anchor ) lift. I hope this helps.

Breast augmentation with a Lift

It seems as though you wopuld need a lift. A lift around the nipple or around and vertical is a good option considering your anatomy. THis would also allow the implant to be placed below the muscle Dr J

Lift and implants

First, I doubt that you truly have a BWD of 15. Most people are between 10-12. Most men are not that wide. Second, it looks like you have a lot of loose skin and need a lift of the areola. A full exam would be critical.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Augmentation With Or Without Lift

First of all, I would recommend that you you use a slightly smaller implant. I think 500cc is too large an implant for you since you are already worried about being "too huge". I agree with Dr. Pousti that your nipple is at a borderline position and that you may well get a nice result if you use an experienced plastic surgeon. The nipple location is always the key; when located at or above the inframammary fold it is possible to obtain a nice result with... more

500 Cc or Go Lower? Do I Need a Lift?

Great photos thanks. Very hard to give exact advise. If you desire larger implants than a 350 cc than I would recommend a staged operations. First the lift I think from your photos the right needs a vertical or full lift while the left a donut. After 2 to 3 months than implant sub muscular a larger than 350 cc to attain the result. Other options are available but best to have in person evaluations.

Beautiful breasts without implants

Dear Paloma, Your concerns are well founded. Implants that size and on top of the muscle will only make matters worse in time and much harder to correct. Allow me to make an alternate suggestion. You seem to have enough breast tissue to have the 'Ultimate Lift'. It's a technique that allows sufficient lift and upper pole fullness without the need of unsightly scars and implants. Do your research so you can make the best possible decision for you! Best wishes, Dr. H more

Don't depend upon the implant for lifting your areolar-nipples

While you may have a broad base width, there are two considerations that will lead toward you needing a breast lift. First it appears from your photographs that the distance from your sternum to the areola is long, and given that you've lost a respectable amount of weight, your tissues might bne more relaxed. By choosing such a large implant (500 cc), and in particular, if you decide to go above the muscle, your tissues will stretch out, you'll be "bottom heavy" and... more

It depends on your expectations.

Both procedures will work for you, implant with lift and without lift. If you consider only an augmentation, then a large implant is needed to fill the excess skin envelope. That may result in a large and ptotic breasts and you may be happy with that. If you desire more symmetry and less droopiness, then a lift is needed along with an implant. The implant will definitely be smaller than 500cc. You need to communicate with your plastic surgeon your expectations, you also need to... more

You need a lift in my opinion

Your breasts have relaxed enough that in my opinion you won't get a great result without a lift with the implants. The lift elevates the nipple and tightens the loose skin of the lower pole that is allowing the breasts to hang too low at present. A big implant especially if placed above the muscle will NOT fix this and may even make it worse. An in person is important to confirm all of this of course.

Do not select larger implants as a substitute for a breast lift.

It is a mistake to think that going larger will give you more of a lift. Breast implants do not provide lift (I've done the measurements). So you should not have 500 cc implants thinking that you need this size to "take up the slack." You should have the correct sized implants (more in the 400 cc range) and accept that you will still have some sagging (which is natural and not completely unaesthetic) or, if you prefer, have a lift with your implants. But... more

You need a lift

Dear Paloma, Nobody wants scars. That's very few patients actually request to get a breast lift. That being said, you have significant ptosis (droopiness). A large implant would give you large, droopy breasts. Only an operation which repositions the nipple-areola complex on the breast mound will give you optimal results, with ot without a concomitant breast implant. Looking at your pictures, I think the optimal incision would be a lollipop, or an incision around the areola and... more

Breast Lift?

You have a borderline situation. Depending on the experience of your surgeon and the size of implants you select, you MAY be able to get away with just augmentation taking into consideration that a breast lift is what will raise the nipple/areola complex higher. IF upper pole fullness is what you want to achieve, then a mastopexy surgery is most likely what you need. Communicate with your surgeon VERY CLEARLY so as to minimize the potential need for further surgery to meet your... more

500 cc implant

I would agree with the other reviewers. I think that a 500 cc implant is a big implant, and you do have ptosis, and would benefit from an uplift with a lollipop shaped scar and a submuscular implant. In the long run, it will look more natural and the results will last longer, with a smaller implant and a lift.

Rick Rosen, MD

3 reviews

Norwalk Plastic Surgeon

Breast augmentation with lift

Based on your photos, nipple position, and frame, I would recommend a breast augmentation with at least a periareolar (doughnut shaped) or vertical lift. In the photos, it does not appear that you have a lot of breast tissue of your own to cover the implant, so I would be a bit cautious about placing the implant in a subglandular position. This would, of course, need to be confirmed by exam. 500 cc implants are quite large and heavy. As you expressed, I would be... more

Breast augmentation or Breast augmentation/lift

Thanks for providing your photos. Given your photos, I would recommend breast augmentation with circumareolar or circumvertical (lollipop) lift. Circumareolar lift will give you scar around your nipple; circumvertical lift will give you a scar like a "lollipop." Given that you seem to have a long chest and excess skin from weight loss, you would benefit from augmentation with lift.

To Lift or Not To Lift?

A breast augmentation with a dual plane technique will aide to give you a mild lift. However, If you have excess loose skin from weight loss, then you may benefit from a periareolar mastopexy (where the scar is hidden around your areolar border) or an additional circumvertical lift (lollipop scar). If you are not keen on a lift at this time, then I would suggest you go for a breast augmentation first. If you do experience residual sagging or are unhappy, you can... more