Opinion needed on getting a breast augmentation, and a possible lift. I have had four children, and I am 27 years old, 5'5", 125 lbs. I am very light-skinned, and I scar really badly so I am worried about scarring that will be pink, and very obvious on my skin tone. I want to look as natural as I can when I’m completely naked. I have added photos of my breast and upper body for a visual on exactly what my breast look like now. So lift or no lift? Augmentation, or not? Also any opinions on the Endoscopic-Assisted Breast Augmentation?
Risk of Pink Scarring After Breast Lift and Augmentation?
Doctor Answers (24)
Promoted Local Answer
Scarring with Breast Augmenation or Breast Lift
Well let's start with the obvious-you look fantastic for having four children. Your breasts appear to have a very small amount of ptosis. And I mean a very small. In addition you have some loss of upper pole fullness. So the best bet would be a subpectoral augmentation with a low profile implant in the 300-350 range. This would both correct the upper pole loss and the minor ptosis. In addition I would do this through an inframammary incision. I make this incision 1cm below the fold which puts it in the fold when the implant is placed. In addition a saline implant can be placed using a 1 inch incision. If done properly you'll never see the incision.
Breast augmentation without breast lift may be possible
Thank you for your question. If you simply want your breasts Fuller a breast augmentation alone without a breast lift may certainly be possible. Please consult your board certified plastic surgeon and specifically asked if this is possible and your case.
If you do choose to have a lift I would reassure you that most patients find that scarring white natural color at 1 year and are very happy with the new shape of their breasts.
Decision-making in breast surgery
What is it about your breasts that you do not like? What is it that you want? While artists and plastic surgeons have certain concepts about the ideal or perfect breast, it does not necessarily apply to each patient. Patients, and doctors, can be hyper-critical of breasts. Your breasts, by all normal parameters, are normal breasts. There are not screaming for surgery. However, what you desire will determine the treatment necessary to get you there. Once the path is outlined, you'll have to ask yourself if it is worth it. These are individual issues that cannot be answered with one glance at a photo.
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Pink Scars after breast lift and augmentation
All scars are initially pink from the inflammation which occurs during wound healing. As scars mature they fade to a silvery white appearance. Thickening or spreading of scars can sometimes occur due to a variety of reasons but this is usually not the norm.
My recommendation is to go with a large enough implant to fill out your skin yet still be compatible with your tissue requirements, ie. not too big or sagging will occur, and try to avoid putting a scar on your breast as a lift would do.
I would go with a subglandular Gel implant and No Lift. The implant would be placed through an imframmammary approach, in the crease, which will be hidden and well tolerated. No need for endoscopic surgery for this. It would not be worth the additional time under anesthesia or the expense in your case.
Most importantly, find a Board Certified Plastic Surgeon to evaluate you in person.
Breast lift and Augmentation
The discussion needs to start with :"Do you like the current size/volume of your breasts?" - if the answer is YES - then we need to only focus on a breast lift (Mastopexy). IF the answer is NO - then we can discuss augmentation.
In my opinion, although good looking results can be obtained with other incisions - the periareolar breast augmentation incision is in many cases, including yours, superior to all others. It allows unrivaled visibility of the breast implant pocket (allowing modification on the go), it can be easily converted to a lift (if the breast implants have not lifted the nipple complex high enough) and unlike some of the others, the periareolar scar is re-usable.
If you would like more volume, I would recommend a perihelia approach breast augmentation with a suitable implant with a possible either perihelia breast lift or conversion to a small Lollipop lift, as needed.
I would not worry about the endoscopic approach here since you cannot really have an endoscopic lift NOR would I be overly concerned about scar quality.
Breast augmentation and lift
In my opinion, you could have a very nice result with a periareolar lift and submuscular augmentation. The lift will elevate the nipple, shrink your areolae which are too large now, and allow access to place the implants. In the end, you should have a very thin scar and it will be between the areolar skin and the normal skin so it wil be more of a boundry than a scar. Please see many photos of this on my web site.
Breast augmentation will give you nice results, but you may need a small lift
Thanks for submitting the pictures - it makes answering your questions so much easier!
Looking at your pictures, you have ptosis (droopiness) of the breast gland, but not much droopiness of the nipple and areola. Most of this can be corrected with placement of a breast implant, which can add volume to the upper pole of your breast. Without examining the breast skin envelope, it's hard to know if an implant alone will allow the nipple-areola complex to settle in the perfect position. In all likelihood, though, if you need a breast lift, it'd be a relatively minor one, with an incision around the areola (circumareolar) alone.
Transaxillary endoscopic-assisted breast augmentation, in the right patient, can be a great operation. I particularly like the operation with placement of saline implants. In your case, though, because you may need s small lift, I think a better choice of incision would be periareolar (at the junction of pigmented areola and nonpigmented skin). The implant could be placed through this incision, and if your surgeon were to decide intraoperatively that you need a small lift, he or she could easily convert that incision to the one needed for the lift.
So to summarize: implants, yes; lift, maybe; endoscopic augmentation, no (in your particular case).
Best advice is to seek consultation with a board-certified plastic surgeon who can examine you in person. Best of luck.
Scar cream after surgery
Breast Augmentation and Lift Is a Decision You Make
You have to decide whether a lift and augmentation would help you achieve the body contour you want. We can only give you medical opinions on how to do that.
Proactive scar management
Every person heals differently and will improve over the next 3 to 6 months. Some patients require up to one year to fully mature. A nice scar starts in the operation room. The incision must be placed in the right position, sutured keeping the tension off of the skin itself. Also it has been show that keeping the incision taped for the first three weeks keeps some of the early tension off of the scar. Then from the end of the third week to the end of the third month it helps to use a topical product with silicone.
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.