Am I a Candidate For Implants Without a Lift?

When women with saggy breasts want to go bigger, I usually advise doing a breast lift along with the implants. Otherwise, the implants create what we call a “double bubble,” where the breast droops off the end of the implant like a sock. Some of my patients, however, don’t want a lift because they want to avoid additional scarring, so sometimes implants alone can fill out the skin and eliminate the saggy appearance. A mastopexy (breast lift) raises droopy breasts from one to several inches and excess skin is removed. If you're sagging or asymmetrical, and are looking for perkiness, you'll need a lift--or, if you also want more volume, a lift and implants.

Your posted left photo, which I assume is you now, shows asymmetric breasts, enlarged stretched areolae, skin stretchmarks on the upper half of the breasts, drooping breasts with the nipples lying well below the inframammary fold, prominent breast veins and wide spacing between the breasts. If you just put in breast implants these issues will not be corrected and you will most assuredly not be happy. The cleavage cannot be corrected by any surgical means. You will need breast tissue and skin procedures including some sort of lift to correct the other issues. You almost assuredly cannot do this all with one procedure. You can do the lift and implant placement together and then a fine tuning procedure or you could do the lift first and implant placement later.

There may be some surgeons who could do all this in one procedure but that would not be the majority of surgeons and no surgeon can guarantee you will be happy with one procedure. The main problem is the amount of drooping and the severe stretchmarks. No one can fully adjust for changes to the stretcmark skin that take place as a result of surgery while planning and performing the surgery. You also need to know going into this that the stretchmarks may become more visible or noticeable after the surgery.

I also strongly advise agains getting implants as large as those in the right photo. Given your skin and current condition that would set you up for additional surgery  within a couple of years as the stretchmark skin has lost most of its original elascticity. If you want to keep returning to the surgeon for more surgery go ahead and put the larger implants in.
 
My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Hi,

You will definitely need a lift in addition to implants (if you desire to be a DDD). There is a new lifting technique that gives you a full lift without the need of a vertical scar. It also allows for your existing breast tissue to be moved upward and secured permanently to your chest muscles. This allows for a more permanent lift as opposed to conventional lifts.The scars are well hidden around the areola and under the breast mound. So please don't be concerned with scarring.  FYI, keep in mind that implants will always stretch tissue regardless of placement  (above or below muscle), so in time you will end up with the same problem you have now, but worse. Now, if you decide against implants the technique described above will raise and reshape your existing breast tissue to resemble that of an implant, without the weight. Patients are very happy because they have perky, firm and natural looking breasts. Best wishes, Dr. H