Which is the best choice to have perky chest again? Will I need a breast lift or breast implants? (photos)

I'm in my early 20's and since I lost 50 lbs (185 lbs to 133lbs) I'm around 5'9ft. My breasts deflated. I used to be a 36DD and my breasts were higher and symmetrical now they are saggy and one is bigger than the other. I am around 34 B at the moment.

Doctor Answers (7)

Mini Ultimate Breast Lift™

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Increasing the size of your breasts will require implants.You have asymmetrical volumes so you will need different size implants or a reduction of the larger one.I recommend a new technique called The Mini Ultimate Breast Lift™.Using only a circumareola incision it is possible to reshape your breast tissue creating upper pole fullness, elevate them higher on the chest wall and more medial to increase your cleavage.This will give you the perky shape and position you want without the ugly vertical scars of the traditional technique.At the same time, implants can be added or volume reduction.Aligning the areola, breast tissue and implant over the bony prominence of the chest wall maximizes anterior projection with a minimal size implant.Small round textured silicone gel implants placed retro-pectoral look and feel more natural, are more stable, less likely to ripple or have complications needing revision.Implant profile is irrelevant in the retro-pectoral position since the muscle compresses it.At size 34 each 100 cc’s of implant corresponds to 1 cup size change.From this, you can compute the volume required to achieve your desired goal.


Best Wishes,

Gary Horndeski, M.D.


Texas Plastic Surgeon
5.0 out of 5 stars 126 reviews

Which is the best choice to have perky chest again? Will I need a breast lift or breast implants? (photos)

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From the photo you posted, it appears that you have some asymmetry as well as some droopiness.  To achieve a perky breast, a lift with augmentation would be recommended.  The lift will remove the excess breast tissue, help with symmetry and also move your nipples back to a central location on your breast mound and the augmentation will give you the volume and fullness that was lost with your weight loss. It would be best to go see a board certified plastic surgeon for a consultation and exam to learn the best options for you and go from there. ac

Angela Champion, MD
Newport Beach Plastic Surgeon
5.0 out of 5 stars 4 reviews

Breast Lift with Implants or Fat Grafting

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Congratulations on your weight loss! To perk up a drooping breast, your surgeon will remove excess skin, reposition the nipple, and redrape and tighten the remaining skin to support the breast. The areola may also be reduced in size. 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.

A breast lift raises droopy breasts from one to several inches and excess skin is removed. If you just want to go bigger, the only way to do that is with implants. The great thing about these techniques is that they can now be down with minimal scarring and performed as an outpatient procedure without the need for general anesthesia. 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.

It is now possible with the newest technique for you to enlarge your breasts without resorting to implants! Specially prepared fat taken from another part of the body, such as the stomach or hips, is placed under the breast tissue to provide increased breast size without the need for artificial implants. The technique is called autologous fat transfers and autologous simply means "your own." And who doesn't have a little fat to spare?

In short, you must know -- realistically -- what you are starting with, as well as what you want to look like when surgery is done. Do you want a natural appearance or a round, perky look? These are some of the factors I weigh with my patients when evaluating what type of procedure to do.

Michelle Copeland, MD, DMD
New York Plastic Surgeon
4.5 out of 5 stars 8 reviews

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A mastopexy with implants will establish youth in symmetry.

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From the photograph there is significant ptosis as well as asymmetry. The combination of breast augmentation and mastopexy can establish symmetry as well as a youthful appearance.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
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Breast lift plus implants may be the best option for breast asymmetry

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Thank you for your question.  A breast lift is the proper operation to correct the asymmetry and sagging of your breasts.  For the optimum size and shape breast implants may also be required in addition. Generally speaking a soft supportive bra without underwires such as a sports bra is most often used after breast augmentation.

Brooke R. Seckel, MD, FACS
Boston Plastic Surgeon
5.0 out of 5 stars 34 reviews

Which is the best choice to have perky chest again? Will I need a breast lift or breast implants?

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This photo is impossible to assess the situation, I would need higher quality photos with multiple views in order to render a decent opinion.

Thomas Trevisani, Sr., MD
Orlando Plastic Surgeon
4.5 out of 5 stars 11 reviews

Which is the best choice to have perky chest again? Will I need a breast lift or breast implants?

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Congratulations on your significant weight loss! Based on your history and photograph, the operation that will best meet your goals is a breast lift operation. You are wise in  achieving your long-term stable weight prior to proceeding.

Whether or not to undergo breast augmentation surgery at the same time is a very personal one;  this decision is not one where “professional” opinions will be of much help to you. In other words, unless you wish to increase breast size, firmness, fullness etc.,   breast augmentation will not be “necessary”.  Of course, your chosen plastic surgeon will be your best resource when it comes to a  meaningful “professional” opinion; communicate your goals clearly with him/her. After this communication process, he/she will be in the best position to advise you  whether or not breast implants will be helpful in achieving the goals. In my practice, I find the use of goal pictures helpful during this communication process.

 You may find the attached link helpful to you as you learn more about breast augmentation/lifting procedures.

 Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 751 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.