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I Have Seen 3 Different Board Certified Plastic Surgeons Regarding Breast Augmentation, and Gotten 3 Opinions? (photo)

Wt 125 lbs Age 38 2 children breast fed 6 to 9 months each. Moderate sagging Current bra size 34B Desired 34 full D 3 board certified plastic surgeons gave 3 different opinions Doctor A recommended under the muscle with breast lift absolutely necessary. Doctor B recommended under the muscle and lift not necessary. Doctor C recommended over the muscle and lift not necessary. I'd like to avoid a lift but I don't want to sacrifice the shape in the long run, I want to be happy with the outcome.

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33 Doctor Answers | Asked by EmNm2013

Doctor Answers (33)
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Breast Aug With Or Without A Lift

There are a lot of different opinions - but in reality, you are the only one who can determine what's right for you based on the opinions you're getting from board certified plastic surgeons. The decision to augment is generally easy, but "to lift, or not to lift" is not always so obvious. See my web reference below for more information on making that decision. The surgeon you ultimately choose should understand your cosmetic goals and be able to answer all of your questions (you... more

Breast Augmentation

When your body changes lead to some laxity of the breast area, the placement of implants can provide some variablility to the final outcome. You appear to be a candidate for augmentation alone, particularly since you want to avoid additional scars from a lift. This does require horever some expectation regarding the final settling of the implants to still achieve a full rounded breast with improved nipple projection. While some techniques of implant placement will enhance... more

Breast Augmentation

Without a breast lift, overtime your breast will droop to an unsatisfactory low position. I therefore think a lift is mandatory. The implants can go either under or over the muscle. The lift will also help keep the implant up, avoiding droopiness.

Breast augmentation results

One thing I might suggest would be to look at many before and after photos. Take note of patients have a similar starting point and have a result that are pleasing to you. Without an in person consultation it is difficult to know what is best for you, but I think a lift would be best for you.

Michael Law, MD

17 reviews

Raleigh-Durham Plastic Surgeon

michaellawmd.com

What would be the best augmentation for this patient.

Several options could be considered, depending as to what you are desiring. A breast lift combined with an augmentation may give you the best result. a subpectoral dual plane augmentation would be the more acceptable technique, in my opinion, to give you upper breast fullness,a more natural shape that allows for better quality mammograms for the future, but may give slightly less fullness along the inner aspect of the breast. Be sure to talk to... more

Breast Augmentation with Mastopexy?

You have an interesting situation. One thing you have to remember is that the plastic surgeons are offering you their opinions based on what will give you the best outcome in their hands. There is no right or wrong answer. The questions you have to ask yourself are: What size would you like to be? Are you willing to sacrifice shape and longevity of your outcome in order to avoid additional scars? I believe a submuscular implant with a limited incision... more

Different Options for Different Patients

Thank you for your interesting question! I am always amazed at the various recommendations that my colleagues make to patients. We have different ideas of what is attractive, and patients have different goals and concerns which drive our recommendations. Your photos show that your breasts have settled. If you did not want a lift, you would have to place a good sized implant over the muscle. This is the treatment that would be recommended to a nude model who... more

Simple answer...

I believe that any Plastic Surgeon still advocating breast augmentations above the muscle in 2013 should be avoided!!! Because of the large amount of breast tissue you have the best answer for you is a submuscular breast augmentation with areolar repositioning (Binelli Mastopexy) to place your breast tissue directly over the implants. This approach will give you a great, long lasting result with minimal scarring...good luck!

Breast augmentation with or without lift

I can simply your situation. I see a lot of patients very similarly to your from an anatomical standpoint. First question: how big do you want to be? what size? This can help decide about whether a lift is needed. Second question: what are your goals for surgery...do you want to be more "uplifted" ? Does the areolar differences in the nipple concern you? If so and you want to be 350 cc or less....then do a silicone gel... more

3 Different Board Certified Plastic Surgeons-- 3 Opinions

I am not surprised to see differing opinions, since this is a "borderline" call. To add to the mix, I would suggest augmentation alone, and decide in 3 to 6 months about the lift. That is the best way to avoid "unnecessary" lift incisions. The risks of no lift are nipples too low breast draping off the implant. The nipples will be low, but not so much that a lift is "manditory." If the breast tissue seems to drape in an unsatisfactory manner, that... more

Implants for volume, lift for perkiness if desired.

There is a saying (tongue firmly in cheek) that if you see 10 different plastic surgeons you will get 15 different opinions. The fact is that you (1) definitely need implants for the volume, and (2) a breast lift is optional. Without a breast lift your nipples will still sit a little low. This is not a problem in a bra. If you want maximum perkiness without a bra, you should consider a vertical lift. Do not consider an inverted-T or periareolar lift as these... more

Three Different Opinions By Three Different Plastic Surgeons

Clearly, you have several options. There isn't a right or wrong way as it truly depends on what you want. The textbook answer, say if I were taking my plastic surgery exam, is to recommend a lift with submuscular placement. If you absolutely cannot live with the scars, then you can do a dual-plane placement. So, if you want the perkiest, best shaped breasts then a lift will give you those things. If you simply care about being larger and can live with the position of the breast, then an... more

It depends on the look you want.

All three will work, but each gives a different result. Just judging by the pictures, which is not a good idea BTW, I would offer this: Going under the muscle with a lift will give you increased volume and raise the breast mound and nipples on the chest wall. The downside is the scar, the upside the longest lasting result and more "ideal" position. Second choice is over the muscle. This allows the implant to be placed lower, and it can be centered on the nipple, giving a lifted... more

Joseph Mele, MD

4 reviews

Walnut Creek Plastic Surgeon

www.DrMele.com

To lift or not

Many surgeons try to avoid a lift whenever they can because it is a simpler procedure. In my opinion, a vertical lift is indeed necessary in your case. Avoid going with large implants. In your case 350 would be plenty in addition to the lift.

I Have Seen 3 Different Board Certified Plastic Surgeons Regarding Breast Augmentation, and Gotten 3 Opinions?

Very hard to address over the internet and you have added your personal restrictions. With all that in mind I recommend a staged operative event. Stage I is placement of implant, in any position (over, under, dual plane, sub facial) as long as the inferior position and pocket is open enough to prevent double bubble effect. Than after 3 months a lift if needed. This in my opinion ONLY way to allow you the opportunity to have no lifting possibility.

I Have Seen 3 Different Board Certified Plastic Surgeons Regarding Breast Augmentation, and Gotten 3 Opinions? (photo)

Well here is a fourth opinion I would recommend a subfascial implant with an internal fixation lift

Lift or no lift with implants

To achieve the best shape and long term result, I would recommend under the muscle and a lift. With the lift I would do, you would have a scar around the areola, and one extending partly down toward the breast fold. Both of these scars are often barely visible after about a year in someone with fairly light skin. There is no absolutely right or wrong answer. It just depends what your priorities are...better shape and nipple position or less scar?

Paul Wigoda, MD

5 reviews

Fort Lauderdale Plastic Surgeon

drwigoda.com

Implant and/or lift

If you want more volume then an implant is enough. If you need a lift that can always be done at a later time.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Breast implants

If you like your current shape and nipple location, and just want to be bigger, then an implant only on top of the muscle will make you larger. With the extra weight, over time you may hang a little more. If you want a perkier result with the nipple higher, and a rounder shape, then a lift is necessary, and then you would need the implant under the muscle to help preserve blood supply to the nipples. Good luck.

Lift or implant only, over or under

As you've seen, there are many choices and no one answer for your anatomy. Here's my thoughts and the logic: 1. I'd suggest implants only no lift - but inform you that you have around a 25% chance of requiring a lift as a secondary procedure. This means you have a 75% chance roughly, of avoiding a lift and its scars. Why not entirely predictable? It depends on you - how your tissue reacts and what the nipple position does. 2. I'd suggest over the muscle in your case... more

I'll take C

After having children and nursing, you have lost breast tissue which is above the muscle. Your nipples look to be at the IM line, so no lift, just fill what went away. Implants, over the muscle .

Different answers

Nothing unusual about getting different opinions from different docors. I would be surprised if you didn't. I have many patients with your anatomy that are pleased with under the muscle implants without a lift as long as the procedure uses a dual plane technique and as long as you don't mind not having much fullness in the upper breast. If for some reason you aren't happy with the results, you can always go back and do a lift later. It is much safer that way anyway.

Different answers

Under the muscle with a lift will give you the shape and size you desire at the expense of additional scars. Doing both (implants and lift) at the same time has a high risk of needing a second procedure to get it right. Doing just the implants is an option and avoids additional scars of a lift, but runs the risk of a "double bubble" or "snoopy" deformity requiring a lift as a second operation later. This is a fine option, and some surgeons recommend staging the operations anyway due to... more

Different opinions

You are getting different opinions from Board Certified Plastic Surgeons because there is not a correct answer. Much of what we do as plastic surgeons is listen to your goals and recommend a treatment to get there. We give you as much information as possible to come to the best decision. If you want to avoid a lift, you can. The tradeoff is some sagging and some nipple asymmetry, which you already have. The breast will look better with implants alone, which takes us to over or under... more

Different opinions for breast surgery options

There is often more than one acceptable way to "skin a cat" (as it were). While you gave the 3 different options by the surgeons, you never stated what YOUR GOALS were. Therefore, this is a difficult question for the surgeons at Realself to answer. As I look at your pictures, you do have a considerable amount of "sagging". If you were to have a formal breast lift, your areolar size could be reduced, your nipples could be positioned at the apex of the breast, and you would restore your upper... more

3 opinions???

If you have had 3 consultations with board certified plastic surgeons....with 3 different opinions, it would be presumptious of me to give you specific advise regarding surgery. The diagnositc question: do you have a significant ptosis (sag of your breasts) to warrant a breast lift must be answered.. If you have significant sag and large implants are placed for correction (regardless of the position of the implants) you will simply have larger sagging breasts... more

To lift or not to lift...

Hi Thank you for the post and the pics. As you can see here, even online, you will get many different opinions all from board certified plastic surgeons. We have different experiences, abilities, and philosophies when it comes to plastic surgery. This is why it is art and not just science. If this was a factual test, like 2+2=4, you would get all the SAME answer. But this is much more complex a question. My impression of the pics you show, is that you have some sagging and... more

Is a breast lift necessary?

I don't think it is possible to answer this questions without more information about your goals. You say you would like to be happy with the outcome and I am sure your plastic surgeon feels the same. What would make you happy with your outcome? What breast shape do you tend to like? round or more natural? Do you prefer a little natural droop or not? Are scars on the breast an acceptable tradeoff? Until you and your PS are on the same page in defining... more

Breasugmentation/ Breast Lift

I commend you for seeking board certified plastic surgeons and for getting more than one opinion. I believe your best result would be with sub muscular implants and a breast lift, it is hard to tell if a peri areolar lift would be enough (without a physical exam). Another option is doing the augmentation alone and see if you are happy, after 3 months you can always do a breast lift alone. This obviously requires a second procedure which many patients want to avoid.

Breast lift or not with augmentation

First, let's dispense with the myth that implants above the muscle lift the nipple. They don't and they risk looking like a ball in sock later. So go under the muscle especially for better mammograms. Second, your photos shows a need for some lifting. Third, you can always do the implants and defer the lift for 6 months until you are convinced that you need it.

Best Breast Surgery for Me?

Thank you for the question and pictures. Although, without direct examination and a full communication of your goals, it is not possible to give you precise advice, I think you'll be best off with a sub muscular (dual plane) breast augmentation along with some type of breast lift. 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... more

Breast Augmentation and Lift

I would advise submuscular implants as this will provide for greater longevity of result and less tissue thinning. This also provides for a more natural superior pole. I think I would recommend at least a circumareolar lift as well. Kenneth Hughes, MD Los Angeles, CA

Breast augmentation options

Hello 'EmNm2013', thanks for your question. First I would like to commend you for seeking consultations with board-certified plastic surgeons. There are so many 'cosmetic' doctors these days who are self-proclaimed experts in cosmetic surgery and who have never had any formal training in plastic surgery. Some of the scary ads I have seen are for family practice, OB-Gyn, and ENT (ear, nose, and throat) doctors performing breast augmentations which they have had no training... more