I am desiring the boobs I had in my 20's (47 now), before I breast fed my two children. I want full, perky boobs, but do NOT want them to look like grapefruits sitting on my chest. I've been researching and don't know if I need a lift in addition to implants. I have a consultation scheduled, but want to get mentally prepared if he says I need a lift. I really don't want the scars, but don't want my boobs to sag any more than they do now. Any and all imput would be greatly appreciated.
I Am Getting Implants! Do I Need a Lift Too?
Doctor Answers (19)
Lift or the right implants
Yes, you will need a lift, too.
Hi, thanks for sharing your photos. If you are desiring fuller, perkier breasts that you had in your 20s, you will need implants and lift. Depending on how your breasts drape over the implants, you will also have lift where you will have scars around the areola (circumareolar mastopexy) or scars around the areola and one extending down to your crease line (circumvertical mastopexy). Whether you have augmentation and/or lift is based on what your goal is. Implants can give you the fuller look but do not change your breast shape to perkier ones. I understand that many patients are afraid of mastopexy scars. Go visit with your plastic surgeon and ask for her/his patients' photos to get a realistic idea. As long as you do not have a tendency to form keloid, scars on breast usually heal well.
In my opinion, based on the photos you submitted, you will need a lift to give you the best, most natural looking result.
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Breast implants and lifts
I would agree with Drs. Epstein, Rand, and Whitt. Your breasts are not too low and can be augmented to a nice result but it is important to understand what breast implants do and don't do, what lifts do and don't do, and what nature does.
Nature made your breasts sag somewhat and probably took away some tone and elasticity of your skin and tissues. Neither implants or lifts can reverse or totally restore that. Neither can keep your breasts from losing more tone or sagging further from another pregnancy, weight changes, hormone changes, or the passage of time.
Breast implants are pillow volume. They fill out what's there from behind and really don't do anything more to your natural breasts. They don't lift the breasts and they don't make them sag. Experience has been that the implant can be positioned behind the nipple areola if it is not too low relative to the inframammary crease and thus fills out the lower pole (along with upper pole scalloping) which is why the breast looks lifted. The forward projection of the implant makes it look perkier but breasts that are relatively low and scalloped do not do well with high profile implants because of the change to a very round and forward projected look.
Lifts can reposition breast higher on the chest and back to more the way they were but can't keep them up and to truly reposition the breast and not rely on skin to hold it up, the nipple-areola and the breast must be separated from the skin, the breast moved up and sutured there, and the skin rearranged/tucked to accomodate it. This requires a lollipop (vertical) incision and probably wouldn't be worth the scars at this point. Lifts also do not specifically fill in the upper pole and don't provide perky forward projection. Lifting and augmenting the breast at the same time can be done but is problematic in terms of predicting size and shape and getting all the variables adjusted to behave consistently with one procedure.
I would recommend accepting the modest amount of sag in your breasts and go with moderate profile or moderate plus profile (Mentor) saline implant or the middle profile choice in gels. Use an inframammary crease incision and make sure the plastic surgeon is experienced in adjusting the crease level and filling out the lower pole of the breast predictably (best seen in before-and-after pictures).
Breast Implants With or Without Lift
Yes, you need a lift. I would use moderate profile implants and a periareolar lift. The scar would end up only around the areola which hides really well. Many surgeons don't like this lift because they are concerned about areolar widening. However, by using a permanent stitch such as Gortex, which is soft and not palpable, this can be prevented.
You won't end up with "grapefruits" on your chest; just pretty, appropriate breasts.
Breast augmentation with or without lift
I believe it's possible for you to have an augmentation without a lift depending on the size and the postop look you want.
If you want to be larger and want a natural looking breast then I think it's possible for you to have an augmentation without a breast lift. The breast will look natural you will not have a Pam Anderson look.
If you choose an implant to small the breast will still be low because you'll be more skin then breast volume. A high profile implant is needed to fill the breast and give the lift. A low-profile implants may allow the breast to fall off the implant.
Augmentation with or without lift
I believe you would benefit most with a combination procedure with lift and small augmentation. This will give you the perky look you are seeking. Donald R. Nunn MD Atlanta Plastic Surgeon.
Breast Augmentation, Lift Too?
Breast augmentation vs. breast lifting
It is important to know that breast augmentation does not lift a saggy breast. It is also important to understand that the surgical goal of an augmentation is to center the implant behind your breast. If your breast gland sits lower than the implant is able to be positioned on your chest wall, then you need a breast lift. There are different types of lifts that are in part determined by the degree that your breast sags. It is difficult to predict from your pictures but you may be fine without a breast lift.
Breast augmentation candidate
Based on the photos you provided, you look like a good candidate for breast augmentation alone. You appear to have mild sagging. Ultimately, it depends on your overall goals. Breast implants will provide more volume and fullness and may provide a minimal lift of your nipple-areola complex. If you desire a more “lifted” look you may benefit from a limited lift, which involves an incision around the areola only. Make sure you consult with a board certified plastic surgeon with extensive breast implant experience.
On this site, I do my best to give advice without a physical examination but I want you to know that a physical examination by a board certified physician is always the best way to get the most accurate information.
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.