Can Breast Augmentation Be Used Instead of Breastlift for Small Sagging Breasts?

Basically there are two things that I don't like about my breasts. 1) I've always had very big areolas. 2) I've lost 66 pounds and my breasts are sagging. I was wondering if there is a way for me to avoid breastlift (e.g. by using implants that are large enough to fill the empty space). If breastlift is necessary, is there a way to avoid the vertical incision? What about the areolas? Please suggest an 'ideal' and an 'adequate' solution and include estimated prices. Many thanks!!!

Doctor Answers (26)

Breast Implants and Breast Lift - Can I Get By With Implants Alone? Avoid the Vertical Incision?


HI Maria in Miami,

No - an augmentation is nothing more than that:  it fills up the pocket.  It may give the APPEARANCE of a lift, and it certainly makes the entire area look "better" - but it doesn't actually "lift" the breasts.  Many people can get a good enough result with implants alone so that you can get away without the scars (and risks) of a lift, particularly when combined with implants.

But there is a limit to what can be accomplished with implants alone.  The combination of your appearance and the fact that you lost weight (and have undoubtedly lost more of the elasticity of your breasts) indicates to me that you would probably need implants AND a lift.  And the lift would include not only the vertical limb but, possibly, also a horizontal extension in the crease so that it would be an anchor-shaped scar.

Sorry about that.  If it's any consolation NOBODY wants those incisions, so if you're seeing those results, you know that people decided to go ahead with the surgery despite the incisions and resultant scars.

I hope that this helps, and good luck,

Dr. E

New York Plastic Surgeon
5.0 out of 5 stars 151 reviews

Saggy Breast Options

Thanks for the pictures, they are very helpful. A breast enlargement above the muscle could be considered an "adequate" option. You will see some improvement in your sagging but may need a bigger implant than you may want to give the modest lifting affect you will see. The implants will also be a bit lower going above the muscle and this will not address your areola size. This procedure costs between $5400-6000 in the Minneapolis area.The "ideal" procedure for you would be a full mastopexy with a modest sub muscular implant. This will give you the fullest, most perky and firmest breasts. It also will allow you to have smaller areoles. This procedure costs between $7400-8000 in the Minneapolis area. Good luck.

Douglas L. Gervais, MD
Minneapolis Plastic Surgeon
5.0 out of 5 stars 88 reviews

Breast Augmentation


An in person examination would be needed for actual advice.  Having said that, I doubt that an implant alone will make you happy in the longterm.  It may look good for a short while, but you run the risk that after a year, your tissues may stretch out again and result in a ball in sock appearance.  I think the best results would be obtained with a vertical lift with or without an implant, depending on your volume goals.


Asif Pirani, MD, FRCS(C)
Toronto Plastic Surgeon
5.0 out of 5 stars 28 reviews

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Breast lift or breast implants


In your case, I would recommend an uplift, called a mastopexy. This will give you a pretty shape and smaller areolas. Implant will also be necessary to give you the fullness most desire. I would keep the implants a conservative size. Remember that more weight equals more sagging with time. All plastic surgery procedures are a trade-off of some sort. Here you are trading large areolas and sagging for scars with an attractive, youthful breast shape. Implants without a full mastopexy would make your problem worse. Thank you for an excellent question.

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Implants do not give much of a lift


Thank you for your question and photographs.  Based on your pictures, a lift is your only real option to obtain a nice breast shape and lift.  Breast implants will not help your condition and may make it worse if they are not combined with a lift at the same time.  I believe that the improved shape that you get from a lift far out-weigh the scars in the majority of cases.

James McMahan, MD
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Breast ilft or breast augmentation


A breast augmentation will do exactly what the term implies, it will augment the size of your breast in its present postion. If a large implant is used, it can fill in the skin for a relatively short period of time, but as time passes, you will go from small and saggy to large and saggy. The problem then is that if you decide to have the lift later, the scars will likely need to be longer as the large implant will stretch your skin out to a greater degree, necessitating longer scars to remove more skin. The lift you get visually after an augmentaiton is a short lived optical illusion.

Julio Garcia, MD
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Can I avoid a breast lift and have implants only?


The degree of sagging you have will require a breast lift.  Breast implants do not lift breasts. Breast implants fill out breasts where they are, they do not lift them up.  Bigger implants fill out the breast more, but they still do not lift the breast. If your breasts are hanging over too far, as does yours, they will hang off of the implant. The bottom of the implant is at the level of your inframammary fold, so you can see how your breast, hanging over the fold quite a ways, will hang off of the implant.  Also, judging from your photos, the degree of sagging you have will not make you a good candidate for the very weak periareolar lift (with only a circular scar) will probably be underlifted, the areolar area will be flattened in appaearance, and the periareolar scar will not be a good one.  It is well worth it to have a vertical scar if your ultimate contour is attractive.  Avoiding a vertical scar and having an unattractive shape and worse areolar scar (which is the most visible scar, by the way) is not a good trade off.  If you do not care about having larger breasts and having more fullness in the upper pole of your breast, you may just choose to have a breast lift and avoid the greater expense and issues with implants...but of course if you desire a larger size or more upper fullness, and implant will be required.

Robert M. Grenley, MD
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Breast augmentation and lift for sagging breasts


For sagging deflated breasts with large areola, I recommend augmenting and lift them.  The implant will fill the breast up and reduce the amount of excess skin that must be removed.  However, the nipples still have to be repositioned higher and this can be done by a "donut"  lift that would result in a scar only around the nipples.  This would also help reduce the size of the areola.    

Your other options would be to do the augmentation alone or the breast lift alone.  If you have a breast augmentation without a lift, the result will be sub-optimum.  The nipples will be drooping over the implants and the breasts may have a "snoopy nose" appearance or a "double bubble".  Your areola will also remain enlarged.

A breast lift alone, or mastopexy, may give you breasts that appears normal at a more affordable price.  Your areola would be repositioned and the size would be corrected.   And, if you ever decided to have an implant later you can still do so.   However, without the implants to fill out the breasts, your breasts would obviously remain smaller and more skin will need be removed during the lift ... so a vertical or anchor incision may be required.

Adam Hamawy, MD
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Breast augmentation


Breast augmentation will fill up the breast skin envelope depending on the size of the augmentation. However there is a limit and the position of the nipple will determine if an augmentation or a lift is the best option for you.

David L. Abramson, MD
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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.