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Breast Augmentation w/ Lift Needed?

asked 1 year ago by San Francisco4668 in San Francisco, CA
Latest answer by Eric Swanson MD
Question viewed 1,490 times
Tags: age 35-44, 110-129 lbs, 5 ft 4 in to 5 ft 7 in, lift

I am getting a tummy tuck and breast augmentation. I am 41, 5'4" and currently weigh 120lbs. (normally 110 lbs. and more deflated) Had 5 children and nursed them all. I am single now. Will it look ok with just the aug? My dr. said it was up to me. I don't mind some sag.. Help!!

36 answers to Breast Augmentation w/ Lift Needed?

+2

When is a breast lift needed with a breast augmentation?

Based on your photos, I recommend a breast lift.  Please note, once a breast implant is placed, to have the best result, your nipple should be positioned at the highest point of the implant.  In your case, your nipple and breast tissue will sag over the implant. The good news is you can have a breast lift at a later time. Therefore, if you are not sure, have the breast augmentation first, and see if you are pleased with the result.  This is a subjective matter and only you... more
Michael A. Jazayeri, MD

Santa Ana Plastic Surgeon
+2

In your case I would recommend implant surgery alone.

Breast implants alone are certainly a viable option for you since as you say you "don't mind some droop". In fact, if the implants are positioned above the muscle then they will actually impart a slight amount of uplift but certainly not the equivalent of a lift procedure. Essentially, adding an implant creates mostly a larger version of your present breast. Although it would mean a second operation if you are unhappy with just the implant, having implant surgery alone will... more
David A. Ross, MD

Chicago Plastic Surgeon

www.thecosmeticsurgeryinstitute.com

+2

To lift or not to lift?

A common question is whether a breast lift is necessary with implants. The answer is rarely straightforward. The implant will fill out the breast skin and provide some upward rotation of the nipple. However, this depends upon the size and shape of the implant, with larger/more projecting implants providing more of a "lift." In certain cases, the nipple is too far down on the breast to achieve an attractive look without the addition of a lift. I believe that you are a borderline... more
David Bogue, MD

Boca Raton Plastic Surgeon
+2

Breast implants with or without a breast lift

Based on your photos, I would recommend you have your breast augmentation alone.  Then, if after 3-6 months you and your surgeon feel you really need the lift, then you can do that at later stage, usually under local anesthesia.  This is called "staging" the procedures and is a great option in your particular case. The reason to do this is that you may be completely happy with breast implants alone, therefore, avoiding the potentially unnecessary scars involved... more
William Bruno, MD

Beverly Hills Plastic Surgeon
+2

Augmentation mastopexy recommended

The problem you describe is a common one.  Given the photographic and clinical information you submitted, you would likely be happiest in the long run with an augmentation mastopexy.  In all likelihood, if you were to undergo only augmentation the implant would remain lower than desireable on your chest wall, in order to make certain that the point of maximum projection of the implant coincided with the nipple.  This would leave you with a larger breast, but in many ways not... more
Richard J. Wassermann, MD, MPH

Columbia Plastic Surgeon
+2

Do I need a breast lift ?

I try to avoid breast lifts with augmentations whenever possible. They add scars, expense and risk. Also they are notorious for requiring frequent revisions or touch-ups when combined with augmentation. Working from your photos only (and not being able to examine you and take the measurements I would in the office) I would say you might be a candidate for breast augmentation alone. I have obtained good results in 'borderline' breasts such as yours using an... more
Eric Pugash, MD

Vancouver Plastic Surgeon

www.vancouvercosmeticsurgery.ca

+2

Breast surgery and abdominoplasty - mommy makeover

Your case is borderline which is why the other surgeons have posted different answers. There is some drooping of the breasts but without measurements we cannot know how much drooping there is exactly or whether you have crossed that threshold for a lift or if you have by how much. There are other issues here including stretchmarks of the breast skin and the downward shift of breast tissue under the skin with some flattening of the breast contour. The correct answer to your question depends... more
Aaron Stone, MD

Los Angeles Plastic Surgeon
+2

Breast Aug with or without lift

The photos are very helpful in that they show the nipple relationship to the fold. You have mild ptosis(droop) that responds well to an uplift with implant. The lift will make the breasts look perkier and give you more fullness above the nipple where you need it, without the need for a bigger implant. If you elect not to have a lift, your surgeon should opt to use a bigger implant that will fill out your shape and give you the desired fullness. Your... more
Beverly Friedlander, MD

Short Hills Plastic Surgeon
+2

Breast implants with or without the lift

For individuals caught on the edge, leaning between a breast augmentation alone or adding a breast lift, one of the first considerations is the breast scar. If you are scar averse then it only makes sense to complete the breast augmentation and see how things work out in terms of nipple position. Breast lift can be done after if the droop and nipple position is an issue. My vote is the augmentation alone. Best of luck, peterejohnsonmd
Peter E. Johnson, MD

Chicago Plastic Surgeon

www.peterejohnsonmd.com

+2

Breast augmentation with or without a lift

Based on your photos, I think you would certainly benefit from a lift.  For patients who are not sure if they want a lift and the extra incisions that come with it, one option is to hold off on the lift for now and perhaps do it as a second procedure.  The reason for this is if you have very little droop and you are ok with this, you may be perfectly happy with just an augmentation.  If after everything settles, you want things to be a bit more youthful and lifted, you can... more
Shahram Salemy, MD

Seattle Plastic Surgeon
+2

Choice of breast lift with augmentation

Your surgeon is correct, it is your decision. From your pictures, you will have a moderate droop even after the breast implants.If all you really want is volume, and you really do not mind some droop, then just having an augmentation is all you need. If, however, you can only tolerate very little droop, you need a lift also. If you elect no lift, you can always do the lift later. In fact many surgeons prefer this.
Robert T. Buchanan, MD

Highlands Plastic Surgeon
+2

Breast Augmentation with/without lift

Hi - Looking at your photos I don't really think you need a lift.  Usually if the nipple is in line or above the fold of the breast an implant alone will restore volume and give some lift.  You appear to really only have deflation of the breast.  A mastopexy will only add scarring, and possibly make your breasts too high.  If you think your breasts are still too saggy after the augmentation, you can always lift them later and that would probably be a safer option. more
Leonard Harris, MD

Burlington Plastic Surgeon
+1

Vertical augmentation/mastopexy works best

You may go either way, with or without a breast lift at the time of implants. If you don't have a lift, be aware that your nipple level will be a little too low, more visible on the side view. A bra corrects this of course. Are you thinking of how you would look in a bikini? If so, a breast lift is advisable. Not all breast lifts are the same. Some techniques that are inadvisable are the periareolar (donut) and inverted-T (anchor) lift techniques, both... more
Eric Swanson MD

Leawood Plastic Surgeon
+1

Breast Lift with Implants

In your case, it looks like the breast tissue is hanging under the pectoralis major muscle. There is not a clear distinction between the areola and the inframammary fold. there seems to be extra skin between the areola and the IMF. These would all push me toward a lift. I realize that you want volume too. Options: Staged. Lift then augment later. Combined: I would put the implant in first ant then mold the tissue over it... more
Jeffrey Roth, MD

Las Vegas Plastic Surgeon
+1

Breast Augmentation and Breast Lift: Filling and shaping the breast

Breast augmentation and a breast lift can be performed together. This will fill out the breast that has lost volume, especially after having children and then reshape the breast. The lift or mastopexy will hold the implant in a higher position. From your photos, if an implant is placed it will sit much higher than your breast and look like a double bubble. Find a surgeon that can do a lift and implant because that is the operation you need. I hope this helps. Dr. Trussler more
Andrew P. Trussler, MD

Dallas Plastic Surgeon
+1

Augmentation and lifting CAN be performed at the same time.

Augmentation and lifting CAN be performed at the same time.  The real key is to determine WHEN they should be performed together. Photographs are sometimes very difficult to interpret for augmentation/lift cases and your photographs are in this category.  The best way to decide is to listen to the advice of your surgeon.  If your surgeon has said "it is up to you" then you could really go either way.  If you really don't mind a little sag then stage... more
Richard H. Fryer, MD

Salt Lake City Plastic Surgeon
+1

Implant Alone Would Make Things Worse

No one wants to perform or receive a breast lift unless it is necessary. The tradeoff is the increased risk of the surgery as well as additional scarring. Unfortunately, in many instances you do not have a choice. I believe your situation is one of them. A nipple needs to be centralized on the breast mound and if it is too low preoperatively, an implant can accentuate the deformity. With early ptosis (sagging) such as first degree, an implant can correct the problem alone.  When the... more
Scott R. Brundage, M.D.

Grand Rapids Plastic Surgeon
+1

Mommy makeover, Breast enlargement and tummy tuck,abdominoplasty

A mommy makeover can include a full breast uplift or just a partial one with removing a crescent of skin above the areola. This does not reshape the breasts but it does reposition the nipple/areola at a higher level. Based on your photos, I would at least recommend that. We are offering special pricing on a mommy makeover as well as a resort stay probably for the price of just a breast enlargement and tummy tuck! We do get many patients from out of town taking advantage of our specials.... more
Edward J. Domanskis, MD

Orange County Plastic Surgeon
+1

Need a lift

Based only on your pictures and your description of "deflated" breasts, I would say that you would certainly benefit from a mastopexy/breast lift. Augmentation alone will not lift your breasts up. I think many surgeons would place large implants in this situation in order to avoid a breast lift. In my experience this looks good temporarily but ultimately results in the skin being more stretched and looking worse over time. 
Jeremy Waldman, MD

Manchester Plastic Surgeon
+1

Breast augmentation does not lift low nipples

Your breasts show the typical changes of pregnancy and nursing; the upper part of the breast is deflated and the nipples are low in relationship to the crease under the breast.  You might be able to get away with a subglandular implant (under the breast not uncer the muscle) but your breast will probably still look droopy, but larger.  It is probable too that you will continue to droop more over relatively little time, particularly with the added weight of implants.  You did... more
Elizabeth Lee, MD

Bay Area Plastic Surgeon
+1

Breast augmentation w/ lift?

You're 41 years old and your breasts are moderately sagging ,you probably not considering a sixth pregnancy.It is a good time to rejuvenate your breasts,breast augmentation with periareolar lift will be the better approach and with minimal scars.
Erel Laufer, M.D.

Tampa Plastic Surgeon
+1

Breast augmentation with or without lift?

I do not think that you would be happy over the long term with an augmentation alone. Based on your frontal photo, your breasts do not pass what I call the "visible skin test". You really need to see skin beneath the nipple areola on the frontal view, otherwise you are going to have persistent ptosis (or droop) following an augmentation alone. I also do not personally recommend a strict subglandular augmentation to try to fill the volume loss without nipple... more
William F. DeLuca Jr, MD

Albany Plastic Surgeon

www.delucaplasticsurgery.com

+1

Breast augmentation and lift needed?

When I consider whether a lift is needed along with implants, it all depends on whether I believe the patient will be happy with the final results. I don't buy time with one surgery and hope for the best and I'm not willing to do a surgery that the patient wants if I don't believe the end result will be satisfactory. In your case, I would only perform a lift along with augmentation or nothing at all. The reason is that If you are to have large implants placed to fill the... more
Andrew Kaczynski, MD

Sacramento Plastic Surgeon
+1

Augmentation and lift

I think the best result you would get would be with an augmentation and some sort of a lift whether it isjust an areola lift or a more formal vertical type of lift.
Steven Wallach, MD

Manhattan Plastic Surgeon
+1

Breast augmentation with or without lift

The general rule of thumb is that when the nipple position falls below the inframammary fold. level a breast lift is required for optimum shape. You look like you are probably at this level. Doing an augmentation alone can be considered, but you need to know that a mastopexy(breast lift) would be required to elevate sagging tissue if you are ultimately not happy with the shape after augmentation alone. This can be done at a later date without a problem.  It also gives you the ability to... more
David A. Bottger, MD

Philadelphia Plastic Surgeon

www.drbottger.com

+1

With drooping, a breast lift is needed in addition to a breast augmentation

You have received quite a diversity of answers ranging from just an augmentation, "it's your choice", big implants + augmentation and a lift along with the augmentation. You have significant drooping in addition to deflation of your breasts. An implant alone will not address this and as a result, you will have lax breast tissue hanging off the implants - not a good or acceptable look. Trying to address this by inserting large implants above the muscle will only ultimately... more
Steven Turkeltaub, MD

Scottsdale Plastic Surgeon

www.turkeltaub.com

+1

Breast contouring, #BreastAugmentation, #Breastlift, #mastopexy

Dear San Francisco 4668 Thank you for your question. The issue with the surgical procedure is 'trade offs'- trade a scar for a better shape for your breasts.  At a minimum- a iift using a suture around your areola will give you a nice shape when combined with an implant and the scars going vertically from the areola tothe bottom of your breast can be avoided.  This will aslo help reduce the size of the areola.   With Warm Regards, Trevor M Born MD more
Trevor M. Born, MD

Toronto Plastic Surgeon
+1

Breast Augmentation and Lift

Based on your photos, it is very possible that you will eventually want a breast lift after breast augmentation.  However, starting with the breast augmentation is reasonable.
Jeff Scott, MD

Everett Plastic Surgeon
+1

AUGMENTATION VS COMBINED AUGMENTATION/MASTOPEXY

Your photos are very helpful.  Which approach would be best for you depends on your goals.  If you would like a more youthful and perky breast then you need to go with an Augmentation/Mastopexy.  If you don't mind that the breast will hang lower on the chest then consider placing the implants under your tissues not the muscle.  If you look on the internet you will be able to find results using both these approaches.  Good luck.
Todd B. Koch, MD

Buffalo Plastic Surgeon

www.toddbkochmd.com

+1

Breast Lift with Implants

Thanks for posting pictures - it makes giving you advice much more easy and informative for other patients.  Based on your pictures, it looks like you would benefit from a lift / mastopexy in addition to the augmentation / implants.  The reason is that the implant will improve the volume of your breast, the the breast tissue will still hang or have ptosis on top of the implant.  That is why a lift would be required in addition to the implants.   Good Luck. more
David Shafer, MD

New York Plastic Surgeon

www.ShaferPlasticSurgery.com

+1

Augmentation alone of with a lift

Though difficult to asses with photographs only, you appear to have a moderate breast droop (grade 1 or 2). With large implants (D+ or higher), your breasts may be "improved", however you will have a similar droop to your breasts. Here's a test you can do: put a pencil at the bottom fold of your breast horizontally. Look in the mirror. If your nipple is more than 1" lower than the pencil, you should consider a breast lift because the bottom... more
Ricardo Izquierdo, MD

Chicago Plastic Surgeon
+1

You have a choice

Your nipples are just at the limit. If they point down you need a lift. You must understand the breast mound will be lower and it is a different look. Have you doc show you photos or you can see a few examples on my site. A peri-areolar lift will work as well with limited incision. My site shows examples as well, see video
Miguel Delgado, Jr., MD

San Francisco Plastic Surgeon

www.dr-delgado.com

+1

Breast Augmentation w/ Lift Needed?

Thanks for posting the series of breast photos. My question is what is the sternal notch to nipple distance? If over 24 cm's than some type of lift will be needed. You can plan on no lifting at the operation with the thought that you can lift after 2 months of healing under local anesthesia, just an idea I do often. From MIAMI 
Darryl J. Blinski, MD

Miami Plastic Surgeon
+1

Breast augmentation with/without a lift

I agree with your doctor, the decision is ultimately yours.  An augmentation alone can give you nice volume.  If you don't mind additional scars you can also have a lift to give you a more perky look rather than a droopy look you would have with implants alone.   If you chose implants only you'll look great in a bra but you may not like it without a bra... thus the choice is yours. Sincerely, Martin Jugenburg, MD
Martin Jugenburg, MD

Toronto Plastic Surgeon

www.torontosurgery.ca

+1

Breast Augmentation With or Without Lift

It appears that you would probably benefit from a mastopexy or breast lift although an exam would be helpful.  Since you are already undergoing a tummy tuck with your augmentation, a lift will add to your operative time and risk.  You will "burn no bridges" if you wait and see if you are happy with the augmentation without a lift.  You can always undergo a vertical lift as a secondary procedure.
John Whitt, MD

Louisville Plastic Surgeon
+1

Lift

It looks like you may benefit from a lift to give you are more aesthetic looking breast after augmentation
Edward J. Bednar, MD

Charlotte Plastic Surgeon

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