Before my 2 children I had perky C cup breasts, but with pregnancy and breastfeeding my breasts went to an E cup and then deflated to a small B, and are left with sagging and no upper volume. I am looking to have natural-looking breast augmentation. Would implants alone lift my breasts enough to give a nice result or would a breast lift be recommended as well?
Will Breast Augmentation Alone Provide Me with Enough Lift?
Doctor Answers 6
Implants under the muscle are best
I have to agree with the other surgeons. You would be best served with a standard breast lift with or without implants. Implants really do not give you a lift. Some doctors will try to talk you into implants of top of the muscle to give you somewhat of a lift but I find this to be a big mistake. I appears from your photographs that your skin has lost much of its elasticity so you probably have more excess skin than what can be seen on the photograph. As you have relatively little breast tissue to cover up the implants, they should certainly be placed under the muscle.
Regaining a youthful appearance
Your plastic surgeon will take detailed measurements which will determine if a breast augmentation alone will lift your breasts enough. If a mastopexy is required, there are short scar techniques which can be considered. Thanks.
Breast implants do not lift nipples
A breast implant will not 'lift' your nipple to a higher position and keep it there. This is a myth. If your nipples are below the 'fold' beneath your breasts, then you're going to need some sort of breast lift procedure in addition to an implant for the best possible result.
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Looks like a breast lift is needed.
Breast hanging, (breast ptosis), is classified as class I, class II or class III. The class is determined by the position of the nipple/areolar complex in relation to the crease under the breast. If someone has a class I ptosis, (where the nipple is at or above the crease), breast augmentation alone may correct the loose skin and hanging. For classes II and III, breast lifting combined with an implant it usually required.
If the skin is too loose and you just have a breast augmentation, the remaining skin can hang down from the breast giving you a long vertical shaped breast sometimes referred to as a "snoopy breast" like the nose on the cartoon character.
Some people try to avoid the breast lift, and scars by going to a larger implant. However, very large implants will weigh more and over time can lead to more drooping especially if you skin and tissues are thin.
Looking at your photo only, you appear to have a class II ptosis and a combination augmentation mastopexy seems to be the best procedure for you. Obviously, I cannot assess the quality of your tissues from the photo. Your plastic surgeon can assess this. Discuss the above thoroughly with your doctor. Also make sure that your doctor is well qualified and is experienced in this type of surgery.
Lift or not with breast augmentation
Breast augmentation frequently will lift the breast adequately without a lift incision if the nipple is not too low. The critical assessment is exactly where the nipple is in relation to the fold underneath the breast. If the nipple is below the fold the nipple/areola will require lifting. Also, the larger the implant the more lift you will get. We do not recommend an implant too large but we do recommend an implant that fits your chest by measuring the diameter of your breast and using that size to begin the discussion.
All the best,
Talmage J. Raine MD FACS
Do I need a breast lift?
It looks like your shape would benefit from a breast lift in addition to implants. That said, based on the pictures alone I'm not sure the trade-off of the scar would be worth the change in shape.
If you don't mind the scars, lift. Otherwise probably not.
There are other factors that must be considered, such as skin elasticity, that can only be assessed at the time of your consultation with a board certified plastic surgeon. Good luck.
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