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Breast Augmentation with or Without Mastopexy? (photo)

asked 6 months ago by MF35 in New York
Latest answer by J. Jason Wendel, MD
Question viewed 301 times
Tags: mastopexy, scarring

I've had consultations with 2 surgeons so far. One said I'd achieve a good result w/ just implants. The 2nd one measured me & said that to achieve my desired result, I need a circum-areolar lift w/ implants to fix my nipple position & reduce the size of my areola. I'm looking to restore upper pole fullness & desire the round, perky look. I want the best result possible, but I also wasn't anticipating the extra scars. Could this be achieved with implants alone or is a lift really necessary?

17 answers to Breast Augmentation with or Without Mastopexy? (photo)

A lift can improve but may not be necessary results with an augmentation

Hi, Looking at your photos, you are really on the borderline of whether a lift would be better or not. I have a patient posted on my web with the same level of ptosis (sag & nipple position) so you can see what it will look like with just an implant. In general, to get an aesthetic result, the nipple areolar complex should be between 18-22cm from the notch in the chest bone; there should be normal skin visible below the areola; and the size of the areola should match your... more

Kimberley O'Sullivan, MD
Boston Plastic Surgeon

Considerations for Breast Augmentation vs. Breast Augmentation with a Lift

Your pictures show that your breast shape, volume, and nipple position are such that you fall in between those patients that don’t need a lift, and those that obviously do. In this situation you certainly will receive various opinions from different surgeons. Different recommendations are related to varying experience and preferences among physicians. With respect to breast lift (and without being judgmental), I believe there are a number of surgeons who try to avoid doing a lift in... more

Kenneth Dembny, II, MD
Milwaukee Plastic Surgeon

www.mycpss.com

Mastopexy and scarring

You could go either way. A purist would say that you need the circumareolar lift with implants to get the result you desire. Yes, this would help bring the nipple slightly up and make your breasts perkier if that is what you desire. But, you can also get a good result with implants alone. When the implants settle, they may not be as high as you want them but the result would still look good with no scar around the nipple. Most women only get the high, pushed-up look with a push up... more

J. Jason Wendel, MD
Nashville Plastic Surgeon

www.mc.vanderbilt.edu

There are many factors that weig on the decision as to whether an augmentation alone

Will achieve the best possible result, or whehter combining the augmentation with a mastopexy or breast lift will achieve the best possible results. As one of the most important factors in this decision ios the desire of the individual patient, it really isn't appropriate to gneralize the answer to your particular patients to all women in your situation. The short answer is that augmentation may acgieve the results you desire with less scarring, and if the scar is critically... more

Michael H. Rosenberg, MD
White Plains Plastic Surgeon

plasticsurgeryweb.com

To Lift or Not to Lift- Should depend on your goal, and your surgeon's skill

Hi there- Your question is very difficult to answer, because to answer in any particular way (yes, have a lift, or no, don't) would require me to have an understanding of the quality of the results your surgeon produces with each technique.... As this is impossible (it is a mistake to believe that all surgeon's outcomes with any particular procedure are equal), the only responsible way to answer your question is to help you understand what I think would be possible in my hands..... more

Armando Soto, MD
Orlando Plastic Surgeon

A breast lift or implant and lift

From your photos, it is clear that you are somewhere in between the lift and the implant alone. However, you do have some existing breast asymmetry that can only be improved by lifting of the breast itself. One of the best options is for you to communicate with your surgeon and especially with your request for "the round, perky look. I want the best result possible" be open to a lift to help restore a more youthful position of the breast. Relying on a heavier breast (if... more

Vincent P. Marin, MD
San Diego Plastic Surgeon

www.marinaesthetics.com

Just implants if you size it right

I think if you pick a good size implant you can avoid a lift. I have seen many patients in my practice such as yourself and have avoided a lift. It can easily be performed at a later date under local anesthesia with no down time if needed.

Michael Constantin Gartner, DO
Paramus Plastic Surgeon

Breast Augmentation with or Without Mastopexy?

I know why you are getting so many different opinions. You have what I call “In-between Breast” & you have a bit too much droop for just implants & not enough droop for a full lift. I think if you do just implants, in 6 mos- year you will be complaining of your breasts being too low..But then a donut lift is really a compromise operation that gives some lift but not a lot..and then there is the scarring..This is a very difficult decision but you can always add the lift... more

John J. Corey, MD
Phoenix Plastic Surgeon

Augment with or without lift

It's a toss up. I think you'll be fine without the lift. You might need to go a little larger, say around 350cc in order to look more "perky". Especially if your priority is to avoid the extra scar. Worst case scenario you needed a small periareolar lift later, it wouldn't be the end of the world. Obviously it would cost you a little more in the long run but might be worth it.

Ronald Schuster, MD
Baltimore Plastic Surgeon

Augment v. Augment/Pexy

I think you would do fine with just an augment. Your breasts are small and have first degree ptosis. I don't think that a mastopexy is indicated at this time and agree that you could certainly avoid the scarring and additional cost. You can always have a lift at a later date but I really don't think this will be necessary and that you will be satisfied with an augment alone.

Robert L. Kraft, MD
New York Plastic Surgeon

Breast Augmentation with or without mastopexy

You are borderline. The test for a mastopexy is typically looking at the areola and seeing if it sits at or below the fold. I think you would get a nice result with a straight forward dual-plane augmentation. Dual-plane is still partially under the muscle but placed slightly lower so that the bottom part of the breast is filled out properly.

Jeffrey Hartog, MD
Orlando Plastic Surgeon

I would do implants only

You have border line breast for the lift and i would recommend sub-muscular augmentation first. If you decide to raise your breast and are OK with the scar ,lift can be done later. Combined lift/augmentation has high complication rate.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon

Lift or no lift with augmentation?

Based only on the available photographs (and without an exam), I would lean toward augmentation only. While a peri-areolar lift may add some roundness to your breasts, I do not believe that the overall result would be enhanced by combining the lift with the augmentation in your case. The lift would add scars around your nipples and has the risk of ending up with widened nipples with a large diameter. Discuss your expectations with your surgeon and bring some photographs of... more

Eric T. Emerson, MD
Charlotte Plastic Surgeon

www.seplasticsurgery.com

Breast Augmentation with or Without Mastopexy

Depending on the results that you are looking for, you can go either way. I recommend that you bring photos of what you want your breasts to look like to your surgeon, and discuss what would need to be done to achieve those results. I typically show my patients examples of before and after photos of breasts similiar to theirs so they can see the difference of the results with or without the lift. If you choose to have the surgery without the lift, your NAC will sit lower... more

Amy T. Bandy, DO
Newport Beach Plastic Surgeon

www.drbandy.com

Uplift or no uplift

Thank you for your photos. In my opinion you would have a more natural appearance with an uplift and implants, not just implants alone. I think that you want the implants behind the breast "mound". If a too large implant is placed, I think that you could correct some of the hanging tissue but not all of it.

Rick Rosen, MD
Norwalk Plastic Surgeon

To Pexy or Not

From the photos you submitted, it looks as if implants alone will do the trick, But remember, breasts ALWAYS end up sagging. You will never get the upper pole fullness you want unless you develop capsules or wear a push up bra. Breasts were not meant to be up on your shoulder. Also, when you do a circumareolar mastopexy, often the scars and or areolae stretch out again. good luck

William B. Rosenblatt, MD
New York Plastic Surgeon

Breast Augmentation with or without Implants?

Thank you for the question and pictures. It is not uncommon to receive different responses from different plastic surgeons during consultation. Ultimately, you will have to make the final decision (after doing your due diligence/ research) and trust the surgeon who you feel most comfortable with to achieve your goals. When you look at your breasts carefully, you'll see that there is some breast asymmetry with the right nipple areola slightly lower on the chest... more