Breast Implants Without Lift? (photo)

Booked in for breast implants alone in 2 Weeks my surgeon said i would get away without needing a lift for about 5 years but eventually i would. My ptosis level is s1 skin pinch 1+ and im going for 465cc high profile unders. what my question is are my boobs really that bad? Are they going to last a good 5 years or am i going to end up with massive saggy boobs? Or is there something that i can ask to be done during my surgery? because in my eyes my right boob is the problem

Doctor Answers (12)

You would benefit from lifting at least at the right side!

+2

Hi,

I just had a similar patient about a week ago. There's no ''perfect'' way to deal with this situation. In my hands your options are:

1- Symmetrization (lifting) for the right breast and subsequent subglandular (!) implants for both breasts. This is probably the best option for the best possible shape and symmetry. But you'll probably have inverted T or lollipop incision scar at right. And even subglandular placement of the implant will correct the sagging (ptosis) of the breast it's very likely that you may feel the implant shell as your skin and subcutaneous fat seems to be very thin (pinch test <2cm).

2- Subglandular implants for both breasts without symmetrization (no lifting for the right side). This probably will yield a very unpleasant result as the asymmetry between the breast will be accentuated. And even if we use different size implants the diameter of the implants will differ, which in turn will yield an asymmetry. But you may accept this option over the former if you don't want any scars at all but off course  you need to understand the tradeoffs.

3- bilateral breast lifting with or w/o implants. This option may yield bilaterally symmetric breasts and scars. 

4- periareolar mastopexy (lifting) for the right side and bilateral implants through periareolar incision. Is another logical option you may give a chance. Periareolar mastopexy usually do not yield good results alone because periareolar tissue excision and stitching leads to depression at the tip of the breast cone leading to diminished projection. This effect can be managed at some extent by implants. Scars will be less obvious as they will be embedded at the skin-areola junction. In terms of symmetry this option will not be able to give the best result but in terms of final scar and general appearance this is a choice.

Good luck!

 

 


Turkey Plastic Surgeon

Implants not enough

+1
You have asymmetry of your breasts with different size skin envelopes, different size areolas and position of areolas. You will need different size implants on both sides as well as a simultaneous lift. I recommend a new technique called Breast Augmentation with Mini Ultimate Breast Lift. Using only a circumareola incision it is possible to reshape your breast tissue creating upper pole fullness, elevate them higher on the chest wall and more medial to increase your cleavage. Through the same incision, implants can be placed. Aligning the areola, breast tissue and implant over the bony prominence of the chest wall maximizes anterior projection with a minimal size implant. Small silicone gel implants placed retro-pectoral look and feel more natural, are more stable, less likely to ripple or have complications needing revision. Why undergo an operation, now knowing you will have to undergo another operation at additional cost in 5 years. It is very unlikely you will be satisfied with implants alone since implants just correct volume and do nothing for areola discrepancies and skin envelope irregularities. Best Wishes, Gary Horndeski, M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
5.0 out of 5 stars 123 reviews

Implants or implants with lift

+1

Thank you for your photos! You have several options.  The most conservative is to start off with a breast augmentation and see how you like that.  If you are not happy with that, then do a lift on your right after about 6 months.  Some patients prefer to not have 2 surgeries so they will do both at the same time.  Some patients also don't like the idea of one breast with lift scars and the other without so they opt to do a lift on both, for balance. It's a very personal decision. Go with your gut and trust your surgeon. ac

Angela Champion, MD
Newport Beach Plastic Surgeon
5.0 out of 5 stars 4 reviews

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Do I need a lift

+1

For the best results the right breast probably needs a small vertical lift.  You can have the surgery as planned with just implants of course,  just know that a staged lift in 6 months might be in order to make nipple and breast position more even. 

Mahlon Kerr, MD, FACS
Austin Plastic Surgeon
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Breast Implants Without Lift?

+1

Tough question without an actual exam. The complicating issue is that the breasts are rather lowset on the chest wall. The nipple on the left is completely normally positioned on the breast, the right one is borderline low. If perfect symmetry, always an illusory goal, is desired, then a lift on that side would be a consideration just to make the areolas more even.Understand that although a lift is not "necessary", you may feel that you need one in the near future if you do an enlargement alone. 

What a lift may do is allow for a somewhat higher positioning of the implants on your chest.

All the best.

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
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Breast implants and a lift?

+1

Thank you for your question and photos.  As you are probably finding out, there is no one absolute correct answer for your question.  With that being said, you are correct in stating that your right breast is quite different from the left.  The areola is larger, the breast is larger and there is more ptosis on that side. The left side would likely not require a lift but the right side, to create symmetry, will certainly need a lift.  Our ultimate goal in breast surgery is to create symmetry to harmony between the two breasts.  I would make sure this is addressed during your procedure. 

Best of luck.

 

Brian C. Reuben, MD
Salt Lake City Plastic Surgeon
5.0 out of 5 stars 10 reviews

Uplift or just implants?

+1

I agree with you that have significant asymmetry.  I don't think your breasts are "really that bad" but they would most likely look more youthful following surgery.

Your operative plan will most likely lift up your nipples but won't correct your asymmetry.  I suggest if this is not a big deal for you then have the procedure and if need be then you could have a minor uplift later on to symmetrise your nipple position.

465 implants will be quite big for you.  You have most likely thought this through already and you do need a large implant in order to get the uplift you need.  I would still consider this carefully though, particularly because you are concerned about your result in 5 years.  The bigger the implant, the more strain on the breast and the more they will be affected by gravity over time.

If you still have concerns I suggest you book into see your surgeon for another consultation preoperatively.  It is best to go into the surgery with a clear idea of what lies ahead, that way you will be most likely to end up with the result you are looking for.

 

Good luck,

 

Dean

Dean Trotter, MBBS, FRACS
Melbourne Plastic Surgeon
5.0 out of 5 stars 1 review

Breast Implants without Lift

+1

You are correct.  The right breast is more of a problem than the left.  Although it is impossible to tell specifically without an examination, it appears that your left breast would do quite well with just an implant and no lift.  However, it appears that the right would do better with a periareolar lift in order to prevent immediate postoperative droop.  Of course, if this happens, you can always come back secondarily and do a periareolar lift.  The scar from this is only around the outside of the areola and is not much more than the scar from the augmentation itself.  The only other problem I see is the size you have chosen.  From your pictures, it appears that you are quite petite.  If this is so, the implants you have chosen may be large for your body.  You need to make certain that the base diameter of the implant is smaller than the base diameter of your natural breast.  Once you have determine this, you can determine the size implant to use.

Robert T. Buchanan, MD
Highlands Plastic Surgeon
5.0 out of 5 stars 4 reviews

Breast lift or implants alone

+1

Hi there,

465cc implants will look big on your frame. Size is very dependent upon your personal choice.  Try the rice test at home to get an idea of what that will actually feel like to you in terms of size, and if it doesn't feel right then you need to discuss size with your surgeon ASAP.  Google the rice test to see how to do it.

Whether you need a lift or not is much more difficult to advise from the pictures.  The best advice I can give you here is to ensure your surgeon is a specialist plastic surgeon with a breast surgery interest and experience, then take their advice on this.

 

all the very best.

Howard Webster, MBBS, FRACS
Melbourne Plastic Surgeon
5.0 out of 5 stars 52 reviews

Breast Lift with Implants

+1

Your right breast does have more droop and will get some correction with the implants but large implants will eventually need to be lifted as your surgeon suggests.  This is an option vs. going through a small peri-areolar lift on the right side at the same time as the breast augmentation.  Wish you the best. 

Tripti Burt, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 28 reviews

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.