I have always had large breasts. After yrs of yoyo dieting i felt i had deflated my natural breasts and opted for a BA when I was 21 to regain my old breasts. Unfortunately I went too big. I had 469cc under muscle put in. I kept them for 3yrs before recently (6 months ago) downsizing to 360cc. Now that I am healed I feel that there is a fair amount of droop, unevenness in shape and nipples are much too big. In addition my own breast fat hangs on the bottom. Which lift would be best for me? THX!
Which Breast Lift Do I Need to Attain Desired Results? (photo)
Doctor Answers (14)
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What kind of breast lift?
Thank you for your question as well as for your photograph. I agree with others in the forum that seeing a board certified plastic surgeon is your best option.
It will share some thinking that may be of help to you.
Iin a perfect breast implant situation you would have two identical breast implants as two identical breasts. When one breast is larger than the other the increased natural breast tissue tends to gravitate towards the bottom of the breast. Natural breast tissue will always respond to gravity.
Based on what I see in your photographs you likely have a larger amount of natural breast tissue on the right side which is why you have the soft tissue under the breast.
To make the breasts match more evenly you might consider lifting of the right breast with removing some of the natural breast volume. The trade off here is the only way to reduce the natural tissue is through larger incisions.
A periareolar lift or lollipop lift may help with some of the droop and elevate the nipple, but these smaller lifts do not reduce the natural tissue which is causin your droop.
In my own practice and will often tolerate some residual degree of asymmetry because a small degree of asymmetry may be better than the scars that would be used to treat it.
Only a vertical "lollipop" lift will tighten your lower poles, reduce areolar size, and avoid a horizontal scar.
Yes, you must have been large to start with because it looks like you have implants that are larger than 360 cc, which tells me you have plenty of your own volume. Actually, your degree of sagging does not look too bad in the photo, but I think you are holding your arms up. The decision is whether to have a breast lift, which can tighten the lower poles and get rid of that hanging breast fat you don't like. The lift can also reduce your areolar size as much as want. It will make you a little smaller, but I think that is okay, don't you? If you have a lift, it should be a vertical "lollipop" style. The donut (periareolar, Benelli) lifts do not work well because they do not remove skin from the lower pole, where it needs to be removed, and these lifts often cause areolar distortion. I've attached a link to the breast lift section of my website in case you with to read more.
Best Breast Lift (Mastopexy) For Me
Good Morning and thank you for the photo.
I agree with your assessment that your breasts are a bit low and a breast lift would be beneficial to give you a very nice aesthetic result. In your situation, determining the right choice of breast lift depends largely on your goals. Based on your single photo, I would recommend a vertical mastopexy ('Lollipop' lift) on the right side and probably a Benelli (circumareolar) lift on the left side. A clinical examination would be necessary to make this determination. You have a significant asymmetry (which may be related to how the picture was taken?) which means that each breast may benefit from a different procedure as noted above.
The goal of a breast lift is to place the nipple-areola in a more pleasing position on your breast. If you imagine that your breast is a circle (roughly), then the nipple should be located at the center (or just above) of the circle.
I hope this information is helpful. Best Wishes whatever route you take!
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Determining best type of breast lift for you
The type of lift needed depends on how far your nipples need to move.
- Donut, Benelli or circumareolar type lifts work well for small amounts of lift. These leave a scar around the areola
- Vertical or lollipop type lifts are good when moderate amounts of lift are needed
- Inverted T type lifts are needed when significant lifting is desired.
You have multiple issues that need to be addressed to get a good result, including droop, asymmetry and possibly capsular contracture. Make sure you see a board certified plastic surgeon to get the best care possible.
Michael Vennemeyer, MD
Breast revision needs to be carefully considered
Thank you for your question and for the photo. In my opinion, it seems that the edges of the implants are visible, which I think is not aesthetically pleasing, and the implants appear overly large. Are these saline or silicone? On the right side it appears that you would benefit from a lift. This would do 2 things. It would raise the level of the nipple and reposition the hanging breast tissue that you pointed out. This will help correct the breast tissue hanging off the edge of the implant. If you feel the areola is too large, this can also be addressed at the time of the lift. I would also discuss smaller implants with your surgeon. It is not uncommon for patients who really need a good lift to have overly large implants placed as a substitute. Remember that larger implants will work against the lift. Hope this helps.
Tracy Pfeifer, MD, MS
Two different breasts, two different lifts
Best thing is to be seen in person by a plastic surgeon who can assess you and better answer your questions.
Martin Jugenburg, MD
Toronto Cosmetic Surgery Institute
Type of Breast Lift
I would recommend that you consult with a plastic surgeon who can assess the degree of capsular contracture that is contributing to your problem, as well as, assess the quality of your breast skin and breast tissue to determine the best course of action.
What kind of breast lift?
What Type of Breast Lift Best for Me?
Although I would like to provide you with precise advice online, this is not possible especially given your past surgical history. You will be best served by doing your due diligence carefully in the selection of plastic surgeon. Once you have selected your plastic surgeon, communicate your goals clearly. In my practice, I prefer the use of goal pictures to help with the communication process.
Remember, that the downsides of breast lift surgery include the presence of scars. Make sure that you are at a psycho socially stable place to proceed with this type of surgery.
Which Breast Lift Do I Need
Besides the issues you have stated, it appears that capsular contractures may be present and contributing to the contour problems. That would need to be addressed as part of your procedure if indeed present.
The lift you need is at least a vertical lift, with an incision around the areolas, which would be made smaller, and a vertical incision down to the breast fold. At an in person consultation, consideration might also be made to a horizontal incision in the fold to remove excess skin.
If the capsule needs to be addressed, at a minimum a capsulotomy/capsulectomy would be needed. If there were contracture problems in the past, adding Strattice will decrease the chance of further recurrence.
Discuss all with your surgeon. Thanks and best wishes.
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.