Breast Augmentation: Q&A

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Do I Need a Breast Lift Along with Implants? (photo)

I'm a 27 yo Romanian who after giving birth have decided to get breast surgery. I have spoken to 2 doctors with different opinions. 1 doctor suggested I would need lifting+implants to achieve my desired look, while the other doctor said implants above muscle will also lift enough. I lost considerable volume in breasts after birth+breast feeding, but distance from the notch on neck to center of nipple is 20cm. Any opinion would be appreciated. Attached are my breasts and also desired outcome.

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sagging candidate lift

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17 Doctor Answers | Asked by simonal in Portland, OR

Doctor Answers (17)
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Breast lift and implants

In order to have a more youthful appearance, you will need some type of lift procedure in conjunction with placement of breast implants. If you undergo the placement of implants alone, you will likely find that your implant will fall into the skin envelop and be much lower that you want them to be. I recommend implants under the muscle and a breast lift. Best of Luck!

Breast implants and breast lift

You have several reasons to consider at least a peri areola lift. your breast look very long and will continue to do so with just and implant the picture you show has rounder firmer breasts that require a lift an implant alone will give you a larger heavier version of your same breasts

Who is a candidate for breast lift?

I am answering this question based on your photos only. In my opinion, you have a large amount of loose skin in the lower pole of your breast and a breast lift with an implant which is proportional to your body will give the best result. Placing a large implant above the muscle to try to lift the breast, in the long term, will result in thinning of your skin and more stretching of your skin, and possiblity of implant visibility. see video

It depends on the degree of sagging

Dear lady, to know of there is a chance that your breasts can sufficiently be lifted with implants alone you need to take a picture with your arms lifted above your head. If this manoeuvre corrects the hanging there is a chance that an implant will suffice, or perhaps just a lifting around the areola would be necessary. Above or below the muscle depends on the thickness of your own breast tissue. If less than 2 cm thick, I would recommend a placement behind the muscle.

Implants With Lift Or Implants Alone

The key to answering your question is the nipple location. If your nipple is situated below the fold beneath your breasts (as your photos suggest), you will likely be unhappy with the result of an augmentation alone. If you choose, you can always have only the augmentation initially and then undergo a mastopexy or lift at a later date.

Need a Breast Lift with Implants?

This really depends on how willing you are to have the additional scars from a breast lift and how large your implants will be. Based on your pictures, including a breast lift is more likely to result in more youthful breast. Some surgeons will do this is stages and you should discuss this with your surgeon.

Do I need a lift along with an implant?

Judging from the photos it appears that you have at least moderate drooping as well as decreased breast volume. I believe that the best results would be obtained by inserting implants under the muscle as well as performing a breast lift with the scar confimed to the areola. This would minimize scarring and maximize result. Of course the ultimate decision as to how to proceed will ultimately be made when you are physically exmained by your surgeon. Good luck!

Breast lift and augmentation

It is possible that, to achieve the size you desire, a submuscular implant would be adequate. This would depend on the laxity of the breast tissue and your main goal. Ideally, an augment/pexy would be excellent but not everyone wants to undergo this procedure either because of scarring or the costs. Your expectations are the most important consideration. Often I advise patients that they must have the combined procedure but, in your case, you may have the implant only option. more

Do I need breast lift in addition to implants (photo)

Nipple to notch looks longer than 20cm in picture (23-24cm), OR your inframammary creases may be naturally high. It is difficult to make this determination definitively online, because the precise relationship between your nipple and inframammary crease, your skin elasticity and quality, and the size of implant you will tolerate all influence the need for formal mastopexy in addition to augmentation. Your areolae are large, and will likely enlarge furthet with implants.... more

Breast Augmentation and Breast Lifting?

Thank you for the question and pictures. I think you may benefit from sub muscular (dual plane) breast augmentation and vertical mastopexy. Based on your body type I would suggest silicone gel implants. Of course in person examination will be definitive. Be careful about having breast augmentation or breast augmentation/ circumareola mastopexy performed- I think you will likely be disappointed with the results. I hope this helps. more

Breast Lift and Implants

From your photos, the best result will be produced from a silicone implant placed beneath the muscle and a "lollipop" breast lift. This will leave you with scars, but it will help reshape your breasts to the most youthful and attractive appearance. An over the muscle implant without a lift will leave you with a low, heavy breast (very different from your "ideal") and a lift around the nipple alone will flatten the breast, not producing the ideal results. No patient... more

Breast lift and implants

Your pictures are a big help but it takes an exam by an experienced surgeon to give you your answers. Based on your pictures, it would seem a dual plane augmentation would go a long ways to reinflating your breasts. Above the muscle implants are rarely the best idea unless you have more thickness to the upper breast than your photos indicate. A lift would help a little but may not be necessary. It is very important to realize the photo you like can probably not be obtained with your post... more

Depends on your expectations

Quite likely an over the muscle augmentation or dual plane augmentation will fill out the breasts, give a fuller look, but the breasts will still sit low on the chest, particularly over time as the implant settle and the skin stretches. If you are comfortable with that look then augmentation alone will probably work, but it is very likely you will need a lift in the future. For the best possible shape, a lift with augmentation will be required, but of course you have to be comfortable with... more

You will need to have lift

Your breast tissue and skin are thin and stretched out. Placing the implant above the muscle is going to give you more problems . You will bottom out and sag more due to the implant weight and gravity. I would do lift and implant later on. Most patients do like this option and would rather to get the combined lift/implant. If you decide to get the combined procedure ,you should be comfortable with revision surgery later on. Your expectations are not realistic based on the posted picture. more

Kamran Khoobehi, MD

28 reviews

New Orleans Plastic Surgeon

LIft with implants

You could benefit from a lift with implants possibly a circcumareola lift or a lollipop lift may be helpful. An exam would be essential to make a final determination.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Yes, a lift would be best

An exam is critical here but just from the photos I can make some general comments. The doctor who would put your implants above the muscle to avoid the lift you need will leave you with a bottom heavy matronly looking "ball in a sock" breast. You have enough laxity and lower pole looseness that a full lift with implants under the muscle will look better despite the scars needed to do it. Check my web site for photos of long term results.

Implants and/or lift?

Implants alone are not likely to give you the results you desire. Going larger is also not a good option to avoid a lift either ( thinking if you fill the envelope more you don't need to reduce it). So decide on what size of augmentation you desire then perform the lift appropriate to the excess skin that remains. This will also address the expanded areolas that occurred as a result of your pregnancy. Both can be performed at the same time as long as you understand that a revision,... more