Breast Lift with Implants, Want to Have As Natural Look As Possible. What Do You Recommend?

After breast feeding 2 babies I want to have a breast lift. My current size is 34B maybe C but the top part of my breast is completely emty. I most likely want to have a implant with a lift. I don't know what type of implant I should have. I am not looking for a fake looking breast, full C, no big gap in between. As natural as it can look. I heard silicon is more natural looking. Any advice?

Doctor Answers (11)

Natural looking Breast Implants with Lift

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Augmentation mastopexy is designed to correct the two most common changes that occur in breast appearance following pregnancy: loss of breast volume, and stretching out of breast skin. While there are some moms who can get an acceptable cosmetic result from augmentation alone or from mastopexy alone, many moms have a combination of breast volume loss and skin excess that requires simultaneous augmentation and mastopexy (breast lift). I frequently perform this surgery in concert with an abdominoplasty (tummy tuck), and this combined breast and tummy rejuvenation surgery is sometimes referred to as a 'mommy makeover'.
Augmentation mastopexy is also commonly performed for major weight loss patients, including those who have had bariatric surgery including gastric banding and gastric bypass. Obesity followed by major weight loss usually produces breast changes that are very similar to those seen after successive pregnancies, and often the effect on breast skin is quite severe. Additionally, as a North Carolina breast implants surgeon, I regularly see patients with significant breast ptosis (the medical term for 'droopiness', pronounced TOE-sis) in young adulthood, without any history of pregnancy or major weight loss. Some breasts are just naturally droopy, and I have performed mastopexy and augmentation mastopexy for patients as young as 21 years.
This surgery is a potentially challenging one which requires thoughtful preoperative evaluation and planning, and careful attention to detail in the operating room. Many surgeons have traditionally performed breast augmentation and mastopexy surgery in stages, usually mastopexy first followed by augmentation at a later date. In the recent past more and more surgeons have adopted a non-staged, single surgery approach to augmentation and mastopexy, and that is what I propose for the vast majority of patients who I see in consultation that need both procedures. I believe that the results of simultaneous augmentation mastopexy are as good or better than a staged approach in most cases, and of course patients quite naturally prefer a single trip to the operating room if at all possible.
Some patients I see in consultation are primarily interested in a breast lift procedure. For those with a significant amount of existing breast tissue, a breast lift alone may produce an aesthetically ideal breast appearance. However, it can difficult to achieve significant fullness in the upper poles of the breasts (the upper aspect of the breasts, above the nipple-areola area) in many patients by means of a breast lift alone. I ask patients who are considering a breast lift procedure how important it is for them to have the appearance of some fullness in the upper part of the breasts, and to thereby achieve a significantly more youthful breast profile. For patients who confirm that this appearance is important to them, and who do not have enough natural upper pole breast tissue to achieve this appearance with a mastopexy alone, I recommend an augmentation mastopexy.
Other patients are primarily interested in increasing their breast volume, but have enough breast ptosis to make the appearance of breast augmentation alone odd and unappealing. Placing implants behind breasts with significant ptosis creates the appearance of breasts hanging off of a pair of implants, which looks distinctly unnatural and aesthetically unappealing. These patients are also best served by augmentation mastopexy, which in addition to increasing breast volume restores the position of the nipple-areola complex to the top of the breast mound, tightens the lower pole and lifts the breast.


Raleigh-Durham Plastic Surgeon
4.5 out of 5 stars 40 reviews

Combination Breast Lift & Augmentation Surgery

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                  Without pictures or a physical examination it’s impossible to make a specific recommendation for combination breast augmentation and breast lift surgery. Several questions need to be answered before proceeding with this procedure. These pertain to the following issues: 1) Implant Size 2) Implant Type 3) Incision location 4) Under or over the muscle and 5) With or without breast lift. Depending on the answers to these questions, a large variety of treatment options potentially exist. Each patient should be considered individually since no two patients are the same. Patients have unique anatomic findings and specific aesthetic goals that impact their treatment plans.

                  In general terms, data shows that the majority of implants are placed under the muscle through an infra-mammary approach. There’s a greater tendency to use silicone gel implants than saline implants, but saline implants are still used frequently. When breast sag is present, most surgeons perform a breast lift, but occasionally plastic surgeons place the implants on top of the muscle to avoid scarring.

                  It’s important that each patient be carefully evaluated by a board certified plastic surgeon who has experience with breast lift and breast augmentation surgery. It’s essential that he or she listens to you and understands your aesthetic goals. It’s also important that you listen to your plastic surgeon; he or she may recognize anatomic limitations that might prevent you from accomplishing your aesthetic goals. These discussions need to occur before surgery, not after surgery. This results in less confusion and patients who are ultimately happy with their procedure. 

Richard J. Bruneteau, MD
Omaha Plastic Surgeon
5.0 out of 5 stars 75 reviews

Natural look

+1

Implants will help fill out the upper pole flatness.  Silicone implants under the muscle will probably give you the most natural look.  See a Board certified Plastic Surgeon for evaluation.  Donald R. Nunn MD  Atlanta Plastic Surgeon.

Donald Nunn, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 5 reviews

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Implants give a bit of a lift by themselves

+1

I understand that you want the most natural look.  Without photos, it is hard to say, but it sounds if you are only a B cup now, that just putting in an implant will give some "lift" like a swing, by putting something behind your existing breast.  If your sternal notch to nipple distance is above 23-24 cm you may not need a lift, but you should seek out a Board Certified Plastic Surgeon that is a member of ASAPS to see you for a physical exam. 

The lower the profile of the implant, the more cleavage you will get, and the less roundness on top that seems to look a bit more fake.  But that is a generalization, and needs to be evaluated with measurements of the base of your breast.  A good new technology to visualize the different implants is to have a 3D photo with the Vectra System to show the different types of implants and sizes on your own body.  Good luck.

Dan Mills, MD
Orange County Plastic Surgeon
4.5 out of 5 stars 16 reviews

Natural look with breast lift plus implants

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Kedves Zsuzsika,

An augmented breast looks different than a breast without implant, especially if the tissues are very thin. Without the benefit of photos, by your description, you are flat on top (requires submuscular placement) and I assume that you do not have a close cleavage. Depending on the anatomy of your chest and rib cage, you may look natural or somewhat "fake". you need to consult a board certified plastic surgeon to see if what you wish is possible surgically. Good luck.

George Marosan, MD
Bellevue Plastic Surgeon
5.0 out of 5 stars 10 reviews

You need a breast lift plus implants.

+1

By your description, you presently are a B-C cup in breast volume and want to be a full C. Thus, you require implants to add volume, since a breast lift removes about 1/2 to 1 ounce of skin in order to tighten your skin brassiere. The exact type of breast lift (full Wise pattern vs. some sort of modified lift) will be determined by your exact measurements and anatomy, and the size and profile of your implants.

SInce you only want a modest increase in breast size, and will be tightening the skin as well, you will almost certainly be best served by a moderate profile implant (widest width for a smaller implant) that will minimize the cleavage distance and keep the breastbone area from being too flat and wide. Lots of plastic surgeons seem to prefer higher profile implants (moderate plus or high profile) for their patients, but these can give an unnaturally high, round, "Baywatch" look. (of course, some women actually ASK for this), but it is decidedly NOT natural, IMHO.

Below the muscle generally gives a more natural sloping upper pole of the breast, as well as reducing ductal bacteria contamination of the implant surface (reducing biofilm formation) that can lead to capsular contracture. Also, implants above the muscle may have very little of your own tissue coverage, leading to visible implant edges, ripples (much higher likelihood with saline than with silicone), and a less homogeneous, natural feel.

Silicone or saline is "easy." Saline implants are good implants, but can leak (requiring surgery to replace them), and have a higher likelihood of visible rippling (which is why most plastic surgeons went below the muscle when the FDA required saline implants between 1991 and 2006 for cosmetic augmentation). Saline does not feel as natural and soft, and can either be rounder and harder (if overfilled), or unnaturally soft with a higher likelhood of rippling if underfilled.

The present generation of silicone gel implants (either manufacturer) features cohesive implants that connot leak, rarely rupture, and "hold together" (cohesive) should the extremely durable implant shell ever be damaged. Most of my patients choose silicone implants for these reasons, but some of my colleagues still favor saline (they are less expensive, and require a slightly smaller incision to place). Most of my saline patients from years ago switch to silicone if they ever leak or rupture, and all of my nurses that have had saline have switched to silicone as well. So save yourself a step and go for silicone! They do NOT cause autoimmune illness of ANY kind, and do NOT require MRI scans every 2-3 years.

See several ABPS-certified plastic surgeons, ask for lots of before and after photos, and decide whose discussion makes the most sense to you. For more information, click on the link below. Best wishes!

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
5.0 out of 5 stars 123 reviews

Breast Lift and Implants

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Silicone implants placed using a dual plane technique often have a very nice natural look and feel for patients after babies. A lift is sometimes necessary. Without photgraphs it's hard to say much more. See a board certified plastic surgeon and they will answer your questions appropriately.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 13 reviews

Breast lift with augmentation

+1

Thanks for your question, without pictures it is hard to completely answer your question.  In general I tell patients that silicone implants look and feel more natural, that is they fill the lower part of the breast more than  the upper part.  If you are trying to regain the volume "the top part" of your breast, I find that a submuscular saline implants achieve that fullness much better.  Good luck

 

Vishnu Rumalla, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 71 reviews

Breast lift and implants

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It is certainly very common to place implants while doing a lift especially if you want more fullness. A full exam is essential to discuss with you your options.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

Breast lift with implants can look very natural.

+1

Hi.

1)  For many women, a lift with a circular scar around the nipples (Benelli breast lift) together with round, smooth walled, moderate PLUS profile, silicone gel implants placed over the muscle (not too big) works very well.  The lift and the implants are done at the same time.  The details depend on your anatomy.

2)  Finding the right surgeon is the most important thing.  Get three consultations,and ask to see a lot of before and after pictures.  The right surgeon is much more important than which implant.   Good luck!

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
5.0 out of 5 stars 9 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.