Don't Want to Increase Size, But Want to Gain Fullness During Breast Lift, Do I Need Implants as Well? (photo)

I am 33 years old and done having children. I am considering having a breast lift done but am concerned with how they will turn out after surgery. Ideally I would like them to be lifted and rounder. I am currently a size 32D-DD and dont feel like I want to add more sizewise, but I worry that if I do not add an implant that I will be left with flat looking breasts. I would like to not have the T shapped/lollipop scar, is that an option for me? Will I need an implant?

Doctor Answers 23

Upper pole fullness can be obtained without implants

A full breast size in the D to DD range with firm breast tissue can produce a beautiful breast shape with excellent upper pole fullness without implants.

We commonly use the breast tissue itself forming an "internal bra" (this procedure was also referred to as "laser bra" in the past) suspending the breast with multiple sutures and forming a full and supported shape.  With abundance of breast tissue to work with, implants are not necessary and a natural, round shape can be obtained predictably.

If a further increase in upper pole fullness is desired later, fat transfer can provide an excellent means of further increase and control over cleavage as well.  The scar pattern is dictated by the exact shape desired in the end.

Plano Plastic Surgeon
4.5 out of 5 stars 26 reviews

Breast Lift With or Without Implants

These are good questions that are very common in my practice. First of all you need a full lift. The periareolar or other short scar lifts are not going to allow your surgeon to improve your shape and increase the fullness of your breasts during surgery.

You appear from your pictures to have good breast tissue that will allow you to get a good result with your breast lift. It is possible to give you a full natural appearing breast without the use of implants. In your particular case the full lift you will improve the shape of your breast, the position of your nipple and have a round, full breast.

Especially since you don’t want to be any larger I would not use an implant.

I hope this helps, you look like a great candidate for a breast lift and will likely have a great result!

Breast fullness and firmness after lift usually requires an implant

Thank you for your question.  A breast lift alone will certainly improve the looks and natural feel of your breasts.

However in my experience a breast lift alone even with adequate breast tissue often produces a "jiggly" breast and does not feel firm.  This is best corrected with a breast implant.

However I agree with all the other surgeons that you should have the breast lift alone first.  You may be perfectly happy with the appearance and feel of your breasts.  If not to you can always have a breast augmentation at a later date after 6 months postop.

Breast Lift Without Implants

Thank you for the photos and questions, Sherrie. I agree with completely. You do not need and should not have a combined mastopexy (lift) and augmentation. You will gain some superior fullness and projection with a vertical lift (less with a Wise pattern). The reason you should not get implants at least initially is studies show that raising your nipple more than 4 cm and then placing an implant at the same sitting can lead to increased complications. I think you will be happy with a lift alone.

Mastopexy without implants

Dear Sherrie,

you are right: using implants my not be necessary and  may open the door to a whole new set of issues.

nevertheless, a " lolipop scar " breast lift may be your best option with an internal reshaping of the breast tissue. that vertical T of the lolipop is essential in obtaining a nice conical breast, with a projected nipple. You do not need an " anchor scar " lift.

those scars are the trade - off to the lift, and will be included in all bras and bathing suits.

you still have to understand you will go down one cup size, since the breast tissue will be compressed and reshaped, and skin will be cut off. If you are a DD/ D cup, you will go down to a full C / small D.

Good luck,

Florence Mussat, MD


Florence Mussat, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 34 reviews

Upper Chest Fullness With a Breast Lift

Dear Sherrie, Thank you for your photos and question.To raise breast volume to the upper chest will significantly improve your shape.  You do not need an implant in my opinion.  Implants used for upper pole fullness often drop over time and do not gived the intended effect  You will however need removal of extra skin and rearrangement of your breast tissue.  Doing that requires incisions , which means that you will need to think that the improved shape is worth the tradeoff of scars. Good luck! 

Mary Lee Peters, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 102 reviews

Auto Augmentation Mastopexy

If a woman has full breasts and wants to have perkier, more youthful looking breasts without adding volume, it is possible to lift the breast tissue and to reposition some breast tissue to create upper pole fullness without adding breast implants.

Michael Law, MD
Raleigh-Durham Plastic Surgeon
5.0 out of 5 stars 70 reviews

Breast implants not necessary

The fullness in the upper portion of your breasts will improve with a breast lift, and you will have more projection and a perkier contour. Breast implants are not necessary but understand that a breast lift can reduce your cup size because tissue will be removed. 

Implants needed with your lift?

Because you are already a DD-cup, you definitely do not need breast implants.  An expert surgeon should be able to give you a beautiful and perky result using only your natural tissue.

David Stoker, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 29 reviews

Anchor Type Keyhole Breast Lift

                  It’s not unusual for women to lose breast volume and develop breast sag following pregnancy. These changes adversely impact self-esteem and self-image and for this reason many women request cosmetic breast surgery.

                  Your pictures suggest that you would definitely benefit from an anchor type keyhole breast lift. This approach is required to address the excess skin and sag that has developed following pregnancy. Breast lift surgery alone may provide enough upper breast fullness to meet your aesthetic goals, but if upper breast fullness is inadequate, a small implant may be necessary as well.

                  If you’re considering breast lift surgery, consultation with a board certified plastic surgeon is appropriate. This surgeon should be able to formulate a treatment plan that’s appropriate for your problem. 

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.