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 (19)

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.

Boston Plastic Surgeon
4.5 out of 5 stars 29 reviews

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.

Jacob Freiman, MD, FACS
Miami Beach Plastic Surgeon
5.0 out of 5 stars 79 reviews

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 9 reviews

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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.

Mario Diana, MD
San Antonio Plastic Surgeon
4.5 out of 5 stars 22 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 83 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. 

Richard J. Bruneteau, MD
Omaha Plastic Surgeon
5.0 out of 5 stars 74 reviews

Implant need with Breast Lift

In order to achieve an elevated firmer breast you certainly need a lift and could do so with a vertical( lollipop ) approach. Regardless you will not have that round fullness in the superior pole that an implant creates. I show my patients similar cases with and without a very small implant and the majority of the time they go with an implant. You can certainly stage the procedure to see if you will be happy, but unfortunately that will increase overall costs. With a small implant and some tissue resection from the lower pole you will not increase your breast size.

William F. DeLuca Jr, MD
Albany Plastic Surgeon
5.0 out of 5 stars 109 reviews

Do I need a breast implant?


Hello Sherrie,

The decision of implant vs no implant for me is pretty common sense.  If you would like to be larger, an implant is required.  If you are happy with the size, I don't think there is any place for an implant.  There is a lot that can be done with breast tissue reshaping and anchoring to achieve "fullness" and shape in the upper pole with your own breast tissue. 

The unfortunate trade-off is that a breast lift requires excess skin excision and resultant scars.  At the least you would need a lollipop scar pattern.  I would have to see and feel the breasts to determine if an inframammary scar would be necessary as well. 

-York J. Yates MD, Utah.

York Jay Yates, MD
Salt Lake City Plastic Surgeon
5.0 out of 5 stars 40 reviews

Breast lift


A breast lift is the wya to go if you just want about the same size and perkier.  If you want more volume you would also need an implant. Very possibly you could have a vertical mammoplaty using a lollipop incision. Sometimes depending upon the laxity, a "T" or anchor type of incision is used.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 16 reviews

Breast Lift and Breast Implants


Hello Sherrie8995,

Your breasts are too large and heavy for an effective breast lift to give you a pleasing result ( 1. Nipples just above the horizontal meridian or 'horizon.'  2. Modest upper pole fulness  3. Minimal fullness that hangs below the inframammary fold.)   In order to achieve this aesthetically pleasing appearance, a full reduction will be required.  This will entail a loss of volume that you will probably want to replace.  To achieve that, breast implants will be necessary, also providing more upperpole fullness in addition to replacing lost volume.  These surgeries can be done simulataneously, but only by those with extensive experience in doing so.  Depending on what you desire, and therefore choice of implant size, your new breast size can be the same, larger, or smaller than it currently is now.

You should see a few surgeons with excellent reputations with complex breast surgery.  These surgeons will definitely be certified be the American Board of Plastic Surgery and also be members of the American Society for Aesthetic Plastic Surgery.

Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills 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.