I definitely want implants as I feel deflated. Do I Need a Breast Lift?
Doctor Answers (12)
Breast Augmentation +/- lift
Without a physical exam, it is difficult to tell what is required in order to achieve your desires. I have had many patients come to me in your situation and were told by a friend that you get a lift with an augmentation. While this is true sometimes, it is not always the case. Sometimes the amount of volume required to provide the "lift" will be too large of an implant than you would want.
An option I provide to my patients when they are unsure of getting a lift is that if they are happy with the volume of their breasts after the implants are placed, but not the position of the nipples, a revision can be done in the office to lift the nipples at a later date. This is sometime more cost effective, as it can be done under a local anesthetic, instead of in surgery center/hospital.
it would really be helpful if you submitted photographs
in order to be able to assess whether a full or mini lift is needed in addition to
implants. In some cases an implant may be enough depending on the degree your
natural breast tissue has either sagged or just simply lost volume in the upper pole of the breast. If it is more of a volume issue vs. sag, then implants may suffice
without pictures or one on one consultation it is difficult to determine what you need
Needing a breast lift or not?
Basically the choice depends on your own starting point and your desired end point. The key thing to understand is that an implant of any size will NOT LIFT the breast and elevate the nipple to a more youthful location. So, if your nipples have fallen down and are at the level of the crease or below it or are pointing down, most would not be happy with the look from implants alone.
Beyond that, the kind of lift you need depends on how much lifting you require for the best shape. A crescent lift barely does anything so I'd skip that one because it distorts the areola. In the end, you can always do the implants and see if you are happy and reserve the lift for later once you believe you need it.
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Is a breast lift needed?
It is impossible to give you any recommendations on whether you need a breast lift without a physical exam. Your plastic surgeon will need to assess the quality and amount of excess skin and the exact degree of sagging. Out of the 4 PS with whom you visited, make sure they are board certified in plastic surgery. Review their before/after photos. And pick the PS with whom you feel most comfortable. I'm sure you'll love your results!
To Lift or Not to Lift
It is very important to understand that there is no hard and fast rule about who we would recommend a lift to and who we wouldn't...
Whether or not it would be advisable for you to consider a mastopexy (breast lift) would depend on your starting anatomy, your desired outcome, and your chosen surgeon's skill and experience in breast surgery.
In other words, I could only tell you what I would recommend after a clear understanding of how you got here, what you look like now, and what you would like to look like after surgery... and even then, it would only be reasonable to follow my recommendations if you were going to let me do your surgery- I know what works well and what outcome is reasonable to expect when I do certain things, but this doesn't mean that if another surgeon does the same things the same outcome will be achieved.
The bottom line is that you should carefully consider where you want to end up, and who you want to do your surgery- then follow that surgeon's recommendations carefully. Only he will have a firm understanding of what works well in his hands.
Conflicting opinions on the need for breast lifts
certainly make the decision process more difficult. Without photos it is even harder to comment. As a general rule, if you place a pencil transversely at the inframammary fold where your breast comes off of the lower and your nipple is below this, you will likely need a lift and if much below this, a lift will be required for an aesthetic result. Regardless, the choice is yours and if you're willing to accept less than perky results, a lift may not be needed. I recommend to my patients, when in this gray zone, that we do an augmentation first and if not happy, then proceed with a lift. If its a small lift, this can be done in the office under local, saving considerable amounts in anesthesia and operating room fees.
Needing a breast lift after explant
There are several important issues to mention here.
One is that no one "needs" a breast lift in the usual sense of the word. It is a cosmetic procedure/choice. The issue is whether an implant can be placed behind the breast like a pillow in order to fill it out or is the breast too low to be filled out with an implant. Or as someone else expressed it, it depends on what your goals are and whether they can be achieved without the lift.
Another important point is that implants do not lift the breast and larger implants do not lift it further. It also has little to do with your tissue tone which is not going to change with an implant or a lift.
The dividing line between "needing" a lift or an implant alone to fill out and reshape the breast is where the nipple sits in relation to the inframammary crease behind it (upright, with arms down). If the nipple is more than 2 cm below the inframammary crease level then a lift is required to get the breast up to the correct position to get an implant behind it. If it is less than 2 cm down then a properly done augmentation with an implant alone will fill the breast out properly and it will look lifted because of the lower pole fill even when it is not actually lifted.
A true lift of the breast requires moving the nipple-areola AND the breast up and getting it healed at a higher level. Periareolar "lifts" do not actually do this generally and so-called crescent lifts are to be condemned as wishful thinking (and areolar distortion). Most proper lifts can be done with a lollipop incision with or without positioning an implant behind the breast at the same time or at a later time.
Without a picture or examining you it’s very hard to tell you what you would benefit from. A picture can be very helpful.
Do I Need a Breast Lift?
This can be a tough decision even with an in person exam (4 docs, at least 3 opinions. It would be harder still with photos, impossible without. If you wish to get more useable advice, consider attaching some photos.
There are some women in whom a lift is suggested who may feel that they have an acceptable result, albeit with a somewhat lower than usual areola.
Others, however, may have a completely unacceptable appearance, with the native breast tissue draping off the implant.
Your consultants can help sort through the possibilities. Those of us who respond to these questions on RealSelf can help with some more info.
Thanks and best wishes.
To lift or not to lift?
Dear Ms. Gluenj. I agree with most of what has been said below. However, in your question you mentioned that one surgeon told you a crescent lift would work. It won't. The only thing that will do is make your areola more oval. If you look on my website, I have some photos of women that were somewhat droopy and decided not to have a lift. If this is what you find attractive, then you don't need a lift. If I can help you in any way, please let me know.
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.