Would I be a good candidate for a breast augmentation? If so, can it be achieved without a breast lift?

If a lift is required what options do I have? Not interested in a vertical lift.

Doctor Answers (15)

Would I be a good candidate for a breast augmentation? If so, can it be achieved without a lift?

+1
Hello! Thank you for your question! Breast augmentation is a procedure often sought by women to increase size, add upper pole fullness and projection along with improve shape and symmetry of her breasts. Women who have the breast augmentation done report increased self-confidence, self-esteem, and more comfortable with her body. In fact, it has been the most popular procedure in plastic surgery in the US for the past few years. You appear to be an excellent candidate but would definitely consider a breast lift due to your droop in order to improve overall shape. I would not sacrifice incision to compromise breast shape - I think a vertical lift would give you best result b

Things to to consider during your consultation, which your surgeon will discuss with you, include implant type (saline vs silicone), shape/texturing of implant (round vs shaped/textured vs non-textured), implant position (sub pectoral, subglandular, or subfascial), incision (inframammary fold, periareolar, axillary, or TUBA), and size of implant. This can be performed with/out a breast lift, which would serve to obtain symmetry in breast size or nipple position as well as improve shape. Good communication between you and your surgeon of your expectations is warranted - choosing your surgeon wisely is the first step. Discussion of your wishes and having an honest and open dialog of your procedure is mandatory. I have found that photographs brought by the patient is helpful to get a visualization of the appearance you wish for in terms of size, shape, fullness, etc. In addition, your surgeon's pre and postoperative photographs should demonstrate a realistic goal for you. Once this has been accomplished, allow your surgeon to utilize his/her best medical judgment during the procedure to finesse the best possible result for you after preoperative biodimensional planning and fitting the right implant for your breast width. Too large of implants for the woman often destroys the breast pocket and breast shape, thus creating an oft seen in correctable problem later.

In general, implant size does not correlate with cup size. The cup size itself will vary from manufacturer to manufacturer as well as who is doing the actual measurements. Thus, cup size or implant size is never a reliable indicator for your breast size. I typically encourage my patients not to communicate her desires in cup size but more on the actual look and appearance. Your breast width is the most important measurement.

Hope me that this helps! Best wishes for a wonderful result!


Scottsdale Plastic Surgeon
5.0 out of 5 stars 12 reviews

Breast lift and implants

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You have breast ptosis and an implant alone will likely not fill your tissues to the point of ptosis correction. When you go to your consultation I would suggest that you be open and open minded about your tolerance for scars.  The vertical component of the mastopexy gives the surgeon much more control of nipple location than does the circumareloar approach.  Having said that, many patients to whom a vertical lift is recommended refuse it - if one is recommended to you and you refuse it just be clear about your expectations of the aesthetics after surgery.

Michael B. Tantillo, MD
Boston Plastic Surgeon
5.0 out of 5 stars 17 reviews

Breast augmentation without breast lift

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Thank you for your inquiry about breast implants.

From the photo, your breasts look as though they definitely need a lift (mastopexy) as well as or instead of implants. Best wishes.

Elizabeth Morgan, MD, PhD
Atlanta Plastic Surgeon
4.5 out of 5 stars 22 reviews

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Augmentation when drooping

+1
requires a lift and your photos suggests you have ptosis (drooping) that would require it for a 'good' result.  Your nipples are also not centered and you could consider having them moved.  Discuss this with your chosen surgeon.

Curtis Wong, MD
Redding Plastic Surgeon
4.5 out of 5 stars 17 reviews

Lift and augmentation

+1
The answer to your question should be based on your assessment.  If you feel your breasts are low and/or sagging now, then you will feel the same way after a breast augmentation, only you will be larger.  If you feel they are low or saggy, you will require a lift to achieve your aesthetic goals of perkier breasts with more fullness in the upper pole.  A lift is well worth it to achieve a pretty breast shape.   

David Marcus, MD
Santa Rosa Plastic Surgeon
5.0 out of 5 stars 13 reviews

Needing a breast lift

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From your photo I would say that it is very likely that you would want to have a lift with your breast implant surgery.  As to the type of lift, deciding this will require an exam but more importantly an in-depth discussion about your goals as far as size, shape, and feel of the breasts that you hope to have after surgery.  Several options are available and so I recommend that you have a consultation with a board certified plastic surgeon to get a comprehensive and individualized evaluation.
Best wishes!

Adam David Lowenstein, MD, FACS
Santa Barbara Plastic Surgeon
5.0 out of 5 stars 28 reviews

Breast lift

+1
Thank you for the picture.


I definitely believe that breast augmentation alone will not benefit your case, I suggest a breast lift with implant placement.


Dr. Campos

Jaime Campos Leon, MD
Mexico Plastic Surgeon
4.5 out of 5 stars 180 reviews

Would I be a good candidate for a breast augmentation? If so, can it be achieved without a breast lift?

+1

Thank you for the question and pictures. Yes, I think you will benefit from breast lifting as well as breast augmentation surgery. Your picture,  even with your arms elevated, demonstrate breast  skin and tissue that sit relatively low on your chest wall. Without breast lifting,I think that one of 2 types of “results” would be predictable:

1. You will end up with “big and low” breasts and unhappy with the aesthetic outcome etc.

2. You will end up with the breast implants sitting high on her chest wall with the breast tissue lower down,  again creating an aesthetically unpleasant outcome. You will also find that you will likely continue to have breast skin sitting on top of upper abdominal wall skin, unless the breasts are lifted.

Patients who are considering breast augmentation/lifting surgery should understand that this combination surgery is significantly more complex than either one of the procedures done separately. In other words, the combination breast augmentation / mastopexy surgery differs from breast augmentation surgery alone in that it carries increased risk compared to either breast augmentation or mastopexy surgery performed separately.

Furthermore, the potential need for revisionary surgery is increased with breast augmentation / mastopexy surgery done at the same time.  This revisionary rate may be as high (or higher) than 20%. Patients should be aware of this higher revisionary rate;  obviously, the need for additional surgery, time off work/life  considerations,  and additional expenses  our “factors” that should be considered before undergoing the initial operation.
Potential risks associated with breast augmentation/lifting surgery include infection, bleeding, incision line healing problems, loss/change of nipple/areola complex sensation, and blood flow related issues  to causing skin or tissue necrosis.   Poor scarring,  pigment changes, areola/nipple asymmetry etc. are also potential problems. Again, patients may experience implant related problems such as encapsulation, leakage, displacement problems ( too high, bottoming out, lateral displacement, asymmetric positioning etc.), rippling/palpability of breast implants etc.  Patients may also be dissatisfied with breast size, shape, and/or how the  breast implants and overlying breast tissues “interface” with one another.    Occasionally, a breast implant may even have to be removed and the patient will generally be “implant free” for several months at least.  Obviously, this situation can be quite physically, emotionally, and psychosocially stressful to the patient involved.

Given the complexity  of the combination breast augmentation/lifting operation and the greater risk of revisionary breast surgery needed, there are good plastic surgeons who will insist on doing the procedures separately.
For me, if I see a patient who needs a great degree of lifting, who has lost a lot of skin elasticity, or  whose goal is a very large augmentation then I think it is best to do the procedures in 2 stages (in order to avoid serious complications). However, doing the procedure in one stage does increase the risks of complications in general and the potential need for further surgery. This increased risk must be weighed against the practical benefits of a single stage procedure (which most patients would prefer).
Conversely, if I see a patient who requires minimal to moderate lifting along with a small to moderate size augmentation (and has good skin quality), then doing the procedure one stage is much safer. Nevertheless, the potential risks  are greater with a 1 stage  procedure and the patient does have a higher  likelihood of needing revisionary surgery.

Having discussed some of the downsides  and potential risks/complications associated with breast augmentation/lifting surgery, most patients (If properly selected and who are doing the operations at the right time of their lives  psychosocially) accept the scars associated with breast augmentation/breast lifting surgery as long as they are happy with the improvement in contour, size, and symmetry.
I hope that this summary of SOME  of the issues surrounding breast augmentation/lifting surgery  is helpful to you and other women considering this procedure in the future.
The attached link may also be helpful.
Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 781 reviews

Lift

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Thank you for the photos and you would benefit from a lift with an augmentation. Commenting on the type of lift would require an examination and a discussion about future breast size. 

Dr Corbin

Frederic H. Corbin, MD
Brea Plastic Surgeon
5.0 out of 5 stars 33 reviews

Breast augmentation without a breast lift?

+1
You will most definitely need a full lift. Implants without a lift will not look good and you will be very disappointed.

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