I'm happy with the size of my breasts, but they could definitely be perkier. Can I get a breast lift without implants?
Breast Lift Without Implants?
Doctor Answers 148
No Breast Implants for You
You only get implants if you want to be larger. Period.
I don't know who it was...but someone started telling patients that they needed to get an implant to get a nice result wtih a lift. Rubbish! In fact, it is better to avoid implants if having a lift.
By definition, any patient needing a lift has skin that has already failed to hold up the existing weight of their breast. Adding weight to that makes no sense. Sure, you have removed skin, but the skin that remains is the same skin that gave way once already.
But for you, who doesn't even want to look any larger, for sure you don't need implants.
Breast lift without implants
Yes, you can definitely get a breast lift without getting implants. A breast lift without implants will give you a natural and more youthful breast shape by raising the position of the nipple, reducing the size of your areola (if needed), and removing the excess skin. If you want more fullness at the upper chest, then you will likely need implants in addition to the lift.
The amount of lift you need is also an important factor. A small degree of lift can be accomplished by adding implants. A larger lift means longer scars no matter what, anywhere from just around the areola, to the anchor type scar. Keep in mind sometime patients feel they look smaller once the excess skin is removed, even though no breast tissue is removed, because some of what fills your bra cup is the excess skin. I would recommend consulting with a board certified plastic surgeon and seeing what would be the best option for you.
Mastopexies (breast lift)
Mastopexy (breast lift) deals primarily with improving the shape of the breast by modifying the skin envelope around the breast tissue. Both breast augmentation and mastopexy can have an effect on the amount of sag that a breast has however individuals with a significant amount of breast sag typcially require a mastopexy (lift) as breast augmentation alone will not adequately correct the shape.
Since you asked about mastopexies let's talk about them a bit.
Believe it or not the first mastopexies were done as early as the late 1800s and principally used "suspension" techniques placing sutures to try to lift the breasts (think thread lifts).
More modern thinking recognizes the need to change the skin envelope around the breast tissue to get good correction of sagging breasts.
How common is a mastopexy?
In the US in 2004 there were reported over 98,000 mastopexy procedures performed.
Why do breasts sag?
Gravity is the master of us all. Women with large breasts have a natural tendency to sag more over time. The structural elements that help keep the breast in a more youthful position include things called "Cooper's ligaments" and of course the skin. In addition weight gain, weight loss and post-pregnancy changes can cause breast ptosis (sagging).
Plastic Surgeons rank breast ptosis (sagging) in the following manner:
- Grade 1: Mild ptosis - Nipple just below inframammary fold (your inferior breast crease) but still above lower portion of breast
- Grade 2: Moderate ptosis - Nipple further below inframammary fold but still with some lower pole breast tissue below nipple
- Grade 3: Severe ptosis - Nipple well below inframammary fold and no breast tissue below nipple; "Snoopy nose" appearance
- Pseudoptosis - Inferior pole ptosis with nipple at or above inframammary fold; usually observed in postpartum breast atrophy
For patients with mild breast sagging (grade I) sometimes increasing breast volume can correction ptosis. Obviously ways to increase breast volume include breast augmentation or autologous fat transfers (I'd be happy to discuss these techniques in more detail - just contact me).
Some surgeons will combine a "peri-areolar mastopexy" with breast augmentation to try to get a lift in patients with a bit more sag. This technique invoves excising a donut of skin around the areola (the darker area around the nipple) and suturing the area closed.
- it is important to understand the limitations of this technique both in terms of what it can achieve in terms of lift and the longevity of the lift.
Patients require more extensive remodelling of the skin envelope. Techniques include "Wise Pattern" skin excisions which are the typical "anchor" scar, and a more vertical "lollipop" scar. Some surgeons employ additional suture techniques to suspend the breast mound however I have found that typically suture techniques do not improve the appearance or longevity of the lift and that the scar tissue that forms naturally is adequate to gettin a lasting result.
Recovery is typically quick with the final breast shape settling in in about 2-3 months.
I hope this helps!
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Breast Lift surgery without implants
Breast lift surgery works well for patients with enough existing breast tissue to build a projecting 'breast mound'. However, in some patients it is difficult to create sustainable fullness in the upper poles of the breasts by means of a mastopexy alone. This is particularly true in patients who have experienced significant deflation following pregnancy and lactation. For patients who indicate that they wish to achieve a fair amount of fullness in the cleavage area as a result of their breast lift surgery, I may recommend that they undergo augmentation mastopexy. This surgery combines a breast lift with the placement of a breast implant, usually of modest size, which produces the most youthful breast profile possible.
For several years I have been using a 'vertical scar' technique for for breast lift surgery, and have been extremely pleased with the results. This new technique often eliminates the horizontal incision, and creates more impressive breast projection and maintains it better over time. The breast lift procedure I perform not only removes breast skin but also moves some lower pole breast tissue to a higher position, increasing the projection of the nipple/areola area.
No implant needed if you happy with cup size
If you are happy with the volume of your breasts, or you're a little on the large size, then you are an excellent candidate for a breast lift without an implant. Using techniques such a vertical mastopexy, great upper pole fullness can be provided with your own tissue. While implants are safe, there is no question that if an implant can be avoided, it will eliminate likely procedures in the future related to the implant. It is also much more difficult to do an impant and breast lift at the same time.
It is true that the longevity of upper pole fullness is more variable, and some women may elect to add a small implant later. In the long run, this well be a safer and more predictable outcome.
Breast lift (mastopexy) is excellent for making yourself look young again!
Breast lift is a wonderful procedure that is perfect for your needs. The primary way to determine if the lift is adequate is to determine if the breast size in the bra is just right, if so, a lift will be perfect to re-juvinate your breast.
The lift will create a very aesthetic breast which will look bigger once lifted. The superior fullness of the breast will be reestablished, but not be as full as you would see with an implant in addition to the lift. A push up bra will create a more natural superior breast fullness & cleavage after a lift than an implant will.
There are many different techniques available for lifting the breast. The technique selected is dependent on the amount of sag of the breast and how much the nipple areola needs to be lifted, the size of the nipple areola complex and the symmetry of the breast.
Peri-areolar and crescent lifts are ideal for minimal changes in nipple areolar position and size differences. A vertical mastopexy will leave less scar but in some people will create a more rocket shaped breast. The traditional standard wise pattern will create a very aesthetic breast shape despite the more extensive scarring. Many people find the scars to be less important than the shape of the breast.
It is very important to look at the overall breast appearance because once the symmetry of the breast is established, the scars become less noticeable.
Breast lift without Implants is an excellent option
The first question I ask patients when they see me for a Breast lift is "are they happy with their size".
We then tailor our conversation to a lift alone or adding an implant for better fullness. I would say that 20-30% of my lifts do not include implants.
The patient must understand that the size will be a bit smaller, but more round and full. Similar to a good support bra. No breast tissue is removed, but you are packing the same tissue into a smaller envelope.
Find a experienced Plastic Surgeon to help you with this and you should get a great result.
Breast Lift with or without implants
Breast lifts can be performed with or without breast implants depending on the degree of breast upper pole fullness and the particular desires of volume enhancement of the breast. In most cases, a breast lift can later be modified to include a breast implant, even years later, so you are never burning any bridges.
Breast Lift Without Implants Works Well With Adequate Breast Tissue
Thank you for your question. Generally, if you have adequate breast gland tissue, a Breast Lift will produce an excellent result without Breast Implants.
When there has been significant loss of breast gland tissue after pregnancy, called Postpartum Mammary Atrophy, often a Breast Implant is added to the Breast Lift to give a full firm appearance to the breast.
Breast lifting does not always require implant augmentation
The answer to your question all depends upon what you think a perkier breast looks like. I have been extremely happy with the vertical technique for both breast lifting and breast reduction surgery. With breast lifting, it involves removing a small component of the lower portion of the breast tissue. When the breast tissue gap is closed, the breast shape becomes tighter at the base and the remainder of the breast tissue is lifted including the nipple and areola. They will certainly become more perky. It will give you some more volume in the upper portion of the breast, but still not as much as with the use of an implant. But unless you are dead set on having significant upper pole fullness, you will most likely be very happy with breast lift alone if you have a surgeon use a breast shaping technique instead of a skin only procedure.
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.