Deflated Breasts! I Am Currently an A Cup Hoping to Be a Large D. Do I Need a Lift?

About 4 months ago I quit breastfeeding my second and final baby. I have completely lost all of my breast volume. I am considering a 600cc silicone implant. Could I have a breast augmentation without a lift and achieve a nice result? I hope to achieve a full but natural look. What would you recommend?

Doctor Answers (22)

Breast augmentation after breast feeding

+4

I specialize in breast augmentation after pregnancy, and I think this is an excellent time to consider breast augmentation after breast feeding.  Most women get some "tissue deflation" after stopping breast feeding and want to replace the volume they have lost. Breast augmentation is a great way to do this.  I would recommend either saline or silicone gel implants under the muscle.  Silicone gel implants feel the most natural and in my opinion have the best overall results.  The best results are achieved when we follow some sort of measurments of your chest wall (similar to sizing when we buy clothing).  As implants get bigger they are also bigger in diameter.  Based on reviewing your photos, I think 600 ccs may be a bit big for your frame.   This is an extremely large implant (especially if you choose saline) and there is a higher rate of complications with larger implants.  If you choose silicone it looks smaller than saline for a relative size and you could get an excellent result even in the 450-500 cc range.  

I would also ask yourself what bothers you the most about your appearance.  Is it volume or the position of the nipple on the breast.  If it is volume and since you favor a larger implant, I would recommend breast augmentation alone.  Silicone gel implants under the muscle and using a dual-plane technique as I perform will give you some internal lift and avoid the scars of a full breast lift.  You can always come back and do a lift later once the volume is established.  If you want a more "uplifted" appearance of the breast, then I would consider breast augmentation with a lift at the same time; however, when this is done together, then a smaller implant is selected (usually less than 350ccs) because attempting large implants with lifts at the same time is a recipe for big problems.  I hope this helps!

Sincerely,

James F. Boynton, M.D. F.A.C.S.


Houston Plastic Surgeon
5.0 out of 5 stars 20 reviews

To lift, or not to lift; that is the question.

+2

Patients often ask if having a large implant put in will help avoid the need for a lift. The simple answer is not really. Generally speaking, if you put a big implant into a sagging breast you end up with a bigger sagging breast. Of course, there are some patients that can get by without a lift though a lift might make the results look better. The size of the implant has little to do with how the end results will look. 

In your case, you seem to be one of those in the middle patients. The way I handle those situations in my practice is a step-wise approach to surgery. Given the choice, most patients would prefer to avoid the lift if possible. That being the case, I usually do the augmentation first and make the decision during surgery about the lift. If a lift is needed we are prepared to perform the lift at the same time. If the augmentation alone looks good we stop there. The patient is aware that the lift may and may not be done. Not all surgeons are willing to take this approach but I have found that it works well for me and my patients.

I hope this info helps!

Adam Rubinstein, MD
Miami Plastic Surgeon
5.0 out of 5 stars 10 reviews

Large Augmentation No Substitute for a Lift

+2

When the nipples are below the breast crease, a lift is your best bet.

Implants will fill out the breast, but do not lift the breast. 

Woman who are "too big" are uncomfortable and unhappy with their breast size: don't make the mistake of "over-augmenting," trying to lift or fill out a droopy breast!

Paul C. Zwiebel, MD
Denver Plastic Surgeon
4.0 out of 5 stars 13 reviews

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Breast lift may be necessary

+1
You would probably benefit from a  breast lift as well as augmentation because elf the extent of sagging you have. In addition, 600cc implants are quite large and will only enhance the sagging if no lift is performed. However, you should have a physical examination by an experienced board certified plastic surgeon for a better assessment of your concern. Best of luck.

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 63 reviews

Implant Selection Process

+1

Thank you for sharing your photos.   First off, 600 cc fill be too large for your chest wall and cause problems longterm.   If you want maximum upper pole fullness, I would recommend a lift.   If you want minimal scarring and are ok with low set implants, I would recommend a dual plane approach.  In terms of size, In order to make an accurate size recommendation, I would need to assess your chest wall and breast mound measurements and characteristics.  Unfortunately, there is not a general rule of thumb or objective criteria to implant selection.

Your plastic surgeon will perform several measurements of your chest wall and breast anatomy and determine a range of implants that both fit your chest wall and reach your desired goals.
The next step is to try on this range of implants in the office with your doctor.   The key to this success is showing your surgeon the body proportion you desire with a bra sizer and allowing your surgeon to guide you to the right implant.   It will be much easier to communicate in implant cc's than cup size when determining the appropriate implant for you.
I wish you a safe recovery and fantastic result.
Dr. Gill

Paul S. Gill, MD
Houston Plastic Surgeon
5.0 out of 5 stars 38 reviews

Deflated Breasts

+1

Your picture shows significant sagging. It seems that you will need a lift and an augmentation, I do not recommend the two surgeries to be performed simultaneously especially with large implants. I have seen too many poor results with combination procedures. Ask your doctor about the consequences of very large implants.

Ivan Thomas, MD (retired)
Los Angeles Plastic Surgeon
4.5 out of 5 stars 13 reviews

Whether a breast lift is necessary with implants.

+1

Thank you for your photos. A lift will allow for better placement of your nipples over the implant. The implant will provide some upward rotation of the nipples and likely decrease the degree of lift you may need. Your always have the option of having the augmentation first then having a small lift performed if the nipple position is unacceptable for you.

David Bogue, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 12 reviews

Do Large Implants Mean I don't Need a Lift?

+1

My recommendation is a breast lift with implants placed under the muscle. The thought that going over the muscle will somehow avoid needing a breast lift is inaccurate. The implant needs to be centered under the breast tissue. If the breast tissue is low, whether the implants are above or below the muscle will not address this. Based on your photographs it appears that your nipples are below the breast crease. In such cases patients will need a lift to bring the breast back up to a more youthful position. Only after this is achieved will the breast implant then be able to fulfill its destiny of increasing breast volume...

On a side note, you say you want a natural look. That typically doesn't equate with 600cc implants.

Hope that helps and good luck!

Dr. Babak Dadvand

Babak Dadvand, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 10 reviews

Breast lift and breast implants

+1

The photos show asymmetry with the left breast smaller than the right and the left nipple in a lower position than the right. Also both nipples are well below the inframammary crease with almost all of the breast tissue below the crease as well. If you just put a implant in above the muscle without any other procedure it will aggravate this sagging appearance and not correct the asymmetry. If you just put an implant in under the muscle your breast tissue will hang below the implant, the asymmetry will still be present and it will look even worse. The bottom line is that for an optimal result you will need a skin procedure i.e. a lift in addition to the implant placement. The question is what type of lift and that depends on the laxity of skin which is only assessable on examination, the amount of trade off you are willing to accept for scar length vs. degree of lifting, the surgeon you choose etc. None of these recommendations or decisions can be made on the basis of this forum alone.

Given the obvious propensity for your breast skin to sag the placement of very large implants like 600cc is a very bad idea. The weight of those large implants will put you at high risk of repeated breast surgery over time as the implant weight stretches the skin.

Lastly in my opinion 4 months is too soon after breast feeding to have implants placed. The risk of stimulating the production of more milk with its associated complications affecting a new breast implant are too high for me to do that type of surgery that soon. I would recommend waiting a year.

Aaron Stone, MD
Los Angeles Plastic Surgeon

A lift with implants will give you the bes results

+1

Because your nipples are below the inframammary fold, you will have the best results with implants and a breast ift.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 44 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.