Is It Safe to Go for a Big Implant While Having a Lift? (photo)

I'm 5'5 112 pounds. I'm currently a small B cup. Goal: DD. I'm 29 no kids yet.. Hope to do so in the next couple years. Larger size implant can cause faster drooping. But i'm thinking i'll probably have to have them redone after children anyway which will probably be in a few years. If this is the case, which most likely it will be with having kids in the next few years (3-4 years) at most...Does it make sense to just go with the large size implant that I want to get to DD?

Doctor Answers (17)

Huge / big implants and a lift- wise?

+2

There are several problems with your plan.  

First, you have a tight lower pole of the breast.  There are maneuvers to increase the size of the lower pole of the breast, but they can diminish the sensation and blood supply of the nipple.  A too large implant may simply not fit underneath your native breast, and appear 'overstuffed'.

Second, lifts make the skin envelope tighter.  Simultaneous implants make the skin implant way tighter.  This is a recipe for disaster, and can result in loss of blood supply to the nipples (dead nipples).

Very large implants have problems of their own, including stretching of the skin, stretch marks, rapid sagging, weird behavior of the muscle when too many fibers are taken off the breast bone, etc.

If you were my patient I would try to steer you toward a nice lift and moderate sized implants.  Nice breasts, nobody gets hurt.


Beverly Hills Plastic Surgeon
5.0 out of 5 stars 90 reviews

Big Implants

+2

You are exactly correct that larger implants cause more sagging. The sagging can occur quite quickly.If you do not want sagging breasts, it makes sense to get a smaller implant. Patients prefer large perky breasts over extremely large saggy breasts.

Michael Horn, MD
Chicago Plastic Surgeon
4.5 out of 5 stars 21 reviews

Large

+1
Sounds like you know all about the trade offs of large implants. There is no reversing the changes to your skin that a large implant will do so you need to be sure you will be ok with more scars in your second surgery

Ryan Neinstein, MD, FRCSC
New York Plastic Surgeon
5.0 out of 5 stars 35 reviews

You might also like...

Very large implants can interfere with mastopexy results

+1

Thank you for your question and photographs. You are correct that extremely large implants can creak complications when combined with a breast lift.

Your breasts require a great deal of expansion to accommodate the size of breast implants that you want.

If you have breast implants alone now they will expand the size of your breast. In addition pregnancy will also likely expand your breast size. Having breast implants now and after your pregnancy having a lift is another alternative.

Brooke R. Seckel, MD, FACS
Boston Plastic Surgeon
5.0 out of 5 stars 26 reviews

Lift and augmentation

+1

good afternoon!

I agree with some of the other surgeons  that your breast has a tight lower pole, meaning you will need every bit of that skin to give you the exaggerated look you are showing in the photo.  Though I would like to see your nipples a bit higher on your breast mound, I am not sure a lift would be in your best interest- it would involve removing some of that lower pole skin that you are already a bit short in supply.  The exaggerated upper pole fullness look in the photo you have shared is quite obtainable in my opinion with a larger implant using a standard augmentation approach.

 

I hope this helps

Robert Steely, MD
Houston Plastic Surgeon
4.5 out of 5 stars 13 reviews

Breast Lift Augmentation/Lifting; One or Two Stages?

+1

Whether the breast lift and augmentation should be done the same time  is not a question agreed-upon by all plastic surgeons. There are good plastic surgeons who will insist on doing the procedures separately and there are good plastic surgeons who can produce excellent outcomes in a single stage.


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.
In my opinion, the decision  to do the operation in a single or two  staged fashion becomes a judgment call made by a surgeon after direct examination of the patient.  

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.

Ultimately, I think you will be best off selecting the plastic surgeon who you feel will most likely be able to achieve the results you are looking for and follow his/her recommendations.
I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 681 reviews

Lift and Implant Simultaneously

+1

While an exam would be necessary before a decision is made, it looks like you either need a periareolar lift (incision around the areola only) or no lift at all. As others have noted, you do have a tight lower pole.  Your inframammary crease (the fold at the bottom of the breasts) probably needs to be lowered.  As for the implant size, I would caution you not to go too big.  Due to your anatomy, a very large implant will give you an unnatural look and will likely lead to problems down the line. I think you can get a very nice result and still be a full C or a D cup.  I would advise against going with too large of an implant in the belief that you can fix any problems after you have had children.  If done improperly, the initial surgery can cause problems that make any revisions that need to be done later on very difficult.  Good luck, Dr. Weider, Dallas, TX

 

Laurence Weider, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 62 reviews

Augmentation and lift

+1

Combining augmentation and lift is an area of controversy among plastic surgeons. Any lifting operation diminishes blood supply to the tissues. Added tissue dissection for implant placement further diminishes blood supply. Some surgeons feel that the risks of losing blood supply to the nipple and areola are too great and will not combine those procedures.

Among the surgeons who will combine those procedures on many patients, I doubt you will find one willing to  place the size of implants present in your "goal" patient at the time of breast lift. Adding the compression of the tissues causing further diminishment of blood supply by this third mechanism is just too risky. 

Furthermore, I am not sure those implants, which I would guess are 800 cc, would fit on your frame. That size implants would either cross the midline causing symmastia, or bulge way out over the sides of your chest, giving a bizarre appearance. 

When you ready for an in person consultation, RealSelf has listings of surgeons in your area. You should consider cross referencing the listings from the The American Society of Plastic Surgeons (plasticsurgery dot org). A listing in the ASPS website assures you that your surgeon is not only board certified,  but also is a member in good standing of the major plastic surgery organization in the U. S. Listen to the surgeon's advice. The doc has been there before. 

Thank you for your question, best wishes.

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.5 out of 5 stars 30 reviews

Is it safe to have a very large augmentation with a breat lift?

+1

In your case, it would not be safe.  Putting an implant in that is a large as you want may lead to compromise of the nipple areolar complex.  It would be best to put the implants in first and let the skin stretch.  The lift could then be done in 6-9 months.

Kenneth L. Stein, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 9 reviews

It is safe but it does increase the chance of revision.

+1

Hello,

Thank you for the question and photos.  You will likely only need a purse-string mastopexy if you are planning on getting fairly large implants.  It will be important for your plastic surgeon to use a permanent suture in your purse-string mastopexy to prevent scar widening.  There is an increased chance of needing to revise the areola size down the road once everything has healed and this can be done under local anesthesia.

All the best,

Dr Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 81 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.