Is an implant necessary for a breast lift?

Otto Joseph Placik, MD answers: Will I be happy with a breast lift alone and no implant?

I am a 36 yr old mom of 2, currently a D cup and happy with my size. My beasts are saggy and have lost all upper volume. My nipples don't point down, but they are low and definitely need to be moved up. The doctor I visited said I only need a lift, but I can't help but wonder if I will be happy with out a small implant. I would have an anchor scar and he said something about an "internal bra" so that they would be "perkier" and that is why I wouldn't need an implant.

Otto Joseph Placik, MD
12 months ago

Breast lifts without implants are more commonly performed in Europe when compared to the US. Perhaps this is because they are familar with the appearance of a natural breast due to their topless beaches.

In the USA, most patients expect upper breast fullness, similar to the way you appear in a bathing suit. Therefore the vast majority of breast lifts performed here tend to be performed usin breast implants in order to accomplish upper breast fullness in the nude. If this is your goal, then implants are essential. Otherwise there is not need for an implant

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A: Correct solution

Bahram Ghaderi, MD
12 months ago

Being a larger cup size allows you to avoid having a breast implant. Your own tissue can be used to give you the fullness you desire. Also the anchor type scar will give you the most powerful and long lasting lift. Adding an implant to an already larger breast size will only add to the weight of your breast and make you sag faster after surgery. Your surgeon has recommended a good procedure for you and you will enjoy the results. In addition, adding an implant at the time of your anchor lift may risk blood supply issues to the nipple/areola. You can always add an implant in the future. For this type of surgery it is not a bad decision to stage the lift and aug - and likely that you will not want an implant. Good luck.

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A: Breast implants often benefit lift results

Peter E. Johnson, MD
12 months ago

The type of breast lift or mastopexy is determined by the position of the nipple relative to the fold under the breast and when the nipple falls below the fold a vertical lift is usually best. This is the around the nipple and down or lollipop pattern that is commonly used. The nipple position is measured from the center of the nipple. Despite the fact the areola is above the fold the center part of the nipple looks best an inch above, or roughly the mid point of your upper arm. The actual size of the areolar is a matter of aesthetic sense. The best size depends on the breast and shoulder width and sometimes on the aesthetic balance. I has to look right.

The issue of upper fill after breast lift is an important one and if not carefully thought out well can be a source of disapointment. It is best to review pictures of breast lift with and without implants. We find very many patients benefit from an implant with lift to avoid the upper "scoop" which will remain without one. There is no need to go very much larger with the implant, though the tradeoff will be the acceptance of implant issues such as implant wear and leak.

Take time to decide, review examples, and make sure that you understand the advantage of each, and disadvantages as well.

Best of luck,

peterejohnsonmd

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