Can I Get Large Implants to Avoid Lift? (photo)

Hi, I'm wanting to end up in the 34f range. Ive breast fed 2 children so I'm pretty saggy/deflated/very sad looking. Is there a way to avoid the lift using a large implant or does that not matter? Also is it customary for the surgeon to place the implants first then do the lift? I think I'm just paranoid my nipples will end up in some strange position. thanks!

Photos Added 12/14/11

Doctor Answers (21)

Large implants to avoid lift not advisable

+2

Hi Kriswill,

Thank you for sending the photos, it is very helpful.  It appears that your nipple is a little low but not low enough that you absolutely need a lift.  There is some sagging of the breast tissue itself.  I advise my patients that we first determine what size implant is appropriate for your body, that you feel comfortable with.  Then, depending on the implant size, we decide whether or not you need a lift.  For example, if you prefer a 240cc size implant, you might need a lift.  If you prefer 400cc and it fits you, you might not need a lift. Another factor is your tissue thickness.  If your tissues are thick enough to put the implant on top of the muscle (and assuming a mid size implant), you might be able to avoid a lift.  I do not think you will need overly large implants to avoid a lift and I absolutely do no recommend using overly large implants to compensate for not performing a lift.   However, you must be examined in person to make this determination.  I have seen many patients who are unhappy with their implants because they had too large implants placed when they really needed a lift, so I am glad you are asking this question and appear to be open to a lift if you need one.  Also, if the implants are placed under the muscle, I do believe a lift will help you achieve a better result, particularly to reposition the breast tissue itself.  Keep in mind that I do not recommend saline implants for patients who have stretched or sagging tissues.   Lastly, even if you do not need a lift now, you might need one in the future. Please consult with a board certified plastic surgeon to discuss your options.  Hope this helps.

Tracy M. Pfeifer, MD, MS


Manhattan Plastic Surgeon
5.0 out of 5 stars 18 reviews

Large Implants to Avoid Breast Lifting?

+2

Thank you for the question.

It is  is not possible to give you precise advice without direct examination.

However, based on your description of “saggie/deflated”  breasts,  it sounds like breast lifting will be your best option. Trying to avoid breast lifting with larger implants generally does not work well.

Given that you do want to achieve a larger breasts look,  it will probably be in your best interest to undergo breast lifting first,  followed by the breast augmentation at a later date. This staging of the procedures  will help prevent some of the complications associated with combination breast augmentation/mastopexy surgery.

Please make sure you are working with a well experienced board-certified plastic surgeon.

I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 779 reviews

Will Large Implants Help Me Avoid Needing A Breast Lift?

+2

Dear Kriswell,  First, without photos and a detailed consultation, it is not possible to determine what size implant would be correct for your body frame and size.  Using some generalizations however, if your breasts have become very ptotic-a fancy medical term for sagging and droopy breasts, then using a very large implant alone to inflate and lift them will probably not work.  Most women's breasts sag and droop during pregnancy and nursing because of the extra size and weight of their breasts and the strain this places on the support tissues of their breasts.  The weight is too much for the support structures to handle and the breasts drop.  Therefore, trying to raise the breasts up by using a large implant may temporarily raise the breasts but as the extra weight and pressure once again applies stress to those same already damaged support tissues, the breasts will again sag and droop and may end up looking worse than they did after nursing.

Because of these reasons, many plastic surgeons will often recommend a breast lift to elevate the nipples and recenter them on the breast mound.  Also, the lift will remove the excess tissues often at the bottom of the breast.  Something an implant alone cannot do.

The exact staging for performing a breast lift and an augmentation varies from surgeon to surgeon.  Some plastic surgeons will always stage their combined breast lift and augmentation procedures performing each procedure in a separate step.  Others will perform both procedures at the same time.  If the plastic surgeon is going to stage the lift and augmentation into two separate procedures, most would perform the lift first and then place the implant in the second stage but not every plastic surgeon will use this order.

I would suggest you resend your question with photos-frontal and profile-and also your height and weight for a more complete answer.  Hope this helps.

 

Herluf G. Lund, Jr, MD
Saint Louis Plastic Surgeon
4.0 out of 5 stars 18 reviews

Lift with implants alone

+1
95% of my patients who have been properly selected for breast augmentation without a lift to address sagging are satisfied with the amount of lift they achieve with implants. The right implants and technique can help you address mild to moderate sagging with breast augmentation alone, by taking into account the size you'd like to be and the amount of lift you require during the pre-surgery planning process.

These three things are considered to help give you the extra lift you require to make your breasts “perkier” without mastopexy:

1) During your breast augmentation, the breast implants will be placed directly under the breast tissue and above the chest wall muscle (in the sub-mammary position).

2) The best breast implants to use for a perkier result contain silicone gel that is more cohesive, such as the Allergan Inspira Truform 2 (formerly known as Soft-Touch gel). These implants are slightly firmer to maintain their shape better, but still retain their natural feel.

3) The shape of your breast implants should have more, rather than less, projection. Breast implants with a smaller base width will make your breasts project more forward from your chest wall and body, creating a more prominent contour. “Profile” is a synonym for projection, therefore look for high profile implants.

Generally speaking, larger breast implants can also help give a better lift, sometimes raising the position of the nipple by one or two centimetres.

Please see an experienced board certified plastic surgeon to find out whether you are a suitable candidate. Best of luck.

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 69 reviews

Breast Implants to avoid lift.

+1

There are different classes of droopy breasts. Class I can be addressed with implants. Usually with other classes you will need a lift, no matter how large of an implant you are considering. The shape of an aesthetic breast relies on amount of skin, position of the nipple/ areola and volume. Depending on the amount of the droop, large implants can not address the position of the nipple/areola complex. Be weary of surgeons out there, many of whom are not plastic surgeons and do not have specific training or experience with breast lifts, who will attempt to place an overly large breast implant into your breast rather than perform a breast lift.  Not only can this give you larger breasts than you wished for, but it can cause long-term negative consequences on the breast tissue and breast-supporting ligaments.  It is in these situations that long-term complications such as implant mal position (the implant sliding down too far) are more likely to happen.

Alfred Sofer, MD, FACS
Fairfield Plastic Surgeon
5.0 out of 5 stars 7 reviews

Large implants make the breasts large but do not lift

+1

Large implants make the breasts large but do not lift the breast. It is very likely that if your skin and tissues are thinned and deflated, that you will not be able to support such a large implant without some type of additional procedure such as a lift or acellular hammock.  Large implants can cause thinning and problems down the road. Consider carefully before proceeding and discuss these issues in detail with your plastic surgeon. Best of luck.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 38 reviews

Breast Lift vs. Implant

+1

Thank you for the photos. Based on the photos, it looks like you have grade 1 ptosis, meaning your nipple is at your inframammary fold or a very slight grade 2 ptosis. That puts you at the border between mastopexy or augmentation. It is a decision you should make with your plastic surgeon once you have all of the facts. A lift will cause more scars but the shape and the location of the nipple will be improved. An implant will improve your projection but with ptosis, you will need a larger implant and your nipples may lie slightly lower on the implant. I have performed both procedures in patients who have grade 1 or 2 ptosis and as long as the patients understood the outcome beforehand, they were happy. If you couldn't decide, I think augmentaiton alone is a great option for you.

Jacob Freiman, MD, FACS
Miami Beach Plastic Surgeon
5.0 out of 5 stars 104 reviews

Breast Augmentation - Can I Get Large Implants to Avoid Lift?

+1

Many patients ask this question but, in general, it does not work.  Of course, each case is different and must be assessed by a surgeon who can examine and talk to you.  If, though, one has saggy skin with deflated breasts, then inserting large implants may be an adequate short-term solution but, over time, the implants will drop and instead of having small, saggy breasts you'll have large saggy breasts that are even saggier than before since they weigh more.  That is not normally a good trade.

No one would have the scars of a lift unless it were necessary and I suspect, based on your photos, that you would need a breast lift and implants in order to achieve - and maintain - the look you want.  Whether or not the scars are worth it to you is something you'll have to decide.  And as far as exactly how it is done - it can be done many different ways.  Some surgeons insert the implants and then do the lift, some do it the other way around and, increasingly, some surgeon are staging the procedures so that they do one part first (usually the lift) and then wait several months to allow adequate healing, at which point they'll insert the implants.

I hope that this helps and good luck,

Dr. E

Alan M. Engler, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 154 reviews

I want to end up in the 34F range

+1

Based on your photos it does not appear to me that you need a lift.

• A breast implant of any volume will not compensate for a breastlift. If you need a breastlift and your board certified plastic surgeon will be able to tell you this after examining you, a breast augmentation alone will not be satisfactory.  Placing a larger breast implant to compensate for not performing the breastlift will make you larger than you may want to be.  A larger implant will accelerate the stretching of the skin and put you in the situation where you are in greater need of a breastlift because the sagging will be increased.  I have seen many patients who have gone down this road to avoid the breastlift and they are unhappy for a number of reasons and they end up having the lift anyway.

• In my practice, most patients would rather have one operation than two.  I tend to perform the augmentation with the breastlift at the same time.  Having said that there are many plastic surgeons who, for a variety of reasons, separate the procedures and that is personal preference and comfort level of the surgeon with the procedure.  Having the result you are looking for, safely is the goal for the surgeon and it should be for the patient as well.

• You should ask to see before and after photographic results at the office where you are having a consultation.  This will give you a good idea about the personal results of your plastic surgeon.  Take into account size, shape, nipple position and scar quality.  Do not expect your breasts to be perfect after this or any operation.  Especially with the augmentation/breastlift a number of issues are being addressed; namely, size, shape and position and size of the nipple and areola.  With all those changes there will always be some differences.  It is a good idea to ask your surgeon how often a revision is performed to address these differences.  The breasts, remember, are naturally different from each other and they will most likely have some differences after surgery as well.

Thank you very much for this question.

Ralph R. Garramone, MD
Fort Myers Plastic Surgeon
4.5 out of 5 stars 24 reviews

Larger Breast Implants vs. A Lift

+1

From your pictures, you are border line on whether you should have a lift in conjunction with your Breast Augmentation in order to achieve a result of perkier and fuller breasts. An option to avoid the lift is to choose larger breast implants, but there are other techniques available to give you the desired look. A technique I often use is a minimal scar technique called a Circumferential Breast Lift. It's where I make an excision around the areola, then excise a donut-shaped piece of skin and then suture it close lifting and tightening your breast skin. The results are lifted breasts and after recovery should have a very minimal scar. You need to consider your lifestyle and if large breast implants will suit your life. Are you active such as running? Will large breasts interfere with anything? You should not base your decision on a possible scar. A good plastic surgeon will minimize that either way.

Michael Salzhauer, MD
Miami Plastic Surgeon
5.0 out of 5 stars 331 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.