You definitely need a lift, but it can be a minimal scar breast lift.

Hi! Some of the most common bad results that I see are in women who tried to get their sagging breasts corrected just with implants. So I urge you not to do that.

1) You probably need a "donut" lift that leaves you only with a circular scar around your nipples, together with implants.

2) If you have really bad sagging, you might need a "lollypop" scar. But you never need the "anchor" or "upside-down T" scar for a lift.

3) How the lift is done really matters. The key is NOT to rely on tightening the skin to get the lift. The lift should be done from the inside. That way, you get good long term shape, and the scars fade.

4) I can tell you that women worry a lot about the scars before a breast lift, but after surgery they are usually very happy.

Dear SLP,

Many women share your concerns regarding their breasts.

The ideal situation would be to improve the shape and size without any scars.

However, if you don't like the location of your nipple, the only way to move it to a better location would be to make an incision around it.

The way to determine if you need a lift or not, is to imagine that your breast was bigger, but your nipples stayed in the same location. Would that look attractive to you?

Based on your two previous consultations, I would guess that even if your breasts get bigger, they will still look droopy because the nipples are too low.

Keep in mind that breast scars generally heal very well. Furthermore, you may find that once you have the lift, you may not necessarily want to be any bigger.

It is always more appealing to have an attractive-looking small breast than an unattractive large breast.

There are many new options for breast lift that can reduce the scar significantly. For example the "donut" lift or the "lollipop" lift can minimize the scarring. But keep in mind that these options are not appropriate for all patients.

Good luck with your surgery.

SLP,

You have had two plastic surgery consultants insist that you need a lift. It is not likely that a third will say any different. However, one option may be to go larger with the implant and place it over the muscle. This gives more of a lift effect to the breast, but is contingent on you having enough chest tissue to adequately cover the implant. Also, very large implants tend to age poorly, especially above the muscle due to their weight. It might be better in the long run to just have the lift now. A new procedure on the horizon for breast augmentation is fat transfer from another area of your body. This is currently in the clinical experimental stage and I don't know if you would be a candidate. Maybe you can find a plastic surgeon in your area willing to do it. Good luck!

It sounds as if your your "skin brassiere" is too large in relation to the amount of gland within it. This causes the breast to fall. Additionally, the fibrous ligaments within the gland no longer maintain tension between the skin and chest fascia. A lift (Mastopexy) is the best way to restore these relationships. Augmentation will not lift and will usually make things worse.

It sounds like with a significant weight loss a breast lift is what you need. Unfortunately the only way to accomplish this is with incisions on your breast.