I was told my areola are too low and they need to be put in the right place. Do I Need a Lift with my Implants? (photo)
Doctor Answers (23)
You are what I would consider to be in the gray zone regarding whether to have a lift with implants or implants only. If it is important for you to have perky breasts, then I would do the lift realizing that there will be scars associated with the procedure If you want to avoid the scars, they your breasts will sag to some degree. If you elect to have implants only, resist the temptation to have very large implants because they will cause the breasts to sag even more. If you elect to undergo a lift with implants, I would recommend either a vertical or full mastopexy and avoid the so-called crescent lift, which some surgeon might recommend. The crescent lift will stretch out your areola without giving you enough lift.
From the picture it looks like you may have what we call a grade 2 almost grade 3 ptosis or sagging (nipples below the level of the skin fold). the treatment for that can be either a large high profile implant to fill the void and effect some lift, or a smaller implant with a breast lift. It really depends on what you want, if you are ok with large implants, you might get away without the lift scars, if you dont want a large breast size, then a lift with a smaller implant is in order. I recommend that you get appropriately measured and graded before deciding which way to go. hope that helps.
Lift necessary with Augmentation?
From the photo it looks like you might be ok with just implants - it's much better to see a surgeon in person to get a better sense of your skin and breast tissue. You don't burn any bridges by just doing the breast augmentation, and yes, more volume will give you more lift. You can always have a lift done later to improve nipple position on the breast.
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Do I Need a Lift with my Implants?
Thanks for the posted frontal photo. It is very hard to answer what exactly applies for you. Therefore I would do a breast implant first operation to see the positioning of the areolar after 3 months of healing. Than if needed a lifting of some typer, most likely a donut lift. Please give us follow up.
Need a lift with implants?
Many surgeons insist on giving you what they consider the ideal shaped breasts. That is missing the point of cosmetic surgery. The goal is in the eyes of the beholder not the surgeon. You don't need a lift unless you want a lift. We never do anymore thana nipple lift at the same time as an implant anyway because each operation interfers with the healing of the other. I much prefer to do the implants first and wait at least 3 months to let the patient decide if she want a little lift or not. There are 4 different degrees of lift ranging from $1400 for a nipple lift to $5055 for a maxi-lift. Most patients can get by with the cheapest lift if they just wait until 3 months after the enlargement. Not only is the result better but the cost is less.
Lift and/or implants
When someone has borderline breast drooping there is always the question of just implants, just a lift or both. Implants alone do not give you a lift but generally make the breasts look better. Implants alone has much less scarring associated with it. The lift , however can really make a big difference in the way the breasts look.
On borderline patients like you what I look at first is the size implant that the patient desires. If it appears large enough to fill out the excess skin then I recommend not doing the lift and wait and see how the patient likes the results. The vast majority of patients will be happy and not pursue a lift.
If the implant size that is chosen is too small then I do recommend a lift.
Sometimes sagging breasts (ptosis) can be camouflaged by breast implants.
If the areola has not descended too fat, ptosis can be apparently corrected by breast augmentation. The photos suggest this might be the case for you. The bigger the implants, the better the chances of correction the problem.
Why you may need a Breast Lift with your Implants
You would probably get your ideal result with a small Breast Lift. Without a lift you run the risk of the breasts hanging a tad too low. Many patients find themselves in your situation and more often than not, a Breast Lift with Implants is the ideal choice. The implants provide for Upper Pole Fullness and the Lift makes your breasts perky.
I have just written about a case study of a patient who had two breast augmentation surgeries. Her nipple position was similar to yours and therefore the decision was not easy. In her first Breast Augmentation surgery (with another surgeon), she did not get a lift. After the surgery, she was not happy with the way her breasts sagged. For her second procedure, she came to me and we performed a Breast Augmentation with a Lift. She had very minimal scarring as it was hidden in the nipple complex border. She was very happy with her results.
Ricardo L Rodriguez
Limited breast lifting with augmentation
There is nothing more confusing than having many opinions expressed from several reputable Plastic Surgeons. The decision should be based on whether the nipple and areola is slightly below the position of the fold of the breast when you are seen from a side or lateral view, as we call it, in viewing you. You have not included this view along with your straight on picture. I would generally say, however, in seeing your one photo that a limited lift would help the quality of the overall result of surgery, however. I have performed this procedure often and the results can look wonderful. I would suggest that you ask your local Plastic Surgeon about a crescent lift, which would be to excise a small amount of skin over the areola in the form of a crescent. When the incision is closed the areola will be elevated by a small amount, but enough usually to give you a more youthful result. This can be done in combination with the augmentation.
I would also agree that different sized implants may often be used to balance the size variations in the breasts. This usually results in your seeing a more balanced shape and volume from your surgery.
Good luck to you.
Frank Rieger M.D. Board Certified Tampa Plastic Surgeon
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.