Currently I am a sagging, deflated 36B. I am not after large breasts but more fullness and perk. Will implants alone help me? A breast lift scares me because of scarring. Ive already had a tummy tuck and ended up with some hypertrophic scarring along various sections of the scar. If a lift is recommended what type would I need? Essentially would you recommend implants alone, lift alone, or both? I would be happy with a small B cup and the largest I would want is C cup.
What Do You Recommend to Gain Fullness in my Breasts?
Doctor Answers 14
There are two issues that need to be addressed
There are usually two issues with breasts that look like they have aged – skin excess (which manifests itself as breast droop) and a loss of fullness in the upper breasts. Both need to be considered for optimal breast aesthetics.
In order to regain fullness of the upper breast, an implant will be necessary. Implants will serve to increase the volume of the breast and also create more of a perky look. That may well be the only procedure needed, provided there is minimal droopiness to the breast.
However, if there is sagging, without correcting the droop (i.e. the position of the nipple & areola); breasts can still look old even with their newfound volume. A lift procedure can correct the droop by positioning the breast higher on the chest, which will help to increase the full appearance.
In a consultation I can immediately determine whether or not a lift is needed and just how much of a lift is necessary. I can also determine what incisions would be needed.
All things considered, when the nipples have dropped to a level close to the fold, you should count on a lift being a very strong possibility in order to achieve the best results. Book a consult with a reputable surgeon experienced in breast augmentation and then go from there.
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Breast implants and lifts
It is unfortunately not possible to judge the need for a lift or implant alone from the single front view as it is not possible to be certain where the nipple sits in relation to the inframammary crease behind it. If the nipple is 2 cm or less below the level of the inframammary crease in the upright position then an implant alone is feasible and likely to give you what you're looking for although the minimum size increase with a low profile implant is one cup size increase.
Implants provide volume only similar to putting a pillow behind your breast. They do not lift the breast but they provide volume, fill, and "perkiness" in the sense of forward projection. A lift procedure (properly done with a lollipop incision rather than periareolar) will not increase the volume, fill in, or give perkiness although it will position the breast higher on the chest which makes it look larger.
In general I do not recommend doing an augmentation with an implant and a lift at the same time as it is very hard to juggle all the factors involved including apparent size, and the two procedures work against each other to some extent including the risk of problems or need for secondary surgery. If your nipple is not too low relative to the crease behind it then I would go with the implant alone using a low profile saline or the lowest profile gel that is matched to the width of your breast and using a dual plane release that keeps the pectoralis muscle covering the upper implant but not in the lower half of the breast. If it's a saline implant you will feel it easily in the lower pole of the breast but very little on the side and not at all in the upper part.
Dual-plane breast augmentation will give some internal lift and give you volume
I would recommend breast augmentation with saline or silicone gel (preferably silicone gel) using a dual-plane technique. In early degrees of breast ptosis (or sagginess) which it seems you have from the photo, this technique of placing the implant utilizing a "dual plane" pocket will provide some "internal lift" or lift effect to the breast without adding appreciable scars. The only incision you would have would be about the width of a quarter in the IMF (inframammary crease) area under the breast. This would give you back the fullness and give you the most one can get with just implants. If after gaining breast volume and some lift effect you still want a more uplifted appearance or you desire the position of the nipple to be higher, you may decide to add a full mastopexy (lift) which is something that could always be added later if you decide you think you need it. I hope this helps!
James F. Boynton, M.D., F.A.C.S.
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Breast Life and/or Implants
Based on your pictures, I would recommend a submuscular silicone breast implant and a traditional lollipop-type breast lift. I see too many patients in my office who have had periareolar lifts which misshape the breast and have stretched scarring. With more pictures or an in-person consult, we could likely give you more individualized advice. Good luck.
Implants vs. list or both?
Based upon the single photo, you may be a candidate for implants and a periareola lift which would limit the scars to just the border of the areola. But a full exam would be necessary to determine this.
Lift vs Augmentation for Breast Fullness
For someone like you without significant droop and not wanting to be much larger or have scars, there are a number of options. You need to decide what you really want and rank the alternatives. You then need to discuss all this with a plastic surgeon after a thorough examination. He/she should be able to give you several choices. Are your breasts the size you wish in a bra now? If you filled them some, but the breasts still were not perky, would this bother you? If you made them larger, how much larger would you like? (It would not take much to achieve what you say you want from what you say you have.) If you could achieve a very perky breast, could you tolerate some scar? You also need to know how the surgeon reinforces the suture line to prevent widening of the scar, and what does the usual scar look like. Once you have discussed all this, YOU can decide what to do using the input you were given.
Breast implants to increase fulllness
There can be doubts between a breast lift with implants, and a go with implants alone. Your nipple is certainly above the fold, and at the 'mid-humeral' line, the middle of your upper arm. Looking at the 'ideal' an implant with a small elevation of the nipple (breast lift) could look best, but at what cost. I would recommend you start with a breast implant to increase volume to a C-cup, not too big. This should have a lift effect on the nipple and greatly improve the breast shape. You can always consider a small lift later, though I think you will fair better without the scar.
Best of luck,
What Do You Recommend to Gain Fullness in my Breasts?
Thanks for the photo. I recommendation is a full lift with small implant like a 250 cc HP. But you will have scars by your own admission. Best of luck from MIAMI Dr. Darryl j. Blinski
Breast lift procedures improve breast shape
You need both a breast lift and a small augmentation. Based on the footprint of your breast, I don't think a large implant would look good on you. I would favor a vertical breast lift with a very small amount of reduction on both sides (right more than left), and a small sub-muscular implant. You don't need a big lift, just enough to get the nipple centered over the implant foot print.
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