I’m 33, 34D/36C. I’m not looking for a perfect look, just a firmer C or D look. I would rather not have possible complications of an implant: rippling, capsular contraction…etc. But I was wondering if an implant is necessary for better shape. One advice I for was that my options are either: a 200cc silicone implant with a Benelli Lift (least scarring) or: a full lift with no implant (vertical and horizontal scars). Thoughts on this? Finally, does the picture say anything about how badly I would scar?
Would I Need a (Small) Implant with a Full Lift, or Can a Lift Alone Achieve Desirable Shape at Same Size? (photo)
Doctor Answers (8)
Lifts and implants
The simplest answer based on the photo is that a properly done or true lift (mastopexy) is your best solution and your breasts will look bigger when they are positioned up higher even though no volume is added. The lift will not give forward projection or specifically fill in the upper pole of your breast nor will it "tighten" or change your skin or tissue tone but you don't really need more volume which is all that an implant provides. Implants add forward projection and fill in the upper pole but you can't just put in a "small" implant. The implant has to fit properly behind your lifted breast and the minimum cup size increase with a low profile implant is one cup size. After a properly done lift procedure you could see if you still feel you need the extra volume and projection but I doubt it.
A Benelli or periareolar "lift" is not a true lift and I wouldn't recommend it. Scarring cannot be judged or guaranteed in advance. A scar on your breast from a biopsy might give you some idea of your scar formation. Otherwise you have to accept the lollipop scar as the tradeoff for the benefit of the lift.
Lift +/- implant
If you truly want to remain your current cup size, I feel you can accomplish this with an aggressive lift. In my opinion, this would mean an inverted T or "anchor" pattern lift. The incisions can be intimidating, but they heal beautifully, and the additional lift and shape control the procedure provides are well worth it.
If you want to be a little bit bigger, do a lift and an implant. If you're not sure, you can do as one of the other surgeons has suggested: have the lift done first and see how you like it. You can always add implants later.
Significant Ptosis: Can A Lift Alone Give Desirable Shape?
Thank you for your question and your picture. Your breasts appear to have 3rd degree ptosis and your arms are elevated in the picture, therefore I am assuming your ptosis is more pronounced than it is in the picture. Your stretch marks would indicate loss of dermal strength and elasticity, therefore you are the classic example of someone who needs a standard lift with anchor scar. If you truly want a firmer C or D as you indicated, then you must have an implant to give you that fullness in the upper quadrant. A lift alone, any lift, will just give you a higher version of the same problem. I would place the implant in the subpectoral space, again to give you a more natural look.
The good news is New Haven, Connecticut, the home of Yale University, has some of the finest Board Certified plastic surgeons in the United States, and therefore, you should have no difficulty finding an experienced plastic surgeon to do your lift with implants.
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Would I Need a (Small) Implant with a Full Lift, or Can a Lift Alone Achieve Desirable Shape at Same Size?
Interesting question of using an implant with a full lifting. In some cases I recommend doing the lift first allowing 3 months of healing than consider implant surgery as a secondary operation. You might fit this criteria.
Implant and Lift Recommended
The first thing that I noticed were the stretch marks. Stretch marks represent loss of elasticity of the skin. A lift will change your shape and an implant will give you upper pole fullness and more than likely give you a better shape than a lift alone.
Type of lift
Based on your photo, a vertical mastopexy with a lollipop scar could give you a nice result. If you want more fullness that could help give you a better shape, a small implant in the sub fascial position could be added. The exact plan would depend on your goals and the skill of your surgeon. Ask to see examples of his/her work with patients who have your anatomy. I do not think a periareolar lift with or without an implant would give you enough lift.
From your picture it looks like an Anchor lift and a modest implant (200-250cc) to give you superior fullness and perkier breasts. From what you have described it’s what would give you what you are looking for. Without a direct exam it’s hard to be exact. Hard to say how you will heal and what kind of scar your looking to get, depends on your skin. If you have any scars on your body, from that you would get an idea on how you will possibly scar.
Best Type of Breast Surgery for Me?
Thank you for the question and picture. As you can imagine, it is not possible to give you precise advice without direct examination ( also consider sending side views of your breasts), and a full communication of your goals.
Based on the frontal view photograph, I doubt that you will have an aesthetically pleasing results with a circumareolar (Benelli) breast lift. I do not think that this type of breast lift will be “powerful” enough to help you with the significant breast ptosis (" sagging”) that is present.
I also think that for a significant superior pole fullness/firmness, breast implants will be helpful.
I would suggest that you do your due diligence in selection of plastic surgeon; ask to see lots of examples of their work and communicate your goals clearly.