I am 25, 5'6 and 120lbs. My breasts are deflated from nursing my two children. I currently a 34b on a good day. I've had two consultations. First said I needed a lift with 425ccs and a slight reduction in my right. Second said I did not, with 450cc in my right 485 in lft. He said hewould insert below the breast as opposed to armpit incision with the first doc. He would even put my fold on left for symmetry. He also said I would need slightly larger implants so that they wouldn't be saggy.
Is It Possible to Get the Desired Look Without a Lift, Just Larger Implants? Both Are Under the Muscle Silicone. (photo)
Doctor Answers (17)
Implant vs lift
In training were all taught that breasts like yours need a mastopexy and there is no other way around it but I found that when I look at each patient individually, each one has different needs and considers different breasts attractive. You need to ask yourself the following: do I want large breasts and nipple position/superior fullness is not important to me OR do I want natural appearing breasts with a small implant and a nipple above the level of the inframammary fold? For some women, a large implant will suffice and they don't want a natural look. The large implant recruits the inferior skin and can fill a little superiorly. For others, perky young breasts are more important and therefore a mastopexy and small implant works. One thing you should definitely not do is focus on the number of ccs in the implant. A 450 cc implant in someone with a base width of 16 cm will look tiny and a 450 cc implant in someone with a base width of 10 will take up both breasts.
You May Need A Breast Lift And Implant For Best Result
Thank you for your question. If your nipple is below the inframammary crease, the fold beneath your breast, then a breast lift in addition to breast implants is usually recommended.
The risk of implants alone is that they may push the nipple down further which creates an unusual appearance called the "snoopy deformity."
Consult a plastic surgeon who is certified by the American Board of Plastic Surgery and who is experienced at cosmetic breast surgery and has a good reputation in your community.
Breast uplift and/or implants?
It's difficult to tell from one lateral photo, but a general rule is if the nipple is above the inframammary crease, you can get away with an implant and not an uplift. Yours are close. Your plastic surgeon can tell you for sure. It also depends on what you are looking for as a result. There are minimal uplifts that are very satisfactory in some cases.
You are fairly tall and thin, so you may not want to be too large as they can make you look heavy in some cases. My suggestion is to go for size that pleases you and then you and your PS can decide if you need an uplift. Trying to achieve that with larger implants can cause you problems in the future. Remember that heavier implants cause sagging sooner that lighter ones. Your plastic surgeon should have sizers to help you decide the proper size to meet your goals.
I think behind the muscle is a good way to go so you won't see or feel any wrinkles in the implants. With someone with ample brease, this is not a problem.
Good luck and thank you for your question.
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Do I need a lift or just implants
Based on the one photo, it does appear that you will benefit from a lift with augmentation. An implant alone will not give you enough of a lift but that really depends on what you are hoping to achieve. Size of implant and symmetry can not be determined from this one side view photo. Consider a high profile silicone gel implant with vertical lift or if you just want to try an augmentation first then incision in the fold. Perhaps see another board certified plastic surgeon and go from there. ac
Large implants invite disaster
At size 34 B each 100 cc’s of implant corresponds to 1 cup size change. 400 cc implants would take you up 4 cup sizes to a F. 400 cc implants would not fit retro-pectoral and dislocate inferiorly and laterally requiring revision. However, more important than just the implant is a simultaneous lift. You are an excellent candidate for a new technique called Breast Augmentation with Mini Ultimate Breast Lift. Using only a circumareola incision it is possible to reshape your breast tissue creating upper pole fullness, elevate them higher on the chest wall and more medial to increase your cleavage. Through the same incision, implants can be placed. Aligning the areola, breast tissue and implant over the bony prominence of the chest wall maximizes anterior projection with a minimal size implant. Small silicone gel implants placed retro-pectoral look and feel more natural, are more stable, less likely to ripple or have complications needing revision. I think large implants alone would be a disaster in your case.
Gary Horndeski, M.D.
Breast augmentation possible lift
It is hard to tell from your one lateral photograph so determining whether or not you need a lift is difficult to determine this is why you have gotten two different opinions about the procedure.
Breast aug or breast aug with lift?
Thank you for your question and photo. Although we are limited by one photo, it appears that you have some ptosis (sagging of the breast). It is not possible to evaluate symmetry or whether one side will need a larger implant, but it does appear that you will need a breast lift in addition to a breast augmentation. Implants simply "augment" the breast tissue that you already have. If there is mild sagging from excess skin, placing an implant can place the nipple in a more appropriate position. However, if the nipple position is too low, the best fix is to do a lift as well. A lift can always be done after the breast augmentation if you are hesitant. If you are going to have a lift, there is little value in placing the implant through your armpit since you are going to have a scar on your breast from the lift.
Best of luck.
Breast lift vs just augmentation
From just a photo it is hard to tell. Measurements and tissue evaluation need to be done. From just that pic. I would suggest an infra mammary crease incision for an augmentation alone. If you needed a lift, consider a periareolar incision with a circumareolar mastopexy. I recommend consulting with a third board certified plastic surgeon and see what the consensus is.
Is It Possible to Get the Desired Look Without a Lift, Just Larger Implants
This is a decision for the consultation room. There is not enough info here. First of all, I can't tell what your desired look is. Many patients have very different goals.
The single side view photo suggests to me that a lift will be advisable, but a frontal view would be helpful. Larger implants will yield larger breasts, but will not accomplish a lift if that is needed.
All the best.