Please Help. Would I Need Both Uplift and Augmentation?

I am a petite 5ft 2 and have always had naturally very large breasts (32F before having a baby) even though i was only 7stone 10. I still Weigh 7stone 10 but my breasts have since childbirth and now feel empty at the top half of my breast, i am wondering would i be able to have implants without an uplift or would an uplift be advised aswell as implants? And is there a great deal of scarring if an uplift and implants are required?

Doctor Answers (13)

Breast Augmentation - Would I Need Both Uplift and Augmentation?

+1

Ironically, you would do better with a lift without implants, than implants without a lift!  It almost always comes down to the anatomy and in your case you have plenty of volume but your breast tissue, and nipples, are too low on your frame.  Inserting implants alone will leave a shape that you won't be happy with initially (your nipples will be too low on the breast mound) and, if the implants settle over time to the bottom of your breast tissue, you will simply recreate the appearance you have now, but with larger breasts.  I think you'll do better incorporating a lift into the surgical plan.  There are, unfortunately, scars associated with this procedure, and the specific scars depend on which technique is use.  There are, as always, advantages and disadvantages with each...but you may to very will with a circumareolar or circumvertical (lollipop) lift along with the implants.  It is entirely appropriate for you to discuss this in detail with your own PS and to seek additional opinions as part of your research.

I hope that this helps, and good luck,

Dr. E


New York Plastic Surgeon
5.0 out of 5 stars 151 reviews

Breast Augmentation and Lifting?

+1

Thank you for the question and picture.

You will benefit from breast lifting. If you also desire more fullness (especially along the superior poles of the breasts)  then  breast implants will also be helpful. The breast augmentation/breast lifting procedures can be done in a single or 2 staged fashion.

This is not a question agreed-upon by all plastic surgeons. There are good plastic surgeons who will insist on doing the procedures separately and there are good plastic surgeons who can produce excellent outcomes in a single stage.

The combination breast augmentation / mastopexy surgery differs from breast augmentation surgery alone in that it carries increased risk compared to either breast augmentation or mastopexy surgery performed separately. Furthermore, the potential need for revisionary surgery is increase with breast augmentation / mastopexy surgery done at the same time.

In my opinion, the decision  to do the operation in a single or two  staged fashion becomes a judgment call made by a surgeon after direct examination of the patient.  For me, if I see a patient who needs a great degree of lifting, who has lost a lot of skin elasticity, or  whose goal is a very large augmentation then I think it is best to do the procedures in 2 stages (in order to avoid serious complications). However, doing the procedure one stage does increase the risks of complications in general and the potential need for further surgery. This increased risk must be weighed against the practical benefits of a single stage procedure (which most patients would prefer).

Conversely, if I see a patient who requires minimal to moderate lifting along with a small to moderate size augmentation (and has good skin quality), then doing the procedure one stage is much safer. Nevertheless, the potential risks  are greater with a 1 stage  procedure and the patient does have a higher  likelihood of needing revisionary surgery.

I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 754 reviews

Breast lifts and breast implants

+1

Although it is not possible to be sure from a single front picture view, it appears that your nipple-areola position is too low relative to the inframammary crease behind it to allow for a properly positioned breast implant and a lift with a lollipop incision is the only option. 

Breast implants are pillow volume and are only good for making the breast look bigger. The minimum size increase with a properly fitted implant is one cup size. Implants do not lift the breast and currently they cannot fill specific areas such as the upper pole of the breast. Fat transfers offer some hope of filling out specific areas but currently for cosmetic situations most feel that there is not enough known about the issues and risks of fat grafting to the breast to recommend it. 

Properly done, a breast lift does not add or subtract volume but moves the nipple-areola and the central breast behind it up to a higher level. This does not give forward projection or specifically fill in the upper pole and the scar trade-off is not as optimal as an augmentation alone but in general it's best to know what a given procedure does and doesn't do and what is feasible or reasonable in your situation. 

Scott L. Replogle, MD
Denver Plastic Surgeon
4.0 out of 5 stars 1 review

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A needed Breast Lift

+1

From the appearance of your current breast shape I believe you would need a breastlift.  This tries to redistribute the existing tissue and nipple to a higher position.  Try a 2 stage approach with the lift first.  If you are happy with the result, great.  if not, implants will replace the upper pole fullness you desire and can be safely done as a second stage.  I hope this info helps.

Ronald H. Stefani Jr, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 2 reviews

Breast implants or lift or both?

+1

Your breasts are overhanging and the nipples are low.  An implant alone will not look good...you will get more fullness at the top but the breast will hang off of it and the nipple will be pointing down. You need a breast lift.  You may get a nice enough result from a lift alone that you decide not to get implants.  If the lift alone does not give you the shape you are looking for (since upper fullness is only created by implants), then you can always add implants later after you see your results.  There are increased risks from doing a major lift at the same time as an augmentation, particularly in a full breast, and there is an increased risk of revisions, both short term and long term.  You may be happy with just the lift.
 

Robert M. Grenley, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 70 reviews

Lift and augmentation

+1

At least from the photos it appears that you could benefit from a lift.  If you want larger breasts, then an impalnt would be necessary. But the key would be to have an exam.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

Augmentation or Breast Lift

+1

I do not think that you will be pleased if you undergo an augmentation alone since you appear to have a good bit of breast ptosis.  Generally if the nipple is below or at the inframammary fold, a breast lift is indicated.  In fact, it appears from your photo that you have adequate breast tissue and probably could undergo a lift or mastopexy alone.

John Whitt, MD
Louisville Plastic Surgeon
5.0 out of 5 stars 2 reviews

Breast lift and breast implants

+1

The photos show drooping asymmetric breasts with the right being larger than the left and the left nipple shifted in position away from the midline. From your history it makes sense that you would have excess skin. Since the breast size is not small I think you would be happiest and best served with a breast lift first. Then if you want the size increased you can add implants later. The reason for saying this is that breast lift done together with breast augmentation has a greater revision surgery rate than either procedure alone.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

 

Aaron Stone, MD
Los Angeles Plastic Surgeon

Uplift and/or implant?

+1

Dear Kiaora,

An implant will make the breast bigger and an uplift will improve the shape of your breasts.  I would not recommend implants without an uplift, because it may be that the implant will fill the top half of your breast, but your natural breast will still be too low with a potential 'double bubble' deformity.

In order to improve the shape of the breast, you will need an uplift.  If you also wanted your breasts to be larger, then you would need implants alone, but if you are happy with your current cup size, all you will need is an uplift.  Good luck.

Jonathan J. Staiano, FRCS (Plast)
Birmingham Plastic Surgeon
5.0 out of 5 stars 9 reviews

Only lift now

+1

it seems that you have a large skin excess, the breast seems to be big enough for a lifting to get a good shape. If you want to have a bigger breast cup, you will need implants and lift at the same time. Of course you can have implants some years laster if you are unhappy withe the size of your breast after lifting.

Massud Hosseini, MD
Düsseldorf 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.