Write a review

The Big Question.....lift or No Lift?! - Baltimore, MD

I have two consults scheduled in April with hopes...

I have two consults scheduled in April with hopes of having surgery the end of June. I was once a full C / small D. After two kids and some weight loss, I'm left with deflated small B's, maybe a small C. I do have some sagging but I feel like my breasts have always been on the lower side even before kids. My main goal is to have FULLER breasts and slightly perkier but also natural looking. For reference, I'm almost 32, about 5' and 120 lbs. I'd love to hear from anyone who has or had a case similar to mine. What procedure did you choose? What type of implant? (Saline, silicone, cc's, profile) Were you happy with the results?

Ok so I've had my two consults: Consult #1:...

Ok so I've had my two consults:

Consult #1: This surgeon wanted to do a periareolar lift with a silicone implant. Office was okay. Staff was a little standoffish and snobby. Doctor was again, okay. He would perform the procedure at a nearby hospital. I found him by word of mouth.
Cost - $9,970

Consult #2: This doctor said I'm a borderline candidate for a lift but he doesn't like periaerolar lifts and doesn't think I warrant an anchor or lollipop style. He suggested silicone gel implant and subglandular since he says I have enough breast tissue to cover the implant sufficiently. This procedure would be performed in his on site surgi-center which has a 100% safety record (I checked) with IV sedation. I was referred to him by a friend who had her BA done last June.
Cost - $6,400

Has anyone ever received two completely different opinions like this? I was expecting them to agree 100% on the best course of action.

3rd consult and more confused.....

Hi ladies! Okay so I've now had my 3rd and FINAL consult. I have to make a decision about this.

The 3rd PS suggested under the muscle saline without a lift. He said my measurements were only CM's from where I would be if he did a lift so at this point, he wouldn't advise it. He then suggested something that neither of the other two PS's suggested. He said he would do saline and only because I have so much breast tissue to cover the implant that you weren't going to feel the implant anyway so why spend the extra money? He said he only pushes the silicone gels when someone comes in with very little breast tissue because he said to the touch, you will feel the implant versus breast tissue.
I'm inclined to agree with him because it does make sense.

However, I'm now stuck on the over versus under thing. He said he doesn't like doing overs because capsular contracture is more common and the difficulty with mammograms. I liked the idea of overs because of the easier recovery but I don't know if I could do saline overs and still get a natural look....

Ugh.....
Was this review helpful? 1 other found this helpful

Comments (36)

Sort by

what did you decide? Have you had it done yet?
  • Reply
This may sound confusing but, I think #2 and #3 are both right. You have a good amount of breast tissue and oddly enough you might get almost the same results with both. I had a breast augmentation in Dec and was very unhappy with the results. I had cohesive silicone gel implants placed in the subfacial position. I like their position but, I have a lot less breast tissue than you and the cohesive gel was a lot harder than I expected it to be plus I can't stand the feel or weight of them. I ended up going to a different Dr. this month (he's a breast reconstructive surgeon) who spent two hours explaining all the different issues with placement, silicone vs. saline and weight. Weight alone, I suggest saline. My recovery was easy because I was subfacial but, after he thoroughly explained the 'under the muscle' to me (in step by step surgical terms), if I had to do it all over again, I might have chosen that position. I was a strong believer in textured until I read this ladies website about the toxicity of implants. She strongly suggests smooth for various reasons (she's a Natropath who has implants too). Going for a 4th or 5th consult is always a good idea. I suggest you look up your local reconstructive surgeons, see one of them and see what they have to say. Also, I don't suggest a lift, plan on that in 15 or so years when you should be getting them redone again. Good luck!
  • Reply
I was on the fence also about getting a lift but ultimately decided to NOT get a lift as I really didn't want the scars. I'm 45 and have quite a bit of sag due to weight loss and 2 children. I figured I can always go back when I have more $$ saved and get a lift. I have to tell you I truly believe I made the right decision to NOT get a lift. I was a 34B and am now a 34 full C or small D(according to VS). Although I am VERY happy with them, my left one was a bit droopier. My PS said I could do a purse string lift to correct 75% of the droop. That makes me very happy..and minimal scars. But he also said, I might not need it depending on where they end up dropping to...I'm only at 5 weeks . :) I would say this...scars are not reversible. I would go without the lift, see how you like it and then possibly do a lift after if you feel it's necessary. (BTW..the purse string lift is done under general anesthesia so no costly fees). Basically only the surgeon's fee.
  • Reply
THANK YOU so much for your comment. I'm also planning on either dual plane or subglandular with salines so it was nice to see your after pics! That is exactly what I'm hoping for!
  • Reply
I had the same issue as you do. I decided to go with saline under 371 moderate on one side and 391 on the other to even them out a bit. I too have enough tissue to cover the implant and am told that saline gives more lift that silicone, plus you don't have to go for MRI's etc with saline. The worst case senerio is that I might want to get a lift at some point, but hopefully I will like them and never have to deal with those scars - it is worth it to me to see what happens first. Just my opinion. He did tell me that I would go through the "scary look" until they drop so I am prepared for frankenboobs but hoping not - lol
  • Reply
Ok, pherhaps the saline makes sense since you have so much of your own breast tissue. But I still don't think you need to go "under" also for the same reason, because you have have plenty of your own breast tissue. Take into consideration that silicon textured implants over the muscle reduce the risk for capsular contraction compared to saline overs. Someone mentioned fat transfer, pherhaps thats worth looking into...
  • Reply
You are a PERFECT candidate for a fat transfer to the breasts since you want a natural look, more fullness & already have nice sized breasts.  Please read my blog and the fat transfer section.  I am VERY happy with my results.  It would be SO nice for you not to have to deal with potential implant problems in the future.  You will also have very little down time from exercise & a heck of a lot less pain!  Good luck in whatever you decide.  I do hope you consider this as one of your options.
  • Reply
I just got my implants yesterday! I went to three drs for consults, the first two, in the same practice, both wanted to do a lift on me. I never fully trusted what they were saying and since a lift does add $ onto the price, I can see why they might want to suggest that. The dr. I went with said no lift and was of course cheaper! I put a lot of trust in what he said, I liked his practice/staff, etc and my friend had implants with the same dr! In the end, I'm glad I went with him and trusted him to put in what looked good and what I was going after. We never discussed cc's or profile, I put my full trust in him to put in what he knew would work! I showed him photos of what I wanted and left the rest to him! I feel his experience was very helpful in me being able to trust him and I find it kind of strange to leave the cc's and profile up to a patient that is not experienced in what works with certain breasts, sizes, shapes and tissue. I suggest you try and find a few more drs to check out before deciding on one, it doesn't sound like one stands out to me yet. I do think you should have some way so in the lift decision, especially in your case, I think my main thought was that they were probably as big at one time as I wanted them to be with implants and the nipple positions was fine. Also, how much will it bother you to have the positioned just perfectly, to me, I didn't find any good reason, but I did also trust my dr that he would make the look good without the lift! Hope that helps, keep us updated on what happens!
  • Reply
also - you should post your pics on here for the doctors to give you some of their thoughts... always nice to have some free opinions from trusted experts!
  • Reply
Thanks, I actually did that and got mixed opinions. Some said I could achieve my desired look with implants only and some said lift and implant.
  • Reply
yep - every doctor will have a different opinion... maybe see 1 more in person if neither has you feeling really good. When I went in for my first appointment with the surgeon I ended up choosing it felt like a great first date really. I was comfortable and felt like even though I didn't understand all his suggestions, that he would get me a great result. And I'm so incredibly happy!
  • Reply
Another thing - I needed the lollipop lift because of my asymmetry - otherwise could have done areolar only... so think a lot probably has to do if you're happy with your shape and symmetry.
  • Reply
I saw 3 different doctors and got 3 completely different suggestions. Think you should seek out another opinion. Also - the under/over muscle depends on your lifestyle and size you choose. If you work out a lot or are worried about distortion (they will move when you gesture) then the subglandular is usually recommended where you have enough tissue (which looks like you do). I think it's so important to feel comfortable with the doctor and staff. You will spend a lot of time there after your surgery - and you'll get the best results from a doctor who takes the time to listen to you and understand what is most important. Nothing will ever be perfect, but you'll be really happy if you pick a good surgeon who is able to weigh the various costs/benefits of different choices so you get the best result for you! Good luck and keep us posted!
  • Reply
The more I read about the submuscular vs subglandular - the more I think subglandular is more appealing to me even though I swore "under the muscle" was the only way to go before I started MY journey!
  • Reply
I am sure you have enough breast to cover an implant in a subglandular position and i know that in the US they tend to prefer under muscle but here in the UK they do both. My implants are subgandular and I had a small A cup and I have no problems at all. Personally I think its a shame to lift and distort the muscle unless its absolutely impossible to fit an implant otherwise. Naturally a breast sits over and mostly women want a natural look anyway. I think the risk of capsular contraction and rippling is no more than going under. And as for aging "over"ages in a strange way with implant sitting high and the natural breast coming down creating a bit of a "snoopy"look. This is what my mum looks like after 28 years with implants. If your second doctor is confident you can get away without a lift, avoiding scars with implants in subglandular position and if you can see some pictures of women he has done that are similar to you with good results than I think you should trust that he will do a good job with you too. God luck!
  • Reply
Thanks for your comment! They showed me pics of patients with almost identical situations "before" and I absolutely LOVED the after. They looked full and natural and not fake or ball shaped AT ALL. I was so relieved to see that he had dealt with my type of case so many times successfully!
  • Reply
Can't speak to the lift part, but I do know that sub glandular placement is almost never a good option (regardless of how much breast tissue you have.) Not only are you at a much higher risk of capsular contracture, but over time, you will be more susceptible to sagging because they don't have any muscle helping keep them in place. See in the picture on this website, the thin piece of muscle holding on to it... http://www.tcclinic.com/augmentation_mammoplasty/submuscularbreastaugmentation.htm
  • Reply
Thank you for your input. The more I read, the more I think subglandular may be the right placement for my case. I have quite a bit of breast tissue and am not looking for a lot of upper pole fullness. I may seek another consult to confirm my feelings.
  • Reply
I was a grade 1 too. .I had the lift. . Glad i did because i would be more than a grade 1 now with the implants. .. ask your question to the real self doctors so you can get more professional opinions. ...
  • Reply
I did ask that question to the real self doctors - got mixed opinions, of course.
  • Reply
Go with a Benelli (spelling?) lift. It's small and less scaring. Your areolais just right below your crease.
  • Reply
My doc recommended a lift, but I chose not to do it. I'm very happy with my decision thus far.
  • Reply
I had a lift done after my implants were removed. I am so happy that I did. I told my surgen to put my nipples a tad higher and make my areola a tad smaller. I had the surgery done one month ago and I feel great. I am still wearing a compression bra to help the healing. I think your breast will look awesome with a lift. Keep me posted. ;) Birdie
  • Reply
I too had deflated breast after children and was nervous about a lift. I scheduled my first consultation and was so excited! When I got there it all went horrible! The doctor wanted to cut half my boon and roll some skin under.leaving a huge scar up the sides. I left crying. I then called and scheduled a consultation with a local doctor. He explained that my nipples were in great position and that there was no need for a lift. He explained that I just neefded fullness at the top and for them to be filled back up. He suggested since i had so much tissue that a moderate plus 350 cc silicone unders would do the job! I left so happy and excited! I trust him fully and can't wait for my surgery in 19 days!! Keep looking till u feel comfortable and know what u want! It's your body and u r paying a lor!
  • Reply
Lady bug you and l are in the same exact boat. I have my consultation in April going to get them in July. With that being said l find your post very helpful. The doctor I'm going to can do a lift internally with no scarring granted if l don't have to get a lift l don't want it. However if l have to doing it internally would be the way l want to go... I'm going to Dr Mark Clayman in Jacksonville, Fl.
  • Reply