24, F, sagging after weight loss – can I avoid a lollipop lift with internal mastopexy + 270cc tear-drop implants? (Photos)

Question

I’m 24 years old and have small C-cup breasts that became saggy after weight loss. I don’t have children yet but plan to in the future. Several doctors have recommended a lollipop lift with tear-drop implants to achieve a fuller look. However, I’m concerned about having a lollipop scar at such a young age, and I’d prefer to wait until after I’ve given birth to have that procedure. Right now, I’m considering an internal suture mastopexy (or internal glandulopexy) combined with 270cc tear-drop implants. Is this a good approach to avoid a lollipop lift for the time being, or should I just go ahead with the lollipop lift now? Also, would 270cc be enough to achieve a fuller D-cup appearance and provide some lift/support? Thank you!

Semih Yildiz, MD, FEPOBRAS · Answer

Based on the photos, you appear to have volume loss after weight loss, some breast asymmetry, and true nipple-areola descent rather than only mild upper-pole deflation. In that setting, an implant with an internal suture mastopexy or glandulopexy may add fullness and slightly improve the shape, but it usually cannot reliably raise the nipple position, tighten the lower breast skin, or control the breast envelope the way a vertical/lollipop lift can. It may be a reasonable temporary compromise only if you are comfortable with a limited lift effect and some residual sagging.

A lollipop lift with an implant is more likely to give a higher nipple position, better lower-pole control, and a more youthful breast shape when there is real ptosis. The tradeoff is the scar. For many patients, a well-healed vertical scar is less of a concern than having an implant placed into a loose envelope that still looks low or heavy. Scars vary, so your skin type, healing history, and surgeon’s technique matter.

Future pregnancy and breastfeeding can stretch the skin again and change either result. If pregnancy is planned soon, waiting on the formal lift can make sense. If pregnancy is years away and the sagging bothers you now, doing the lift now can also be reasonable, understanding that revision may be needed later.

A 270 cc implant may provide a modest size increase, but cup size is not predictable from cc alone. It depends on your chest width, current breast volume, implant dimensions, projection, and bra brand. In your photos, the key issue is not just size; it is skin envelope and nipple position. Ask your surgeon to show you what an implant-only/internal-lift compromise is expected to leave behind compared with a true mastopexy.

Frank Agullo, MD · Answer

it looks like your nipple is above your inframammary fold. This means that you could get away with a breast augmentation without a lift, but would probably do better with a small circumareolar (donut) lift.

There is no true effective internal breast lift. You could achieve some additional skin tightening with BodyTite.

I would stay away from teardrop breast implants as they have texture, and these have been associated with a risk for lymphoma-type cancer. The closest implant to this look would be a Motiva Ergonomix implant, which is round, but moves with your body for a more natural look.

You should try on different sizers. A 270cc might result in a smaller size than you think. Trying it on or visualizing it with 3D software may help.

#StayBeautiful,

@RealDrWorldWide

Daniel Barrett, MD · Answer

Dear yearofthehorse,

my preferred lift is a lollipop lift when a periareolar won't do (ie greater than 2cm lift required). The lollipop technique was created by a Canadian plastic surgeon named Elizabeth Hall-Findley and treats the breast as a three dimensional structure instead of two dimensions (anchor - lift). Most importantly it does not require the horizontal component scars that the anchor-lift requires and breasts appear much more natural, lifted, and less boxy. Lastly, the lift lasts longer because the lollipop doesn't rely on the skin to hold the breast up, its actually breast tissue thats being brought together to support the breast and hence improves longevity.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Gary M. Horndeski, MD · Answer

The breast lift technique I recommend is the Bellesoma. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. Later, fat transfers or small implants can be placed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Ted Eisenberg, DO, FACOS, FAACS · Answer

Do I need a breast lift? You might not need one.  After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what size and style breast implant is right for them. Mildly Sagging Breasts: If your breasts are mildly droopy, a saline or silicone gel implant placed behind the pectoral muscle might help create the illusion of perkiness. That’s because as the implant fills out the top of the breast, it also fills out the bottom, making it look as if the nipple has moved higher. It hasn’t. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

24, F, sagging after weight loss – can I avoid a lollipop lift with internal mastopexy + 270cc tear-drop implants? (Photos)

Answers (5)

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