40 Year Old Breasts. Augmentation Under the Muscle, Can They Lift What I Have As Well? (photo)

I recently turned 40 and have long considered breast augmentation. After two babies and nursing them both, there is very little left of my breasts. They 'fill' a B to C cup, but they are very thin, with little to them. I'd like to be a C to a D cup(I realize that is dependent on bra manufacture, but you get the point). What will they do with the sagging breasts that I have? Do they lift them so they don't look odd with the implants??

Doctor Answers 20

Breast Implants and Lift?

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Thank you for the question and pictures.

Your breasts are in a somewhat “borderline” position on your chest wall;  it is hard to know for sure since your arms are elevated holding the camera.

I think you will have a very nice result with breast augmentation surgery  but do not expect the breast implants to “lift” the breasts.  If breast lifting is necessary ( this will be determined best on direct physical examination by a well experienced board-certified plastic surgeon)  then minimal lifting ( possibly only around the areola) will likely be necessary.

I hope this helps.

Lift of not

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One would need to examine you to determine if you would need a lift or not.  If the nipples are above the inframmary fold an implant alone would suffice.  But other factors such as skin quality must also be taken into consideration.  Discuss this with a board certified Plastic Surgeon.  Donald R. Nunn MD  Atlanta Plastic Surgeon.

Donald Nunn, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 51 reviews

Breast augmentation, is it enough for me?

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Thank you for the photos. I believe you can get a very nice result with augmentation alone. It seems that your nipples are at the level of you breast crease or slightly below it. You will get mature looking breasts, maybe not like what you had at age 16. You will get more fullness superiorly, the inferior pole will be rounder giving the illusion that your nipples have been lifted. See a board certified plastic surgeon who can do an examinatioin and measurements to match you with the appropriate implant size and projection. Good luck.

Breast augmentation and Breast lift?

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Given your helpful photos, it is unlikely that a breast enlargement alone will provide you with firm, rejuvenated breasts that are appropriately shaped with the nipple-areola complex in the appropriate position. It is more than likely that a concomitant breast lift would need to be performed as well. Of course, a physical examination would need to be performed to be able to more precisely determine exactly what you need.

Steven Turkeltaub, MD
Scottsdale Plastic Surgeon
4.7 out of 5 stars 33 reviews

Augmentation With/Without Lift

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From your photos, it appears that you could have a very good result with an augmentation alone.  If you were my patient, I would probably suggest having an augmentation after which I think you would be very satisfied. If you wished, a small lift could be performed later under local in the office.

John Whitt, MD (retired)
Louisville Plastic Surgeon


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As you have probably figured none of us can say without seeing you in person. Implants do fill out loose skin but are quite limited in how much "lift" you get. If you want better nipple position and tighter skin, then a lift would be advised to accomplish this

40 year old breasts can be rejuvenated

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With a thorough examination and discussion of your goals it is likely that a very nice improvement is achievable. There are trade-offs with every surgical approach but in many cases like yours an implant in a dual plane or subglandular location will do the trick. Learn about the pros and cons of each from your Plastic Surgeon. Filling out your breast shape will correct many of the features that are currently making your breasts look droopy.

good luck,

Dr. Mosher

Mathew C. Mosher, MD
Vancouver Plastic Surgeon
4.5 out of 5 stars 34 reviews


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You are just at that point where you can go with a straight forward aug to fill where you have lost breast tissue-

if you are happy after the procedure where your cleavage is -you need not do anything else


Edward J. Bednar, MD
Charlotte Plastic Surgeon
4.8 out of 5 stars 144 reviews

Dual Plane Internal Breast Lift Breast Augmentation

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Seventeen percent of my augmentations are done with a dual-plane approach to lift breast tissue, elevate the nipple-areolar complex, and release a tight breast crease. This is technically a breast enlargement procedure—I call it the “internal lift.” It creates a breast pocket above and below the muscle (hence the term “dual”) where an implant is inserted. By releasing the breast attachments on top of the muscle, the breast slides upward around the implant. This technique avoids the more extensive scars of an external lift, and can be especially useful in fixing early sagging.

Finally, you could put a card under each breast to show how much tissue is located below the crease (if any) and to show if the nipple is above, at or below the crease.  All the best, "Dr. Joe" Gryskiewicz

Will Implants Lift My Breasts?

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In my opinion, implants alone under the muscle will augment you out of MOST but not all of your sagging. This is mainly dependent on how large you go. Going above the muscle will give you more of a lifting effect but will increase your risk of capsular contracture and rippling. Consult with an experienced plastic surgeon who specializes in breast augmentation to discuss what size implant would be best suited for you. Good luck.

Douglas L. Gervais, MD
Minneapolis Plastic Surgeon
4.8 out of 5 stars 178 reviews

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.