500 Cc or Go Lower? Do I Need a Lift?

I am 25, 5'4", 135 lbs, bwd 15.5, and ribcage measures 33". I have recently lost 40 lbs. I thought I might need a lift, but my ps said I could get good results with just an implant. However due to the extra skin I would need 500 cc's (silicone over muscle). I'm afraid they will be huge and cause even more sagging. But I have a very wide bwd, so will they really look that big? Is there a small enough difference between 400 & 500 cc's that I could go smaller? Should I go ahead and get a lift?

Doctor Answers 19

Augmentation With Or Without Lift

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First of all, I would recommend that you you use a slightly smaller implant.  I think 500cc is too large an implant for you since you are already worried about being "too huge".  I agree with Dr. Pousti that your nipple is at a borderline position and that you may well get a nice result if you use an experienced plastic surgeon.  The nipple location is always the key; when located at or above the inframammary fold it is possible to obtain a nice result with augmentation alone.  You can always have a small lift performed at a later date if you wish.

Louisville Plastic Surgeon

To Lift or Not To Lift?

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A breast augmentation with a dual plane technique will aide to give you a mild lift.  However, If you have excess loose skin from weight loss, then you may benefit from a periareolar mastopexy (where the scar is hidden around your areolar border) or an additional circumvertical lift (lollipop scar).   If you are not keen on a lift at this time, then I would suggest you go for a breast augmentation first.  If you do experience residual sagging or are unhappy, you can always opt for a conservative lift later (if needed).    Based on your photos,  you appear to have a fairly long torso and may benefit from a lift.  Of course, a formal physical examination is needed to make any formal recommendations.  Best of luck.


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I think that, with your frame and current shape, a lift will be necessary to avoid a look of an exaggerated upper breast.  Your nipples are low and your breast volume is almost completely behind your nipple.  If you are against having a lift then I would use a smaller implant.

Scott E. Newman, MD, FACS
New York Plastic Surgeon
4.9 out of 5 stars 42 reviews

Do I need a Breast Lift or not

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Using a larger breast implant to substitute for a breast lift may achieve your desire goals in the short term, but will not result in a long-term excellent outcome. The increased weight of the implant will continue to cause your breast to sag over time and will result in you needing a breast lift in a short period of time, but with thinner tissue and therefore, a compromised outcome. You should strongly consider a smaller implant and either a circumareolar or doughnut mastopexy or a vertical mastopexy.

Ankit Desai, MD
Jacksonville Plastic Surgeon

Deciding Whether or Not a Breast Lift is Necessary...

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Hi there-

While I have seen just as many photos of ugly breast lift scars as you have, and therefore definitely understand when a patient expresses a desire to avoid a lift if possible, there are a few critical points to understand:

  1. Not all surgeons are created equal, and so therefore not all breast lift scars/outcomes are equal either
  2. It is possible to achieve a lovely breast lift with scars that are very inconspicuous 
  3. Placing large implants above the muscle in an attempt to avoid a breast lift is short-term fools gold... You will successfully avoid the breast lift, but the likelihood of you being highly dissatisfied with your breast after a short time (1-2 years) is extremely high. With only skin and (already loose) breast tissue supporting the weight of a large implant, it really won't be long before your breasts look like bowling balls in pillow cases...
  4. Your weight loss means that the QUALITY of your skin has diminished, in addition to there being a problem of QUANTITY. This cannot be camouflaged with an implant.

Obviously without a formal, in-person examination, it is difficult to say for sure, but based on the photos you provided, it is my opinion that not only do you need a breast lift to achieve a lovely and long lasting result, but without one you are very likely to be unhappy and want another surgery in a year or two.

I realize that this is probably not what you would prefer to hear, but strongly believe that patients would rather hear the truth about what is possible than to have an operation that was never likely to achieve their goals in the first place.


Implant Cannot Mask Need For A Lift

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Based on your photographs, I do not think that a simple breast augmentation would work for you.  Your breasts appear to sit lower on your frame naturally.  Along with the ptosis present in your breasts already, an augmenttaion would just give you larger, low breasts.  I would recommend a dual-plane breats augmentation with some sort of lift, ranging from a periareolar ( benelli or donut lift) to a full wise pattern ( anchor ) lift.  I hope this helps.

Breast augmentation with a Lift

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It seems as though you wopuld need a lift. A lift around the nipple or around and vertical is a good option considering your anatomy. THis would also allow the implant to be placed below the muscle

Dr J

Lift and implants

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First, I doubt that you truly have a BWD of 15. Most people are between 10-12.  Most men are not that wide. Second, it looks like you have a lot of loose skin and need a lift of the areola.  A full exam would be critical.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

500 Cc or Go Lower? Do I Need a Lift?

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Great photos thanks. Very hard to give exact advise. If you desire larger implants than a 350 cc than I would recommend a staged operations. First the lift I think from your photos the right needs a vertical or full lift while the left a donut. After 2 to 3 months than implant sub muscular a larger than 350 cc to attain the result. Other options are available but best to have in person evaluations. 

Beautiful breasts without implants

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Dear Paloma,

Your concerns are well founded. Implants that size and on top of the muscle will only make matters worse in time and much harder to correct. Allow me to make an alternate suggestion. You seem to have enough breast tissue to have the 'Ultimate Lift'. It's a technique that allows sufficient lift and upper pole fullness without the need of unsightly scars and implants. Do your research so you can make the best possible decision for you!

Best wishes,

Dr. H

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 230 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.