Am I a Candidate For Implants Without a Lift?

Or something smaller than a full lollipop lift... I'd like to recieve rather large implants DD/DDD. I am a saggy D now.

Doctor Answers 21

Implants without a lift?

Larger implants can help to reverse sag, but they have to be placed selectfully. You must have a very experienced surgeon perform this procedure.

Grand Junction Plastic Surgeon
4.1 out of 5 stars 14 reviews

Unrealistic expectations from breast surgery

Unfortunately, your expectations won't be met at all without a full lift.  In addition, because you have very poor tissue elasticity, huge heavy implants won't stay up and full over time.  Your best plan in my opinion would be to have a full lift and more moderate implants.  Good luck!

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

You'll definitely need a lift

Your breasts shape is similar to a tubular breast. Your breasts are long and narrow with a wide cleavage. The areola are disproportionately large for your breast size. You would definitely need to have a lift. As far as being a double D or larger, that is something that would have to be discussed, because I'm not sure your body size can accommodate that. I have done some extremely large breast augmentations for certain patients but it's important to discuss things fully and make sure you understand that that larger breast will lead to sagging much more quickly and then a smaller size breast implant.

Joseph M. Perlman, MD
Houston Plastic Surgeon
4.3 out of 5 stars 21 reviews

Breast lift with or without augmentation

When women with saggy breasts want to go bigger, I usually advise doing a breast lift along with the implants. Otherwise, the implants create what we call a “double bubble,” where the breast droops off the end of the implant like a sock. Some of my patients, however, don’t want a lift because they want to avoid additional scarring, so sometimes implants alone can fill out the skin and eliminate the saggy appearance. A mastopexy (breast lift) raises droopy breasts from one to several inches and excess skin is removed. If you're sagging or asymmetrical, and are looking for perkiness, you'll need a lift--or, if you also want more volume, a lift and implants.

Michelle Copeland, MD, DMD
New York Plastic Surgeon
4.6 out of 5 stars 10 reviews

Wanted- Large Breast

It is not possible to make your breast look like the photo on the right with implants alone nor with implants and a Mastopexy. You can get a good result with an Augmentation Mastopexy if reasonable size implants are used rather than just the largest implant that can fit. Your goals have to be realistic before any surgery is done or you will not be happy in the long run. 

Walter D. Gracia, MD
Fort Worth Plastic Surgeon
4.7 out of 5 stars 3 reviews

Implants + Sagging Breasts = Rock in a sock!

Implants do not lift breasts.

Lifts lift breasts.

Lifts must lift breast tissue not the skin on the breast. Pick your technique wisely.

My rule is that if the nipple to sternal notch distance is less than 25 cm's, then a Tear Drop circumareolar lift is possible. For greater than 25 cm's, a Lejour lift is appropriate.

All lifts will reduce some volume as part of the procedure. To add volume, add an implant!

Robert M. Freund, MD
New York Plastic Surgeon
4.8 out of 5 stars 33 reviews

Breast lift and breast implants

Your posted left photo, which I assume is you now, shows asymmetric breasts, enlarged stretched areolae, skin stretchmarks on the upper half of the breasts, drooping breasts with the nipples lying well below the inframammary fold, prominent breast veins and wide spacing between the breasts. If you just put in breast implants these issues will not be corrected and you will most assuredly not be happy. The cleavage cannot be corrected by any surgical means. You will need breast tissue and skin procedures including some sort of lift to correct the other issues. You almost assuredly cannot do this all with one procedure. You can do the lift and implant placement together and then a fine tuning procedure or you could do the lift first and implant placement later.

There may be some surgeons who could do all this in one procedure but that would not be the majority of surgeons and no surgeon can guarantee you will be happy with one procedure. The main problem is the amount of drooping and the severe stretchmarks. No one can fully adjust for changes to the stretcmark skin that take place as a result of surgery while planning and performing the surgery. You also need to know going into this that the stretchmarks may become more visible or noticeable after the surgery.

I also strongly advise agains getting implants as large as those in the right photo. Given your skin and current condition that would set you up for additional surgery  within a couple of years as the stretchmark skin has lost most of its original elascticity. If you want to keep returning to the surgeon for more surgery go ahead and put the larger implants in.
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
5.0 out of 5 stars 2 reviews

Implants without Lift?

Thank you for sharing your photos.    Based on the left photo, you have a very complex breast shape to fix.     You have very large areolas and most of the breast is loose skin.     In addition the breast footprints are very far apart.   Bottomline, I would want to educate you on what cosmetic surgery can safely accomplish for you.   I do not think a DD/DDD is realistic with your body frame and breast anatomy.  I think a realistic goal would be a full C.    In order for me to optimize your shape, size, and symmetry, I would recommend a full anchor breast lift.    These scars heal very nicely in most patients.   I think the patient photo on the right is not a realistic outcome for a patient with your breast anatomy.    I think it is always important to study the before photos as closely as the after photos to get a realistic understanding of what cosmetic surgery can do for you.   I wish you a safe and happy recovery :)



Paul S. Gill, MD
Houston Plastic Surgeon
4.8 out of 5 stars 85 reviews

Sagging breasts cannot be corrected with implant alone

Hi DNCole,

You definitely need a lift.  I also believe you need a lollipop scar.  If you have just a peri-areolar lift, the scar quality will be very poor.  Naturally, I understand you are concerned about the scars.  However, fine quality scars usually do not bother patients.  I do several things to promote good quality scars:  1.  Use a permanent suture around the areola to minimize the chance of the areola spreading and widening after the surgery; 2.  Use Quill sutures which take the tension off the closure and produce fine line scars; 3.  Use paper tape on the scars for 3 months post-operatively, 4.  Patient takes supplements that support wound healing pre and post-operatively.  Use the proper size implants helps maximize the result as well.  Hope this helps.

Tracy M. Pfeifer, MD, MS

Tracy Pfeifer, MD
Manhattan Plastic Surgeon
4.8 out of 5 stars 29 reviews

Breast lift and determining implant size

you will need a breast lit (mastopexy) to reposition your areola and tighten some of the loose skin and reshape your breasts. However, this will not fill in the loss of volume that you're looking to restore them to. Thus, while you'll need an implant, the safest way is to stage these procedures in that you'll require the lift initially and then follow with an augmentation 6 months later. I would encourage you to not arbitrarily choose any random breast implant size, but work with your surgeon to select an implant that is appropriate (based on both your tissue characteristics and your anatomic limitations) to achieve an excellent cosmetic outcome. 

Jeffrey D. Hoefflin, MD
Los Angeles Plastic Surgeon
4.1 out of 5 stars 16 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.