Will 400cc implants give more upper pole fullness or do I need a lift? (Photos)

Question

I’m trying to avoid the additional scars that come with an uplift. I currently don’t havd upper pole fullness and thinking of getting 400cc implants. Will this increase the fullness of my upper pole?

Harry T. Haramis, MD, FACS · Answer

Many of my patients avoid a breast lift and its scars with implants alone.

Larger implants (400cc or more) above the muscle or dual plane can restore upper fullness and “lift” the breasts enough for a nice, natural result.

They will not be high and extra perky as with a combined formal lift, but many patients are ok with them remaining slightly low/natural but much fuller.

An exam and consultation with a plastic surgeon is recommended to confirm this as well as discuss your options and expectations.

John LoMonaco, MD, FACS · Answer

Thanks for the photos. You can have implants alone, but they will ahve to probably be in the 300 - 450 range to round out your breasts and make them look full. Because you have a long breast fold, implants alone will make the bottoms of your breasts sit lower, perhaps even by an inch depending on how your skin stretches.

A lift would allow a smaller implant but comes with scars. Get a few opinions as you have options to move forward.

A lift would allow a smaller implant but comes with scars.  Get a few opinions as you have options to move forward.

Gary M. Horndeski, MD · Answer

Your breasts are asymmetrical in volume, shape and position. You would benefit from a breast lift using 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. The weight of the breast is transferred to the underlying pectoralis major muscle resulting in long term stability. 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.

Paul E. Chasan, MD, FACS · Answer

Thank you for your question.  I have been in practice for over 30 years, and breast surgery and revisionary breast surgery is a large portion of my practice. You definitely would need implants AND a lift to get an attractive result.  I imagine this, you are already drooping, and then you are placing a larger implant with additional weight.  I have seen this scenario so many times for patients trying to avoid the scars associated with lifting.  Ultimately 6 months or a year later, invariably, they will say "I wish I never went this big and now my breasts are drooping down to my knees".  The scars associated breast lifting heal beautifully if done by someone very experienced at this procedure.  Often times, I will perform a technique I developed called Reductive Augmentation which also involves removal of extra beast tissue from the inferior pole, so I can use the implant to shape the breast. You should be able to achieve a beautiful result. Best wishes to you.

Miguel Mota, MD · Answer

Yes it will. And it will fill out your breasts for sure. But that is all it will do. It will not lift your areola position. And it will not make them more symmetrical. You can only achieve symmetry and properly positioned areolae with a lift…. Results with implants alone might fall short. The good news that a donut lift is a good option if you want the best results possible with the least amount of scarring.

Best of luck,
Dr. Miguel Mota

Best of luck,
Dr. Miguel Mota

Ram Kalus, MD, FACS · Answer

Thanks for your question and photo. If you are satisfied with your areolae you will almost certainly not need a lift. Not knowing your height, weight or breast measurements it is impossible to nail down an exact implant size and therefore an examination in person would be necessary to properly advise you. That said, 400 cc is a relatively large implant for an augmentation. In my practice I have patients share with me images of women’s breasts they deem aesthetically pleasing and I ask them to leave the ultimate sizing decision to me. Remember, there are three numbers associated with every rest implant: volume (400 cc), diameter or width (usually 10-14 cm) and projection (anywhere from 1.5-6.0 cm).

Do your research, consider more than one opinion, and don’t get hung up on which implant size you need. Leave that to your surgeon. Best of luck to you.

Do your research, consider more than one opinion, and don’t get hung up on which implant size you need. Leave that to your surgeon. Best of luck to you.

Mert Demirel, MD · Answer

400cc implants can increase breast volume and may create more upper pole fullness, but they will not truly lift the breast or move the nipple to a higher position. If the nipple sits low or the breast tissue hangs below the fold, implants alone can sometimes make the breast look larger but still saggy.
From the photos, there appears to be significant drooping and loose lower breast skin. In this situation, trying to avoid lift scars by using a larger implant can lead to a “waterfall” effect, where the implant sits higher and the natural breast tissue hangs off the front or bottom.
A 400cc implant may give fullness, but it is also a relatively large implant and adds weight. Over time, that extra weight can stretch the skin more and may worsen sagging, especially if the tissue is already loose.
A lift is usually the more reliable way to improve nipple position, breast shape, and lower pole tightness. The trade-off is scars, but the trade-off with implants alone is a higher risk of poor shape, low nipples, bottoming out, or needing a revision later.
My advice would be not to choose implant size only to avoid lift scars. Ask your surgeon where your nipple sits compared with the breast fold and whether your tissue would sit nicely on a 400cc implant or hang below it. If the main issue is sagging, a lift with or without a more moderate implant may give a better long-term result.

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. You can always get a lift later if you feel you are not perky enough when fully settled and healed. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Camille Cash, MD · Answer

From the submitted photos you have both ptosis and volume asymmetry which is not uncommon.  To correct these and give you upper pole fullness a lift with implants is recommended.  You should have a very nice result.  Implants alone will give you more volume, including upper pole fullness, but will not correct the asymmetry nor lift the nipple position.  Visit with a board certified plastic surgeon near you to learn more.  I've included a video I hope you find helpful.

Mark Eberbach, MD · Answer

Don’t confuse larger with younger. You also have substantial asymmetry. To accomplish improvements in all three you will need a lift and an implant. The warning is don’t go too big.

Will 400cc implants give more upper pole fullness or do I need a lift? (Photos)

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