Breastfeeding made my breasts uneven and a bit saggy. Do I need a breast lift on both breasts or just the one that is saggier?

I want to look like the girls in my "dream boobs" photo. Do I need a breast lift on both breasts or just the one that is saggier? I don't mind a slightly mature look. I want to get at least 550cc saline mod plus or more (under the muscle).. I am 5'2 120 lb., will this work for me? I have a rib cage of 30 inches and a BWD of around15-16cm but since my breasts are oddly shaped, I am not sure what to get. I have a consultation tomorrow but want more opinions. Thank you!

Doctor Answers 10

Should I get a breast lift to correct asymmetry, or will implants alone work?

Thanks for sharing your question.

I agree with most of the opinions you have gotten thus far, and I will say that it appears as though you do have slightly more breast drooping on one side vs the other.  In cases with this type of asymmetry I do prefer to add a lift with similar incision patterns to optimize symmetry.  I feel this allows the best control, and in the end guarantees the best result for you.

If you did decide to try and avoid a lift it could be reasonable to avoid this with a sub glandular augmentation (above the muscle).  I would only recommend this if you have adequate volume of breast tissue which is determined on exam and not with photos.  It is valuable to get at least a couple of opinions and follow the advice of the surgeon you are most comfortable with.  Make sure to select a surgeon certified by the American Board of Plastic Surgery to ensure you are seeing a well qualified specialist.

Best of luck to you

Fort Worth Plastic Surgeon
4.9 out of 5 stars 93 reviews

Breast lift needed?

The general rule of thumb is that if the nipples sit below the inframammary fold (the crease under the breast), then a lift is recommended.  However, there are several other anatomic factors of the breast as well as the patient's desires and expectations that further determine whether a lift is performed or not with or without an implant.  Because a breast lift tightens up the breast envelope and breast implants expand the breast envelop, you are more limited by this fact than any other when trying to go with a large implant.  One way around this issue is to have the procedures done separately, for example have the lift done first then 6+ months later undergo the breast augmentation with implants.  In general it is always best to fit the implant with the patients breast anatomic dimensions thus minimizing immediate as well as long term complications. Once you are ready, consult with a board certified plastic surgeon that can then perform an in person physical exam and help you best decide on a final surgical plan.  Based upon your photos, I'm guessing you will not need a lift.  Glad to help.  

Ryan Stanton, MD
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 117 reviews

Lift both breasts for optimal symmetry

Thank your for your question and photos.  From what I can see, it appears that you have some early, borderline ptosis, with likely loose skin after breast feeding.  If you proceed with an augmentation alone under the muscle, you will likely end up with a snoopy breast/double contour as the loose breast tissue and skin falls off the imlant.  You could potentially avoid this effect with placement on top of the muscle, but this would  need to be determined in person.  Additonally, location above the muscle can increase the risk of visibility, palpability, and capsule contracture.  
If you were my patient, I would likely recommend a submuscuar augmentation with a
vertical mastopexy.  The incisions may be just a lollipop or and anchor (upside down "T") depending on the amount of excess skin.  This approach will give your surgeon optimal control over shape and symmetry.  Try not not  to focus too much on the scars, as the shape and  symmetry are more important.  The scars fade well with time.  
It is very helpful to bring pictures of "dream boobs" to your consultation, but remember to have realistic expectations.  The women in your photo do not appear to have had an augmentation with lift, so your results will likely be somewhat different.  Nevertheless, I think you will get tremendous improvement  from a lift and augmentation.  Make sure you seek out a board certified plastic surgeon and have all of  your questions answered. 

Matthew H. Steele, MD
Sioux City Plastic Surgeon
5.0 out of 5 stars 85 reviews

Breastfeeding made my breasts uneven and a bit saggy. Do I need a breast lift on both breasts or just the one that is saggier?

Breast augmentation with a lollipop lift will give you a better shape to your breasts while avoiding the full scar associated with the anchor lift.  An exam would be helpful to make this determination.

Select a plastic surgeon who performs hundreds of breast augmentations and lifts each year, has great reviews, and has great before and after pictures.

Kenneth Hughes, MD

Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

Breast Augmentation with Mini Ultimate Breast Lift(TM)

You are an excellent candidate for a new technique called Breast Augmentation with Mini Ultimate Breast LiftTM. Using only a circumareola incision it is possible to reshape your breast tissue creating upper pole fullness, elevate them higher on the chest wall and more medial to increase your cleavage. Through the same incision, implants can be placed. Aligning the areola, breast tissue and implant over the bony prominence of the chest wall maximizes anterior projection with a minimal size implant. Small round textured silicone gel implants placed retro-pectoral look and feel more natural, are more stable, less likely to ripple or have complications needing revision. Implant profile is irrelevant in the retro-pectoral position since the muscle compresses it. Implants as large as 550 cc’s will not fit retro-pectoral, will extrude inferiorly and laterally requiring revision. At size 32 or 34 each 100 cc’s of implant corresponds to 1 cup size change. 550 cc implants would take you up 5 ½ cup sizes from a B to a size G or H. This would not be a practical solution, would not be stable long term and require revision. 22% of women who undergo breast augmentation alone require revision within 2 years because they are dissatisfied with the result. Frequent causes of dissatisfaction are over implantation and not performing a simultaneous lift when needed.

Best Wishes,

Gary Horndeski, M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 223 reviews

Whether or not you need a lift

My guess is that your consult helped understand your options a little better but here are my thoughts on your case based on the photos.
You do not need a lift, but a lift on the one side can be used to even things out a little bit better. An option to avoid a lift would be asymmetric silicone gel implants above the muscle.  Implants below the muscle would put you at high risk of double bubble. Many surgeons seem hesitant to take advantage of the flexibility added with implants above the muscle but in cases with some but not dramatic droop and adequate breast tissue, the results can be terrific.
I would say, however, that 550 cc implants are going to be exceptionally large in a woman your size.  It is important that you do your research into the long term implications of implants that size in a small framed individual. That is not to say that they can't be used, just that the downsides should be understood by you.  Although your surgeon can walk you through them, your own research may be more useful and poignant.
Feel comfortable seeing more than one surgeon until you feel comfortable and confident in your decision.
Dr. Pyle

Jeremy Pyle, MD
Raleigh-Durham Plastic Surgeon
4.9 out of 5 stars 109 reviews

Very large breast implants for sagging breasts usually need a lift

based on the final result that you desire you will need fairly large breast implants as you describe in your question.

There is risk that without a breast lift on both sides the large implant will displace your nipple downward and cause a snoopy deformity.

Please consult and experienced board certified plastic surgeon who has an excellent reputation in your community.

Breast lift and implants on both sides.

Hi SecretLovahh.  It is hard to make a recommendation based on only oblique views, but after looking at your pictures, I think you need surgery on both breasts.  The mastopexy (lift) can be designed a little differently on the more saggy side, so you have a more symmetric final result.  It is important to understand that you should not expect to look like the girls in the pictures.  They all have different bone structure, muscle development, breast tissue quality and skin quality (among other characteristics)  than you.   A plastic surgeon can make you look more like them, but not exactly so.   Hopefully, you will look even better!  Good luck

Lewis Ladocsi, MD, FACS
Richmond Plastic Surgeon
4.8 out of 5 stars 28 reviews

Saggy Breasts

Thank you for your photos.  It is hard to determine without a photo that is straight on.  Based on what I see you will need both breasts lifted.  I would consult with several BC PSs.

Earl Stephenson, Jr, MD, DDS, FACS

Saggy Breasts

Thank you for your question. You should get a lift for both breasts so they will match post op.
The best way to determine the correct size for your implant is a consultation with a plastic surgeon. The surgeon will perform an exam and measure your chest to help you select the correct implant size. During  the consultation, you will be able to try different implant sizers to help you choose your implant size. Good luck.

Lisa M. DiFrancesco, MD
Atlanta Plastic Surgeon
4.8 out of 5 stars 34 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.