Is a breast lift necessary to achieve/maintain upper pole fullness with implants? (Photos)

Question

I am 34y/o and have been told that I have ptosis and recommended a lift but I would like to avoid this because of scarring concerns and especially because I do not want to lose nipple sensitivity. I was trans and bound them for 7 years which likely contributed to premature sagging. I want to have larger/fuller breasts especially to increase upper pole fullness so I can have cleavage and am wondering if this is possible with just OTM implants. Thank you for your time.

Zoran Potparic, MD · Answer

You will have quite an improvement with augmentation without lift. After few years you may consider a lift. A hope this helps. Good luck.

John LoMonaco, MD, FACS · Answer

You have some skin laxity and "glandular ptosis" meaning a lot of your breast tissue is below the nipple.  Adding an implant alone to "take up" the excess skin may require an implant larger than you would expect.  Be very clear about this with your surgeon. A too-small implant will not help attain your desired upper pole fullness.

Adding an implant to a breast with ptosis ultimately stretches the breast lower over time, speeding up the day you need a lift.

I do feel a lift with a modest-sized implant would be your best option.

George Volpe, MD · Answer

When being evaluated by a plastic surgeon for possible breast implants or lifting, one of the more important measurements is the distance from the nipple to the crease under the breast. Also the relationship of the nipple to the location of the crease is similarly quite important. When standing, if the nipple is lower than the crease, often a lift is required. The downside with lifting procedures of course are the resulting scars which are more substantial than just implants alone. By the photos, it is quite possible that implants alone can be used and will give upper pole fullness but this depends on a number of factors. Obviously, a larger implant will have a larger diameter and will be more likely to increase upper breast fullness.Also the type of implant profile of the implant is similarly important. Saline implants provide probably the most upper breast fullness but in a lien individual, often one can feel the implant. Silicone gel implants have undergone significant shape changes over the last 15 years or so and it is possible to get silicone gel filled implants that can help maximize upper chest cleavage. For example, the mentor SMHX Gel implant Can be a good choicewhile maintaining reasonable diameter and upper pole fullness and softness.Of course, having cleavage is a subjective term in it would be wise to bring photos with you to your consultation showing what you feel would be your best wishes and your surgeon will be able to tell you if it is realistic or not and also discuss with you why and other possible alternatives.

Yily De Los Santos, MD · Answer

Based on your photos, you appear to have mild to moderate breast ptosis. While implants alone can add volume and improve upper pole fullness, they cannot reliably correct sagging. In many cases, this may result in a “bottomed-out” appearance over time.

If preserving nipple sensation and minimizing scars are your priorities, a thorough consultation with a board-certified plastic surgeon is essential. Depending on your anatomy and goals, implants alone may be an option, but combining them with a lift is often the best way to achieve long-lasting fullness and a balanced breast shape.

Is a breast lift necessary to achieve/maintain upper pole fullness with implants? (Photos)

Answers (4)

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