Pseudoptosis? Lift or just augmentation? (Photo)

Question

I'm scheduled for a consult with a surgeon next month but in the mean time, I would like to get as much an idea as possible about what I'll be looking to have done. I've included photos of my breasts and also of breasts that I find appealing. My goal is not to have round globes in the center of my chest. I would like a bit of natural slope but with much more fullness. I don't want to go huge but big enough (specific, right?) Thank you for any input!

Ted Eisenberg, DO, FACOS, FAACS · Answer

I believe that you could get a good
result with an implant alone. Oftentimes, an augmentation can give the illusion
of a lift. As the implant fills out the upper portion of the breast, it
also fills out the lower portion, which makes it appear as if the nipple
is located higher on the breast. After a minimum of 9 months, when the
implant has settled, you'll have a better idea whether or not you think they are
perky enough. You can always get a lift later if needed. For more information on this and
similar topics, I recommend a plastic surgery Q&A book like "The Scoop
On Breasts: A Plastic Surgeon Busts the Myths."

Kenneth Bermudez, MD, FACS · Answer

It appears that you have a degree of pseudoptosis and breast implants or autologous fat grafting are possibilities. Please consult with a board certified plastic surgeon that can give you all of your options.Good luck.

Gerald Minniti, MD, FACS · Answer

Hello,Your breasts do demonstrate at least pseudoptosis, and perhaps more; only physical examination will be able to determine that. In my hands, I prefer to lift the breasts in these borderline situations, as I know that it won't be long that the implants just settle into the soft tissue envelope making for increased pseudoptosis with little upper pole fullness.  Unfortunately, so often we focus on a photograph of a patient and her results, and we don't realize that this is literally a snapshot in time.  What we don't realize is that result is always in evolution; what looked good then doesn't look so good in a few months or years. I urge my patients to look towards the future too, to eliminate the need for repetitive reoperations and complications. In this vain, I encourage lifts when necessary, the use of inframammary incisions for implant insertion, proper implant sizing based on anatomic measurements, and the use of textured, anatomically shaped, highly cohesive, form stable silicone gel implants. Best of luck!

Austin Hayes, MD · Answer

It appears that your nipples are above the level the crease below your breasts. I'm not sure that you would benefit from a lift. Of course an in person examination is required for definitive recommendations.If you're unsure about having a lift, it's important to understand it can always be done during a second procedure. There may be some additional cost if you have a second procedure, but separating the procedures gives you the opportunity to see how you look after just an augmentation. Many patients will be happy with just an augmentation alone, and they won't have the extra scars from the breast lift.

Thomas Trevisani, MD · Answer

In my opinion- the best result in your case will be achieved with a mastopexy ( breast lift) and implants placed sub-muscular.

Scott C. Sattler, MD, FACS · Answer

Based on your photo - I would suspect that a breast lift to eliminate the sagging breast tissue that you have (pseudoptosis) would be a consideration in a surgical plan, if you met with me. Check out the link I provided for a before/after example.

Jed H. Horowitz, MD, FACS · Answer

One of the primary intended result of a Breast Lift (#Mastopexy) is to improve
the shape and position of the breast without reducing their size. It is used especially for breasts which sag or droop (#ptosis). Many women have more satisfying results if an implant is used at the time of #mastopexy. The implants better shape their breasts and restore superior
fullness or volume which may be lacking due to #ptosis. In regards to implants alone, this is usually said to be mistake  by patients reflecting back at the decision. Most breasts will look larger and
more droopy with solely implants.  They will sag more and
sooner,  due to the sudden and excess weight. At times it's possible for a “Snoopy”
breast or double bubble to develop as a result.Additionally, an implant with lift may be useful to re-position the nipples which may have been affected by ptosis or drooping. Your Plastic Surgeon will measure you to determine the best shape and size of the implants to be used. Shaped implants are all textured and should not rotate when used properly. In my practice, about 20% of the patients benefit from shaped implants.

Tania Medina de Garcia, MD · Answer

Hello dear, thanks for your question and provided information as well... The breasts may lose their elasticity and firmness
which can be caused by different factors such as pregnancy, massive weight
loss, lactation and aging. To reaffirm the breasts and restore the natural look
your surgeon can perform a mastopexy or breast lift with augmentation such as soft cohesive silicone implants, you will get very nice results, hugs!

Richard J. Wassermann, MD, MPH, FACS · Answer

Hello and thank you for reaching out. From the photos you have provided, and without a physical exam, it is hard to determine which procedure I would recommend for the best results. I find that most women are very satisfied with a mastopexy augmentation, or a lift with implants. To place an implant in a breast that already has ptosis (sagging) can sometimes only further the issue of ptosis, but only after a physical exam would I be able to tell accurately. I would suggest asking for information on both procedures at the time of your consultation. Best Wishes.

Zachary Farris, MD, FACS · Answer

Thank you for your question and photos.  Indeed, it looks like you have pseudoptosis.  In a situation like this, I think breast implants would be great, improving your fullness and volume.  Placed under the muscle, it will give you a nice slope.  A physical exam is required to determine if you need a lift as well.  It seems that you have reasonable expectations; showing your surgeon your desired breast size with those pics is a great idea.  Be sure that your plastic surgeon is experienced and is certified by the American Board of Plastic Surgery.  Good luck!

Pseudoptosis? Lift or just augmentation? (Photo)

Answers (16)

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