Breast Lift - Should I or Shouldn't I? Above or Below the Muscle? (photo)

After two pregnancies and nursing I have been left with empty and saggy breasts.. I 've consulted with a few doctors and have been advised to go under the muscle to achieve the fullness I am looking for as well as over the muscle to avoid a lift. I am 5'9", 135lbs, Sternal NotchtoNipple=22cmR,22.5cmL, NippletoFold=8.5cmR&L. Ultimately I'd like to achieve the appearance of a fuller and less droopy breast. Can this be accomplished with an augmentation alone? It seems most of you are suggesting a lift but I wanted to be a bit more specific. In considering a lift I'm not thinking about ending up with super perky breasts. I actually like the way they fall and in a perfect world I'd like to have less of my breast resting on my rib cage and am only interested in gaining an inch of vertical lift with of course volume. Can I do this with augmentation alone?

Doctor Answers 20

Breast augmentation of the deflated breast

I think you actually might be able to do ok with a breast augmentation without a lift. I say this because you have not very much ptosis and are more of a volume problem then a skin excess problem. I do not think there is a plausible way to do your surgery well with an implant over the muscle as you are just too thin and would have trouble with implant visibility and ripples.  For a procedure like yours, the implants I would probably suggest are one of the two lower height style, high profile shaped devices (round based or oval based)  from Sientra in the low-mid 400 cc range depending on where you're breast width is. These implants differential shape and very high lower projection are effective in addressing borderline or mild ptosis.

Breast augmentation of the deflated breast

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I think you actually might be able to do ok with a breast augmentation without a lift. I say this because you have not very much ptosis and are more of a volume problem then a skin excess problem. I do not think there is a plausible way to do your surgery well with an implant over the muscle as you are just too thin and would have trouble with implant visibility and ripples.  For a procedure like yours, the implants I would probably suggest are one of the two lower height style, high profile shaped devices (round based or oval based)  from Sientra in the low-mid 400 cc range depending on where you're breast width is. These implants differential shape and very high lower projection are effective in addressing borderline or mild ptosis.

Breast Lift - Should I or Shouldn't I? Above or Below the Muscle?

You have some minor ptosis and very thin breasts with minimal tissue. I would place silicone implants under the muscle combined with a vertical (lollipop) lift. I think without a lift you will look very saggy. The scars usually heal very well and you would have a much better shape as well.

Breast Lift - Should I or Shouldn't I? Above or Below the Muscle?

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You have some minor ptosis and very thin breasts with minimal tissue. I would place silicone implants under the muscle combined with a vertical (lollipop) lift. I think without a lift you will look very saggy. The scars usually heal very well and you would have a much better shape as well.

Breast enalrgement, breast lift, fat transfer

I am not a big fan of the scars breast lifts leave on patients breasts.  By the look of your photos, I would recommend a breast enlargement alone.  80 to 90% of my patients are happy with the enlargement.  They are also happy they did not spend the extra money and they are happy not to have the extra scars.  Good luck with your decision.

Ralph W. Bashioum, MD
Minneapolis Plastic Surgeon
4.2 out of 5 stars 17 reviews

Breast enalrgement, breast lift, fat transfer

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I am not a big fan of the scars breast lifts leave on patients breasts.  By the look of your photos, I would recommend a breast enlargement alone.  80 to 90% of my patients are happy with the enlargement.  They are also happy they did not spend the extra money and they are happy not to have the extra scars.  Good luck with your decision.

Ralph W. Bashioum, MD
Minneapolis Plastic Surgeon

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Breast Augmentation with or without the lift

Thank you for sharing your photos.   In order to get an inch of vertical lift and to achieve fullness with "the breast off the rib cage", I would recommend that you have a peri-areolar breast lift with implants placed under your muscle.   

Dr. Gill

Breast Augmentation with or without the lift

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Thank you for sharing your photos.   In order to get an inch of vertical lift and to achieve fullness with "the breast off the rib cage", I would recommend that you have a peri-areolar breast lift with implants placed under your muscle.   

Dr. Gill

Breast augmentation, implants and possible mastopexy

Your breasts do look rather deflated in the picture after having your children.  But it is difficult to tell skin quality by a picture and it is better to do it by exam.  I would anticipate that breast augmentation alone would be most beneficial.  I prefer under the muscle, to hold the implants in good position.  You could wait 6 months and see if you need a breast lift later.  Hopefully you will be satisfied with the outcome of augmentation alone.  Visit with a board certified plastic surgeon for a full assessment.

My best to you.

Breast augmentation, implants and possible mastopexy

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Your breasts do look rather deflated in the picture after having your children.  But it is difficult to tell skin quality by a picture and it is better to do it by exam.  I would anticipate that breast augmentation alone would be most beneficial.  I prefer under the muscle, to hold the implants in good position.  You could wait 6 months and see if you need a breast lift later.  Hopefully you will be satisfied with the outcome of augmentation alone.  Visit with a board certified plastic surgeon for a full assessment.

My best to you.

Below muscle and simultaneous lift

You are an excellent candidate for a new technique called Breast Augmentation with Mini Ultimate Breast Lift.  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 gives maximum anterior projection with a minimal size implants.  Small silicone gel implants placed retro-pectoral look and feel more natural, are more stable, less likely to ripple or have complications needing revision. 

 

Best Wishes,

 

Gary Horndeski, M.D.

Below muscle and simultaneous lift

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

You are an excellent candidate for a new technique called Breast Augmentation with Mini Ultimate Breast Lift.  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 gives maximum anterior projection with a minimal size implants.  Small silicone gel implants placed retro-pectoral look and feel more natural, are more stable, less likely to ripple or have complications needing revision. 

 

Best Wishes,

 

Gary Horndeski, M.D.

Above or below the muscle

If you were my patient, I would reccomend below the muscle and a vertical lift because you specifically requested getting some of your breast off of the rib age.  Good luck.

Above or below the muscle

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If you were my patient, I would reccomend below the muscle and a vertical lift because you specifically requested getting some of your breast off of the rib age.  Good luck.

Breast augmentation without a lift

Thank you for your question and posting appropriate pictures. You seem to be a good candidate for breast augmentation alone using silicone gel implants partially under the muscle. Please see a board-certified plastic surgeon can examine you and ascertain your candidacy. Even if there is a question of a lift, this could be staged to be performed a later time avoiding any breast lift scars at the initial operation.  Best of luck. 

Breast augmentation without a lift

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Thank you for your question and posting appropriate pictures. You seem to be a good candidate for breast augmentation alone using silicone gel implants partially under the muscle. Please see a board-certified plastic surgeon can examine you and ascertain your candidacy. Even if there is a question of a lift, this could be staged to be performed a later time avoiding any breast lift scars at the initial operation.  Best of luck. 

Deciding whether or not to lift

If your goal was to be super perky, I would definitely recommend a lift, but since you are happy with how your breasts fall against your chest, I think you would have a great result with a dual plane breast augmentation using a silicone implant.  The dual plane approach. allows me to position the breast implant partially under the muscle.  Unlike implants placed completely under the pec muscle, with a dual plane approach, the implant can settle nicely into your breast skin envelope.  I would recommend silicone for you since you have little breast tissue.  A dual plane breast augmentation is great for giving the appearance of less droop without creating breast lift scars. Please see the link below for one of my patients whose before pics are similar to yours.

Deciding whether or not to lift

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If your goal was to be super perky, I would definitely recommend a lift, but since you are happy with how your breasts fall against your chest, I think you would have a great result with a dual plane breast augmentation using a silicone implant.  The dual plane approach. allows me to position the breast implant partially under the muscle.  Unlike implants placed completely under the pec muscle, with a dual plane approach, the implant can settle nicely into your breast skin envelope.  I would recommend silicone for you since you have little breast tissue.  A dual plane breast augmentation is great for giving the appearance of less droop without creating breast lift scars. Please see the link below for one of my patients whose before pics are similar to yours.

Breast Lift - Should I or Shouldn't I? Above or Below the Muscle?

You have more deflation than droop and should get a very nice result with only an augmentation, but it will be slightly low on your chest just as your natural breast location is a little low. You will get the nicest result with silicone subpectoral implants.

Breast Lift - Should I or Shouldn't I? Above or Below the Muscle?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

You have more deflation than droop and should get a very nice result with only an augmentation, but it will be slightly low on your chest just as your natural breast location is a little low. You will get the nicest result with silicone subpectoral implants.

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