Augmentation VS Lift. Advice? (photos)

From your photo and description of your goals, you would have the best results from an augmentation and lift. You can select a conservatively sized implant to give you more upper pole fullness without a lot of volume. Nipple sensation changes are a risk with either procedure, but are not common. Patients may notice sensation changes right after surgery due to swelling, but most recover normal sensation within a few weeks to months.

I recommend an in person consultation with a plastic surgeon to discuss your goals and be measured. 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

Dear Trustworthy809869,
determining whether you need simply a breast augmentation versus a breast lift can be somewhat complicated. It depends on a number of factors including skin laxity and current nipple position. Generally speaking, if the nipples are lower than the inframammary line the patient will most likely need a breast lift. If the nipples are at or above the inframammary line we can generally get by with just a breast augmentation depending on the size of the implant the patient wants. I often still using implant when I perform a breast lift because it provides more upper breast fullness after the lift. To be sure a consultation with a board-certified plastic surgeon will help determine what the patient actually needs.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Good afternoon,
You need a donut mastopexy (breast lift) as well as submuscular placement of saline or silicone gel implants, depending on your preference. We would figure out the exact size and profile when I measure your chest, we review photos together, and you have an opportunity to try on the implant sizers here in the office! The nice thing about the donut mastopexy is that the scars are well hidden around the outer border of the areolas, there is no vertical scar (yay!!), and I find that this type of lift does not inmterfere with breastfeeding or nipple sensation!

The technique I recommend is The Bellesoma Method. 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. 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 totally submuscular, if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Thank you for sharing your question and photograph.  Unfortunately based on the limited view supplied it is difficult to offer definite advice, but it appears that you would most benefit from implant placement and a lift.  The implant will help restore lost breast tissue after pregnancy and weight loss, while the lift will remove excess skin and allow for resizing and repositioning of your nipple into a higher, more youthful, position.  Hope this helps