Would a lift be needed? If so, would a periareolar lift be acceptable versus a full lift? (Photo)

I have had two consults regarding a breast aug- I am 5'5" 150# and have breast fed 2 kids. I am wanting to restore my breast to pre pregnancy appearance! One consult said no lift was needed based on measurements the other said absolutely a full lift was needed (no measurements taken) and the implants and lift would need to be completed at different times! I'm hesitant to go for a full lift due to scarring but at the same time I don't want an aug that I'm unhappy with

Doctor Answers 21

Augmentation without Lift

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Dear kbegley,

Your pictures indicate that you have pseudoptosis (fake drooping). That means the nipple areolae do not need to be lifted up as they are already higher on your torso than the underlying breast fold. This means that there is a mismatch of more skin envelope than contents. You are a perfect candidate then for breast augmentation without a lift. That will restore the balance between the skin envelope and the breast contents. The only reason to entertain a full lift with or without implants is if you wanted the highest-riding, roundest, Barbie doll type breasts.

I hope this has been helpful.

Robert D. Wilcox, MD

Dallas Plastic Surgeon
4.1 out of 5 stars 22 reviews

Minimal scar breast lift without implants

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You may be a candidate for The Horndeski Method breast lift that does not require a vertical incision or the extra risks and complications associated with breast implants. The pictures you submitted are not standardized photos. Please view the video attached to see an example of what can now be achieved with current techniques. The patient shown did not have breast implants placed.
I hope this helps.
Best wishes and kind regard,

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

To lift or not...

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You are a borderline candidate for a lift and would more than likely benefit from one. However, for my patients that really do not want scars, I do suggest doing an augmentation first and allowing time for the implants to settle, at least 6 months. If they are satisfied with the appearance then we continue to observe. If not, then we discuss options for a lift. Quite frankly, although my augmentation mastopexy procedures are always in one stage in non-smokers, doing a lift in 2 stages is generally safer anyway. Good luck with your decision! 

instagram: @mesbahimd

Alex N. Mesbahi, MD
McLean Plastic Surgeon
4.8 out of 5 stars 24 reviews

Augmentation Mastopexy

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Neither surgeon is correct.

To get the best result possible, you'll need a full lift.  Periareolar lifts are for very small, deflated breasts, with minimal ptosis. Surgeons that do it in two procedures do so because of the high complication rate of performing a full lift and augmentation simultaneously. However, there are many surgeons that perform this surgery frequently without significantly higher complications. 

Go visit a few ABPS certified/ASAPS member surgeons that specialize in cosmetic breast surgery. 

Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 100 reviews

To lift or not to lift?

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You will need to make a choice between two competing objectives, each of which is valid.  One goal is to restore the pre-pregnancy appearance of your breasts.  The other is to avoid the scars of a lift.  If it is important to bring your breasts back to the position where they were before your pregnancy, only a lift, possibly combined with implants, will accomplish this objective.  If you are willing to accept fuller breasts that are lower than their pre-pregnancy position, then a simple augmentation will probably suffice.  Peri-areolar lifts offer a mild re-balancing of the breasts, but their power is limited.  Best of luck.

John Q. Cook, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 12 reviews

To lift or not to lift?

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Whether it will be or not to be depends more on your stated goal of returning to your prebaby shape and volume.  If you want your breasts not to rest on your upper ribs, as they appear to in your photos, then a lift is your best bet.  If you are scar adverse, then a breast augmentation alone can fix the volume issue but you will have some relaxation of your breast gland.  Suppose you could see if you like the results from your augmentation alone and get a breast lift later if you aren't satisfied with your results.  Perhaps another opinion will help clear up your best option.  Why not ask your OB/GYN for their opinion. They will be most familiar with your local plastic surgeon's work.  Best wishes

Craig Harrison, MD, PA
Tyler Plastic Surgeon

Breast augmentation

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From the looks of your pictures I would guess that you do not need a lift. Since you are very concerned about the scars I would suggest doing the augmentation 1st and see if you like the results. If you think you still need a little bit higher position for the nipple then a lift could be done later.

Good luck!

Mark T. Boschert, MD
Saint Louis Plastic Surgeon
4.9 out of 5 stars 37 reviews

You have glandular ptosis

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Breast implant with skin tighetening and not a formal lift will give you your best results. It should be done as one operation. Scarring wll be small price to pay for better aesthetic outcome.

Vasdev Rai, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 24 reviews

Breast Lift vs Implants

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What has happened to your breasts is very natural. Due to weight loss or pregnancy many women's breasts will deflate over time. The solution is either to fill up the excess skin that you do have with an implant, tighten the skin with a lift, or some combination of the two. An augmentation with an implant will result in less scarring but your breasts will still be lower on your chest. The lift is appealing to some women because it is more natural and does not require an implant, but there is much more scarring involved. A board-certified plastic surgeon with experience in cosmetic breast enhancement should be able to help you determine what will give you the results you're looking for.

Would a lift be needed? If so, would a periareolar lift be acceptable versus a full lift

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Without seeing pictures of what you were before the pregnancy, it is hard to say what wold get you closer to that idea. An implant alone will give you more roundedness on the upper part of the breast, as well as make you bigger, but the new breast mound will be no higher on your ribcage. It will remain in its present position, no higher.

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.8 out of 5 stars 27 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.