BA and Uplift with Large BWD, What are my Options? (Photos)

I'm having a Breast Augmentation lollipop lift. My BWD is 15cm. My surgeon has told me that the largest cc I could go to will be 335cc with a diameter of 12.4cm over the muscle. I'm worried that I'll look odd with an implant that is too small, but if I can't get a larger implant because of the amount of skin left from my uplift and the strain it would put on my incisions then what are my options? Thanks I'm 5' 6" 9st 4lbs Currently a droopy 34C

Doctor Answers 8

Options for aug and lift


You have the beginnings of a good future result in part because of the shape and symmetry of your breasts.  Breast augmentation is designed to improve volume and brast lift is designed to rshapr the breast.  Pick the implant size that gives you the look that you are going for first.  This can be done by trying on the implants under a sports bra or tight T-shirt in your plastic surgeons office.  The implants should be MP+ or HP as anything with less projection that that is unnecessary for you.  Once the implants are chosen the BWD should be close to the diameter of the implant but do not have to be identical since there is some play there and measuring the BWD on top of your breasts is just an estimate of whats going on inside your breast.  I would have your plastic surgeon do the augmentation first and then sit you up in the operating room.  This process will tell him/her what type and how much of a lift you will need if any.  A lollipop lift is likely the best option.  Finally, although I am a big fan of subfascial, I think you should consider under the muscle from your photos.

All the best,

Dr Repta

Scottsdale Plastic Surgeon
4.9 out of 5 stars 165 reviews

BA and Uplift with Large BWD, What are my Options? (Photos)

You might consider 2 operations. First the L-shaped lift than allow 3 months of healing than do a larger implant like 450 cc range. This allows a choice. Also the expander implant is a good idea in your case. Best to discuss further options before consenting to the planned surgery. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 174 reviews

Answer to breast augmentation/lift question

I would generally agree with the other surgeons who have responded and not recommend placing the implant over the muscle.  You appear to have a relatively thin skin envelope with little existing breast tissue in the upper poles of your breasts.  Visibility, palpability, and rippling may be more of a problem if the implants are placed above the muscle.  The capsular contracture rate may also be somewhat higher.

You may be able to use an implant larger than 335 cc's, but it is unlikely that I would place an implant larger than 400 cc's if a lift is also done.  In addition, I believe that your surgeon should be careful not to move your nipples too far upward at the time of the lift.  Your nipple already appears to be at the level of your infra-mammary fold (based on your lateral photograph).  Placing the nipple too high can result in an unusual breast appearance, particularly if the lower pole of your breasts relaxes after surgery.  This can be a difficult problem to correct.  Staging the procedures (implant first followed by lift, if necessary) is also not a bad way to go.  Good luck.

Eric T. Emerson, MD, FACS
Charlotte Plastic Surgeon
4.7 out of 5 stars 28 reviews

Breast lift and implants

First, I think just from your photos you are not a 15 cm BWD. Most women I see are between about 10.5-12 and you look about the same size as most of the women I see in my practice. As for the right implant for you, it would be hard to say without seeing you in person.  Certainly a vertical lift( lollipop) should probably be ok.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

You may be happy with breast augmentaion alone

The combination of the lift and implant has much higher risks like implant malposition,thicker scar and nipple loss. You have grade II ptosis and you can get good result with breast augmentation alone(sub muscular,400 cc ,High profile,silicone).If you find that your breast are saggier that you were expecting, you can get breast lift later on. Most patient do not like the staged approach because of two surgery,but it is much safer and predicable.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.7 out of 5 stars 124 reviews

BA and Mastopexy

I agree that your implants should be placed behind the muscle.  The are some long term benefits with being submuscular.  Seeing as you will be having a lift there is no reason why you can't go behind the muscle.

Jeffrey Hartog, MD
Orlando Plastic Surgeon
4.5 out of 5 stars 60 reviews

BA and lift options

I would agree with a lollipop lift based on the photos you showed. You could go slightly larger in implant but that seems to be a good size based on the amount of breast tissue you have and the size of your abdomen. I suggest you go online to look and befores and afters looking for someone who looks like you starting out, and you like the post op result. then sit down with your surgeon to discuss things.

Rick Rosen, MD
Norwalk Plastic Surgeon
5.0 out of 5 stars 22 reviews

Breast augmentation and Lifting

Thank you for the question and pictures.

I do not want to sound critical but I would not recommend sub glandular breast  augmentation in your case. I think the chances of complications such as significant rippling/comparability/ encapsulation  are much greater with this approach.

You are correct, that when mastopexy is being performed, care must be taken with selection of breast  implant size  to avoid  complications.

Please make sure you're working with a well experienced board-certified plastic surgeon. It will be very important to communicate your size goals with your surgeon.  In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or “C cup” or "fake looking" or "top heavy" means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.
I use  intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison.
I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible.
By the way, the most common regret after this operation, is “I wish I was bigger”.

I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,498 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.