BA only or lift too? I have insufficient glandular tissue. (Photos)

Hi jcchuq,

Determining whether you need simply a breast implant versus a breast lift or both 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 breast augmentation depending on the size of the implant the patient wants. I often use an implant when I perform a breast lift because it provides more upper breast fullness after the lift.

These two surgeries can be done at the same time and this may be optimal as the risks can be minimized. 

In addition, upper pole fullness is achieved with appropriate implant selection but more importantly, submuscular placement, and precise pocket dissection. The submuscular placement allows the muscle to cover the top part of the implant which allows the upper pole to appear fuller. Keeping away from the lateral chest during pocket dissection allows the implant to remain higher and prevents it from falling off to the side.

You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.

Daniel Barrett, MD, MHA, MS

Certified, American Board of Plastic Surgery

Member, American Society of Plastic Surgery

Member, American Society of Aesthetic Plastic Surgery

Given your shape and shorter nipple to breast fold distance I think we are limited in the size of implant that can be used. Too big of an implant like the picture you like will not fit in your breast soft tissue envelope. It would not be a stable long term result. I agree with Dr. Reish good luck!

Hello and thank you for your question. You are a great candidate
for a breast augmentation using a dual plane technique without need for a formal lift.  The size, profile, and shape of the
implant is based on your desired breast size/shape, your chest wall
measurements, and soft tissue quality.  This decision should
be based on a detailed discussion with equal input from both you
and your surgeon.  This entire surgery
can be performed with a small incision technique.  Make sure you
specifically look at before and after pictures of real patients who have
had this surgery performed by your surgeon and evaluate their results.   The most important aspect is to find a
surgeon you are comfortable with. I recommend that you seek consultation with a
qualified board-certified plastic surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D. FACS
Harvard-trained plastic surgeon

Your one photo from the side shows your nipple above your breast fold. You should do well with a well done dual plane augmentation. This pocket is below the muscle which I almost always recommend due to less capsular contracture rates and more natural look and feel. Discuss all with your plastic surgeon. Good luck.

Thanks for your question.Most large weight patients with breast sag will require some type of lift with their augmentation for the best results.  It really depends on the exam by your board certified Plastic Surgeon, if the quality of your skin and its elasticity are adequate - implants may work.  It is too much skin for the amount of volume.  Either add Volume or Remove skin - or a combination of both.