What procedure for mother of 1's breasts? (Photo)

After having my child, my breasts are deflated and asymmetrical. My right areola has become stretched. I do have some sagging, but I am unable to judge if it is mild, moderate, or severe. I am not sure if I should aim for a lift, a lift with augmentation, or if I can get away with simple augmentation and having my areola fixed or tattooed over. I know this is no substitute for an in-person consultation, but I'm not ready to buy yet.

Doctor Answers 20

Breast lift with implants

 In this scenario, I can only tell you what I would do given the pictures you have shown. I would recommend a vertical mastopexy with removal of breast tissue from the right so as the amount of the gland be the same, then, a breast implant of small to moderate size would be recommended to still the upper portion of the breast. Having similar size breasts to begin with, and the same breast implant size, in my hands has led to a greater persistence of symmetry throughout different changes of weight. Good luck Seek out a board-certified plastic surgeon in your region to discuss these options.


Louisville Plastic Surgeon
4.7 out of 5 stars 44 reviews

Breast ptosis

You appear to have breast asymmetry and ptosis and deflation of your breasts. In my opinion you should have a very nice result with augmentation and mastopexy. This will correct your asymmetry, lift your nipple and give you the projection and fullness you are looking for. It is best that you meet with a board certified plastic surgeon and together you can choose the implant size that will give you the result you are looking for.

Mark Deutsch, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 28 reviews

Breast Lift is a must

Hello and thanks for reaching out to us! Based on your photos, I think you would benefit most from a breast lift with implants. When I discuss with my patients about breast lifting techniques and also use of implants, I break down the different topics into parts.

The easy way to decipher what each procedure produces is that implants increase breast volume and add upper pole fullness. Implants are placed in either a subglandular or subpectoral pocket centered over the left and right chest breast footprint. In your case, because your skin appears thin, I would recommend subpectoral placement. When you have ptosis/sagging, where the nipple-areola complex is at the fold or lower, your breast will continue to hang off of your chest onto your upper abdomen even after implants. In fact, in patients with such sagging who undergo an augmentation without a lift, their breast tissue hangs off of the implant that is sitting on their chest, creating a shape like Snoopy's nose, hence called a "snoopy" deformity. Implants can not give a therapeutic lift and taking shortcuts will only lead to suboptimal results. In some borderline cases of ptosis, breast augmentation can be performed and if there is unsatisfactory sagging, then a lift can be performed later at a second stage, but in your case, an in person examination with a board certified plastic surgeon will be most instrumental in going over your lifting options in conjunction with implants.

Two lifting techniques that are very good ones in the right patient and I use are based on the following:
1) if it is mainly the nipple position that needs lifting, I like the circumareolar approach (also called a donut lift)
vs
2) if a large portion of the breast tissue/weight needs to be lifted, a circumvertical and sometimes a full anchor incision is needed as the circumareolar approach in my mind is not strong enough to hold the weight of the breast and results in stretching of the areola and drooping over time.

Click on the link referenced below and scroll down and the two examples listed are of patients whom had both mastopexy and augmentation and you can see one patient in whom the circumareolar approach was sufficient whereas the other needed the circumvertical incision. I hope this helps you!


Sincerely,
Dr. Sean Kelishadi

Sean Kelishadi, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 22 reviews

Breast lift

Thank you for your question and photos.  It appears that you would be an excellent candidate for a full breast lift based on the significant sagging of your breasts.  Whether or not you would like a small implant as well is dependent upon your surgical goals that you will discuss with your board-certified plastic surgeon.

All the best,

Dr. Results
Miami, FL

Postpregnancy issues with breast shape

Good question-- one this to consider is that you want to make sure you have fully progressed through any changes after the pregnancy, that your breast have reached a new, stable condition, no longer lactating, deflating, etc.  So, your idea to do your research is a good one, as long as you keep in mind that some subtle changes may still be in store, depending how far postpartum you are (some patients breast feed longer or shorter than others).

Because the nipple is below the crease beneath your breast, most surgeons are going to recommend a breast lift, to reposition the gland and nipple (I agree).  This typically makes your breast cup size slightly smaller, and does not provide much fullness in the upper pole of the breast (i.e. cleavage).  To be fuller or to have more cleavage, you may want to talk to your plastic surgeon about implants.  An implant alone will likely make your breast look even saggier, and will stretch the tissues more over time.  Please resist the urge to have a large implant placed to "fill the loose skin"-- this results in sagging, more atrophy of the breast due to the weight of the large implant-- the lift involves some additional scarring, but the results in terms of shape are worth it.

Best wishes,
--
Erik Hoy, MD

Erik Hoy, MD
Warwick Plastic Surgeon
5.0 out of 5 stars 2 reviews

Significant ptosis of the breast cannot be camouflaged by breast augmentation.

The picture demonstrates significant ptosis of the breasts. In lesser circumstances of breast augmentation alone can camouflage this problem. In your case however I think a mastopexy will be a requirement for a good aesthetic result. Breast implants would be indicated if you want to be larger.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 32 reviews

What should I do?

From your photos, you appear to need a lift on the right side for sure and possibly on the left side as well.  This would best be determined as you stated with an in person exam.  If you desire fullness in the upper pole of the breasts, then placement of implants would be warranted as well.

Todd C. Case, MD
Tucson Plastic Surgeon
5.0 out of 5 stars 55 reviews

Breast lift with Breast Augmentation

Thank you for your question. You are likely an excellent candidate for a breast lift with an implant. Given that you are asymmetric at baseline with widened areolas, the lift will help to make you more symmetrical. You also used the word "deflated" - this is why an implant at the time of the lift is likely what you're looking for. Some things to consider - the type of implant (silicone vs. saline), and whether you are done having children. Most women are opting for silicone implants, given their more natural feel. As you know, with pregnancy the breasts can change again - some women opt to have their breasts lifted after having their last child. As you know, an in-person examination is your best option. Best of luck! 

Which procedure?

Thank you for your question and providing photos. Based on the photos provided I believe a breast lift can take care of all your concerns. A breast lift alone will leave your breasts smaller. If you want your breasts the same size or larger a breast implant will be required for the additional volume. I would recommend consultation with a board certified PS. Best of luck 

Breast lift

Hello. You are a candidate for a BL with or without small implants and an areolar reduction. An implant procedure without a lift would be ineffective in recreating a beautiful, youthful breast. See a BCPS, cerification matters. 

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.