Do I need a breast lift? (Photos)

Question

I want to get a boob job but the surgeons I have sent photos to 2 out of 3 of them said I need a lift aswell but I don’t like the scars would it be a bad idea to get it without a lift

Yasemin Aydinli, MD · Answer

Hi,
Based on your photos, I can see some breast asymmetry. The left breast appears to have more noticeable pseudoptosis, while the right breast has a better nipple position but still demonstrates some skin laxity.
For this reason, I would be concerned that augmentation alone may not achieve the result you are hoping for. Implants can add volume, but they do not fully address excess skin or reshape the breast envelope in the same way that a lift does. In addition, augmentation alone may leave some of the existing asymmetry unchanged.
Another consideration is implant size. A smaller implant may not provide enough volume to adequately fill and support the loose skin, while choosing a significantly larger implant simply to compensate for skin laxity can create other aesthetic trade-offs and may not produce the most balanced result.
This is likely why two of the three surgeons who reviewed your photos recommended a lift in addition to augmentation. While scars are understandably a concern, a lift often provides a more predictable breast shape, improved symmetry, and a more harmonious long-term result in patients with asymmetry and skin laxity.
Ultimately, the best approach depends on your priorities. If minimizing scars is your main goal, augmentation alone may still be an option, but it is important to understand its limitations and the possibility that you may not achieve the degree of lift or symmetry you desire.
Best wishes.

Daniel Barrett, MD · Answer

Dear jaisnsisn,

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

Mehmet Ozdemir, MD · Answer

hank you for your question.
Based on your photos, you are suitable for breast implants. However, there is some sagging present, so a breast lift is often recommended to achieve the best shape and position. Getting implants without a lift may not fully address the sagging.
A detailed evaluation would help determine the most appropriate approach for your goals.

Drew Davis, MD · Answer

The need for a breast lift is determined primarily by nipple position relative to the breast crease and the amount of skin laxity in the lower pole of the breast. When nipples sit at or below the inframammary fold, even if volume is present, a lift is typically recommended to achieve a balanced, lifted contour. Your photos indicate that the nipples are low relative to the crease, and there’s notable skin laxity. In this situation, implants alone would likely increase volume but not correct sagging, so a breast lift (with or without implants) is usually the most effective way to restore shape and placement.

Emre Guvercin, MD, FEBOPRAS · Answer

Based on cases like yours, a breast lift is not strictly mandatory, but skipping it comes with clear trade-offs.With a Preserve (tissue-preserving) implant technique, you can proceed without a lift if your priority is avoiding scars &mdash; as long as you accept that asymmetry and mild sagging may remain.Why surgeons are recommending a liftThey are likely seeing:Mild to moderate breast descentNipple position that isn’t idealAsymmetry between the two breastsA lift would:Improve symmetryRaise nipple positionCreate a more balanced, “textbook” resultSo their recommendation is about optimization, not necessity.What happens if you choose implants WITHOUT a liftWith a Preserve inner / subfascial approach:Breast tissue and internal support structures are respectedThe implant adds volume without aggressively stretching skinScars are limited to the implant incision onlyHowever:Existing asymmetry may persistNipples may still sit slightly low or unevenShape improvement is good, but not “perfect”This is a reasonable choice if scars are a major concern for you.Why Preserve technique matters if you skip the liftTraditional implant techniques rely on skin tension, which can:Worsen sagging over timeCreate bottom-heavy breastsIncrease revision riskA Preserve technique:Reduces downward forceMaintains better long-term shapeGives the best possible result without a liftImportant reality check- An implant does not lift the breast- It only fills itSo skipping a lift is not “wrong” &mdash; it’s a conscious compromise.

Andac Aykan, MD · Answer

Hello, thank you for asking this.
Based on what’s visible, you have breast sagging (ptosis), not just low volume. An implant alone would add size but would not lift the breast, and it would likely make the nipples sit even lower, leading to a heavier, less natural result.
If your goal is a good shape and nipple position, a breast lift is necessary. Avoiding a lift to avoid scars usually leads to disappointment and often revision surgery later. The scars fade with time, but shape issues do not correct themselves. I hope my reply was helpful for your doubts. 
Andaç Aykan, MD, Assoc. Prof.

Gary M. Horndeski, MD · Answer

Your breasts are low on the chest wall and the breasts are asymmetrical in volume, shape and position. If implants are placed, they have to be centered underneath the nipple-areola complex, which is below the level of the pectoralis major muscle, so the implants will end up low on the chest wall. You may be better off doing a lift by itself and then doing implants.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Donovan Rosas, MD · Answer

Patient concerns regarding the appearance of their breasts can typically be divided in two pools: volume, ptosis (droop). The procedures to address these issues are as different as the issues themselves. However, these concerns are not mutually exclusive. Many patients, whether they are aware or not, will benefit from both.
There are two factors which can help to answer the question of which surgery will deliver the most satisfying result: mastopexy, augmentation or both. Patients must first consider the position of the NAC (nipple areolar complex i.e. the pigmented portion of the breast) as it relates to the inframammary crease. If the nipples are at or below the level of the crease the patient may benefit from a lift or mastopexy. The breast lift is designed to elevate sagging breasts to a more youthful position. It also helps to reshape and tighten the skin of the breasts. This is typically accomplished via a periareolar (around the nipple) incision with or without a vertical incision. 
Mastopexy is an effective way to address sagging breast, however, the changes which accompany weight loss or pregnancy can also decrease volume of the breasts. When a woman wants the volume restored, or increased, a breast augmentation will also be needed in conjunction with mastopexy. Augmentation can help restore the volume loss which is well known to women following children. There are a number of options available to women considering augmentation ranging from size and implant type to access incision.   
A breast augmentation alone may also be appropriate if ptosis is mild. If the patient is comfortable with the natural appearance of the breasts but desires them to be larger, a breast augmentation alone is the right procedure.  Augmenting significantly ptotic or sagging breasts tends to magnify the problem. In these cases, a mastopexy performed in conjunction with an augmentation is preferred.
Based on your photos, you do not appear to need a lift. Your nipple position is preserved. the mild amount of pseudoptosis/glandular ptosis may not warrant the added scar burden of a mastopexy.
There is a procedure for every problem. To determine which technique is right for you, consult with a board certified plastic surgeon (ABPS).

Gulcin Nujen Cardak, MD, FEBOPRAS · Answer

Hello, thank you for sharing your photos. After reviewing them, I noticed that your nipples are at the level of the inframammary fold. Based on this, a breast lift does not appear to be necessary. With an appropriately selected implant size, it should be possible to achieve fuller, more lifted, and perky breasts.However, please keep in mind that a definitive treatment plan can only be determined after an in-person examination. I hope this information is helpful.

Ted Eisenberg, DO, FACOS, FAACS · Answer

Do I need a breast lift? You might not need one.  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

Do I need a breast lift? (Photos)

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