Would like a BA with a lift. Is removal of breast tissue typical for larger breast that have sagged? (Photo)

I am 30 years old 5'3, 113lbs and a 34C. Want to be no larger then a D cup. One PS said I am not a candidate for a lift. A 2nd PS Recommend a BA with a lift suggesting that he remove as much breast tissue as he can, so that they don't fall a year later. He mentioned my breasts are heavy, dense and I have thin skin. Does the removal of breast tissue cause any lumpy or uneveness? What are my chances of the breast falling back to where they are now, after surgery? Nervous, suggestions appreciated

Doctor Answers 16

Augmentation Mastopexy With Tissue Removal

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Although your pictures are helpful, it's virtually impossible to make a specific recommendation without a physical examination. Depending upon this examination, you might need a dual plane breast augmentation or possibly the combination of breast lift and breast augmentation surgery. Irregardless of the procedure chosen, it's safe to say that removal of significant amounts of breast tissue isn't necessary.

If you're considering this type of procedure, consultation with a board certified plastic surgeon is appropriate. This surgeon should be able to formulate a treatment plan that addresses your concerns and avoids the unnecessary removal of breast tissue.

Augmentation Mastopexy for Larger Sagging Breasts

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Often times the sagging is too great to be treated by implants alone. In addition, adding an implant gives both volume and shape to the newly lifted breast. #Augmentation/Mastopexy. This procedure can also be combined with a minor breast reduction to reduce the breast width if desired.

There are a variety of techniques for these operations. Lollipop lift (vertical lift), donut (periareola) lift, Benelli lift, crescent lift, anchor lift (inverted T ). The nipple-areola complex is repositioned higher, the excess skin is removed, and the breast is reshaped in a pleasing contour and in a more normal position. I prefer to use a #shortscar technique, #LollipopScar or #DonutLift” rather than the majority of surgeons in the United States that use an anchor pattern lift which involve more significant scarring.

BA with a lift?

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Thank you for the question and the photos. I will echo the other responses that none of your tissue needs to be removed. A good reshaping of your breasts can be done with a sub-muscular augmentation and a lift or possibly with a shaped silicone gel implant as well. Discuss your options with a board certified plastic surgeon.

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Would like a BA with a lift. Is removal of breast tissue typical for larger breast that have sagged?

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I would not remove anything other than skin.  Breast augmentation with a lift would be a reasonable option just based upon the pictures, but an exam will be necessary to make a determination. Find an expert in breast surgery who has great reviews and great before and after photos.

Kenneth Hughes, MD

Los Angeles, CA

Do not remove breast tissue to make room for implants during a breast lift.

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You have very normal breasts  with a slight amount of ptosis.  Your a good candidate for a sub-muscular breast augmentation with a breast lift.

I agree with your fear that if an attempt is made to remove breast tissue that could create lumps bumps and irregularities and divots in the breast.  You have very nice breasts with good breast tissue which simply can be lifted and the size enlarged and fullness gained with the use of submuscular implants.  Seek consultation with a board certified plastic surgeon who is experienced and has explanations makes sense.

Breast lift with Breast Implants

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Thank you for your question.

Yes, from the pictures, you appear to be a good candidate for a breast lift with implants.  You also appear to have enough of your own breast tissue that you could have textured implants placed above the muscle if you want.  Under the muscle is fine too.

I wouldn't have too much of your own tissue removed.  This could contribute to scarring and also lead to implant rippling. Only a small central strip at the bottom needs to be removed.

The good news is you appear to be a candidate for an excellent result.

To be sure what is best for you, see two or more board-certified plastic surgeons in your area for a full and complete evaluation to make sure you are a good candidate and that it is safe for you to have surgery.

I hope this helps.


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Your breast tissue sits primarily below your muscle. Therefore an implant placed under the muscle will require some lifting of the breast tissue.   Some tissue may need to be removed however it depends on what you are trying to achieve.  I typically take a small amount of tissue in order to create a proper breast contour, however this is not always the case. If you place the implant over the muscle, this will likely lead to more sagging (a ball in sock appearance) over time if you do just the augmentation. That being said, it's difficult to say without a proper evaluation and consultation.

Alberto Aviles, MD
Detroit Plastic Surgeon

Breast Lift With or Without Implants

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If you wish to be larger than an implant for fat transfer to your breast and in particular the upper portion would be required. A  lollipop type of short scar lift can be done to have more of your breast higher on your chest wall. Although an exam is required I do not think you need breast tissue removed.

Breast Lift with Implants

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Your nipple height looks good, as it appears to be above the crease.  I would not remove tissue.  I would have to measure you, but I think you could consider a dual plane internal breast lift.  See the web reference below for illustrations.  Yes, your tissue could re-stretch, this is always a risk after a lift.  Be sure to see only a board certified plastic surgeon (by ABPS - The American Board of Plastic Surgery) who is a member of ASAPS (The American Society for Aesthetic Plastic Surgery) and or a member of ASPS (The American Society of Plastic Surgeons). Also, ask if they have an established, high volume breast augmentation practice, performing several hundred breast augmentations each year. Ask to see their before and after photos if you didn’t see any on their website. If they are experienced, they should have several 100 breast implant patients for you to view. I would also recommend that your doctor offer you the chance to talk to past patients who would be happy to discuss their experience with you. You need to feel comfortable, so make sure the environment is safe as in an accredited surgery center. Also, ask a prospective surgeon if he or she has ever published journal articles in professional peer-reviewed journals, which they can provide you.  All the best, “Dr. Joe”

Breast lift and implants?

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If you want  more volume you need implants. A lift will help tighten the skin envelope and will help raise the breasts.  Best to be seen in person.

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.