Will a breast lift and breast argumentation (200 or 250 cc) help increase natural volume in my types of breast? (Photos)

Op date is Oct 18. I've meet w/ my surgeon twice and she's very optimistic and I'm so excited for my procedure. ultimately the decision is down to whether I decide on 200cc or 250cc. I'm afraid to go so large that it's noticeable. I'm doing this surgery for my self confidence. It's hard to put a cup size on me because of the skin tissues. Right now I wear a 36C and my tissue just lays like liquid in the cups. I've been measured as a 34/36 B recently. Would like to be a natural C.

Doctor Answers 6

Breast lift with implants is the best choice

When there is a lot of loose skin and ptosis (sagging of the breast) then the loose skin needs to be addressed.  Certainly, one can just place implants without removal of the excess skin (mastopexy or breast lift) but in this situation the end result will probably look like "a ball in a sock".  Round, droopy breasts without any firmness or upper pole fullness, almost doomed to failure.  I would recommend a lift with a small implant (200 cc or 250 cc), the best lift would be the lollipop or circumvertical lift with the implant under the muscle (saline or silicone).  Most women are choosing silicone because they wrinkle and ripple less and feel more natural than saline.

The pictures are not ideal, but it seems that the right breast is larger than the left and the right nipple sits lower on the chest wall.  There is second degree ptosis (third is the worst), the areolas are stretched and the skin is thin with visible veins.  A mastopexy/augmentation could address all of these variables.  The excess skin would be removed and the nipple/areola complex would be lifted to the same level and the areolas made smaller.  A slightly larger implant would need to be placed on the left breast for symmetry, maybe 250 cc on the left and 200 cc on the right.  

This type of procedure can be performed as an outpatient, there are no drain tubes and dissolvable sutures can be used.  The resultant scar would be around the nipple/areola and straight down vertically at the 6:00 position, no inframammary scar is needed.  The pain and discomfort is moderate and probably off of work for a minimum of 1 week.  So, the recovery is longer than just placing implants, but this procedure is addressing all of the issues of your anatomy, not just size.

Please consult with a Board Certified Plastic Surgeon who specializes in breast enhancement procedures to assure yourself of the best possible result.

Good Luck!

Omaha Plastic Surgeon
4.9 out of 5 stars 70 reviews

As you are having a lift

lifts do diminish cup size slightly and because of that, would have no hesitation to use your larger implant option.  They will offset if you will.  But a lift will certainly make you perkier and elevate those nipples.  And don't focus on cup size... focus on the look you want.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 32 reviews

Lift with or without implants

Hello dear, thanks for your question and provided information as well.. The breasts may lose their elasticity and firmness which can be caused by different factors such as pregnancy, massive weight loss, lactation and aging. To reaffirm the breasts and restore the natural look your surgeon can perform a mastopexy or breast lift with augmentation such as silicone implants, you will get very nice results.

Patients who goes to a consultation for drooping breasts (ptosis) or volume loss after pregnancy (pseudoptosis) almost always have one very important question. "Can my drooping be corrected with just implants or do I need a lift".

Implants alone will correct drooping when:

  1. Breast drooping is mild
  2. The nipple is still near the center breast and does not point downward
  3. There is some visible skin beneath the nipple/areola when looking at the breasts straight on.
  4. The patient is okay with being at least a cup size larger

A breast lift (with or without an implant) is better when:

  1. Breast drooping is moderate or severe
  2. The nipple is at the bottom of the breast or points downward
  3. There is no visible skin under the nipple/areola when looking at the breasts straight on.
  4. The patient is already a C or D cup breast size and doesn't want to be larger
  5. The areola is too large and the patient wants it reduced

I also show the patient photographs of a spectrum of breast scar present after a breast lift in order to check their tolerance for this scar. Most patients are surprised how little the scar shows and are okay with proceeding. If the patient really needs a breast lift, but is concerned about the scars, I will suggest they wait on surgery. In time the breast appearance problems will usually outweigh their concern about the scars.

I use implants in combination with a lift when:

  1. The patient wants to be larger in addition to being less droopy
  2. The patient desires to maintain projection and roundness of the breast mound
  3. The drooping is severe..... I recommend to see a board certified plastic surgeon for a personal evaluation and also to talk about your goals.

I recommend to make an appointment with a board certified surgeon for an evaluation and to talk abuot what kind of lift do you need and to talk about your goals.

Good luck :)

Tania Medina de Garcia, MD
Dominican Republic Plastic Surgeon
4.6 out of 5 stars 327 reviews

Breast Lift with Implants

Hi KT, Good Luck!!

Here are a few tips for you because this is perhaps the hardest decision for a patient to make, as well as the surgeon.  Also see the video attached to my answer.  We spend up to two hours for our BA consults to be sure there is careful communication. We do a full exam in front of a full-length mirror taking six exact measurements.    We put your photos on a large computer screen for imaging, and go over your “ideal-size” photos. We then save this information to your password protected “web account.”

     First and foremost the implant should fit the dimensions of your breast and tissue cover.  Balancing the implant to your over-all body shape and tissue cover is essential.    The main thing is to have the diameter of the implant fit the diameter of your breast "foot-print".  Higher profile implants tend to have a smaller diameter.  Higher is really a marketing term, but often translates into the same volume implant with a narrower base.  Saline implants actually tend to decrease in diameter as they are inflated!  The average size chosen over our last 7,000 breast implants was “350cc”.  BUT, 90% of our patients tell us they wish they were bigger a year after BA.  (We will see you every year for routine checks at no charge.) It’s like your mind incorporates the "new you" into your own self-image over a period of time. Cup size estimates can be misleading, but I generally advise patients that they will experience an increase of approximately one cup size per 200 cc.  You can try on implants in the office by placing them into a special bra.  The implant is also flattened somewhat when under the muscle, so it is a good idea to bump it up a bit. Approximately 1-ounce (25cc) is added to the final volume to account for flattening of the implant in the partial sub-muscular pocket.  Once you decide on a size you like, then add on 25cc, because in real life the implant will be flattened slightly by your tissues.  Multiple measurements need to be taken to fit an implant to your exact anatomy.  Have your surgeon's office show you the charts of the implant dimensions for the various profiles of silicone and saline from the manufacturer.  Then you and your surgeon can piece together the puzzle by matching your measurements, with your wishes, versus your tissue cover and the available implants to arrive at a surgical plan.  Keep in mind larger implants tend to have more problems over the years.  Since silicone implants wrinkle less than saline implants, they might be your best bet.

     You can also approximate this at home by measuring out an equivalent amount of rice placed into a cutoff foot of old panty-hose, and put this in your bra.  Wear this around the house for a while, and see what you think.  Implant size must square with assessments of tissue cover, breast diameter, and chest wall width.  Multiple measurements of your chest wall are taken (seven in total).  Implant size selection has been an issue of much discussion.

     Therefore, I use a wide variety of methods, but the implant size is always established preoperatively.  Also, patients are advised to bring reference photos demonstrating their ideal size and shape.  A photo album of patient pictures is maintained to assist them.  These photos ultimately help in determining where the implants will be placed, since they can be shifted inside (to provide more cleavage), to the outside, up or superiorly, and down or inferiorly during surgery.  In determining the final size selection, I always place the highest priority on the preoperative measurements and potential tissue cover.  Finally, your verbal requests are factored into the analysis.

     We use the quick-recovery approach, so click on the web reference link below to have this explained and you can see the list of Quick-Recovery (Flash-Recovery or Rapid-Recovery) Breast Augmentation articles from peer-reviewed surgery journals.  It is a surgical procedure that uses special instruments and techniques to minimize tissue damage and avoid touching the ribs. It causes far less trauma to surrounding tissue than traditional approaches, and it dramatically reduces pain and recovery time. In published studies of BA patients, 95-percent of women interviewed after the procedure returned to normal daily activities within 24-hours. Quick-recovery BA is not a “gimmick.”  These specialized techniques, which actually speed recovery and get you back to your daily routine, kids and work, are published in our plastic surgery journals.  Because these PS journals are “peer-reviewed” and edited, they are the gold-standard in our field as being valid science. Therefore, these are sound techniques, not marketing hype. 

     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 the PS has an established, high volume breast augmentation practice, performing several hundred breast augmentations each year.  Be sure the PS has been in practice for a while, about 20-years might be a good gauge.  Does the PS offer all three incisions?  Discuss the implant type (gel or saline), shaped "gummy bear" or non-shaped, smooth or textured, implant pocket (over or under the muscle) and the "quick-recovery approach."  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.

Also,lease put an index card in your breast fold.  If your nipple is at the edge of the card or below, then you would be a candidate for a lift, either a vertical or anchor or areolar incision.  If your nipple is above the edge, you could be a candidate for an internal lift called the dual plane.  Please see the web reference and video reference below. Be sure to seek a consultation with a BC PS to be sure.  All the best, “Dr. Joe”



Will a breast lift and breast argumentation (200 or 250 cc) help increase natural volume in my types of breast?

I think that an uplift with asymmetric implants and reduction of your larger breast is a good plan for you.  I also agree with the choice of those two implants that you cited.  Good luck and enjoy your results.

Jon A Perlman MD FACS 

Certified, American Board of Plastic Surgery 

Extreme Makeover Surgeon ABC TV

Best of Los Angeles Award 2015, 2016 

Beverly Hills, Ca

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 29 reviews

Implant size

Hello and thank you for your question. You are a great candidate for a breast lift with an implant.  The size 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.  

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 67 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.