I am wondering what my best option would be. A lift or implant? (photos)

Hi there. I am 23 years old with already sagging breasts. I'm not sure why as i've never fluctuated with more than 5kgs throughout my life. My right breast seems to be significantly more saggy than my left. i am wondering what the best option would be as i don't want my breasts any larger than a B. I just want them to be perky. Thank you for your help.

Doctor Answers 18

A lift or implant?

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Since you're looking to have "perkier" and smaller breast, it's probably suggested that you do a breast lift with a smaller implant. If you do just an implant you may have to go with a slightly larger implant in order to see more perkiness. An implant will fill you out but it will not lift you up, although sometimes it can give the illusion of a breast lift but usually you will need a larger implant. An implant also will not correct any asymmetries between the two breasts, a breast lift would be better suited to correct asymmetry. The downside of a traditional breast lift is the scarring can be unsightly. There is a new technique for a breast lift called the Bellesoma Method breast lift. The benefit of this procedure is the scarring is hidden with no vertical scarring and it may also minimize the need for use of an implant. It's always best to speak to a Plastic surgeon in order to see what the best treatment option is for you and to weigh the pros and cons of each procedure in order to make an educated decision on what is the best procedure for you. 

A lift or implant?

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Hello Dear, thank you so much for your questions and pictures.

According with your pictures the best procedure for you would be a combination of breast lift with implants, this would give you a firm breast. 

Hope to hear from you soon, best wishes!!

Ramon Morales, MD
Dominican Republic Plastic Surgeon

Lift or Implant

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Hi Jade

You may be able to get away with either an implant or a lift, however probably combining the 2 would give you the best result. It is a little hard to advise you based on these photos, but a consultation would help you make the right choice. Regards, Dr Steve Merten, Sydney, Australia

#breast aesthetics

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Hi Jade.   You have had a few opinions from multiple surgeons and I think the true answer is what is going to give you better looking breasts.  In my opinion I would offer you a modest sized augment on both sides (roughly a full C cup) and a crescent lift on the right in which the scar would be very difficult to see.  This will give you fuller perkier breasts on both sides and give better symmetry.

Regards Damien


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Hi Jade,

Thanks for the question.  The issue and the goal, here will be achieving a result where the nipple sits on the top of the breast mound. That can be achieved by living the nipple and leaving the breast volume as it is, and not using an implant. If you are though happy to increase the breast volume, then an implant will be needed, and depending on the size a lift may be avoided.

The difficulty will be that to avoid a lift a large implant will be needed and this then fails to meet your objective of a B cup

My advice is to decide the cup size you desire then achieve that result with the simplest procedure, and i think in your case that may be a lift with or without a small/moderate sized implant

I hope that if some help.

Jeremy Hunt

Best Option

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Hi there Jade,

This is not a case that is really appropriate for discussion here. There are many things to consider and it will involve discussion between you and your surgeon to find out exactly what you are trying to achieve.

For example it would be important to find out exactly what you mean by perky and whether by a B Cup you mean you don't want to be any bigger than you are currently or whether you do want an increase in volume. These questions will have an important impact on which operation is best for you.

You do have some mild asymmetry but that is very common and could be addressed by surgery.

I hope that is helpful


Breast augmentation/lift

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Thank you for your question and photographs.

I would recommend that you schedule a consultation with a board certified plastic surgeon to have an examination of your breasts done. At that point, the surgeon can recommend whether you need a breast lift, breast augmentation or both. From the photos you have posted, it is hard to determine whether a breast lift is necessary, a breast augmentation with implants may be sufficient to correct the sagging appearance and add projection and volume. At my office, we use Crisalix which is a virtual reality device that will allow you to view what your breasts would look like after a lift, or view different sizes of implants and pick which best suits your desires.  As the only board certified plastic surgeon in Pittsburgh offering this virtual reality imaging system, we have a 100% satisfaction rate.  Crisalix  is truly a unique experience for our patients as they can view themselves using virtual reality goggles and can instantly visualize their own breasts changing in size and shape with all of the various brands, sizes and shapes of breast implants.  Thus, our patients leave the consultation feeling confident with the size of the implant they chose.  
Best of luck in your endeavors!

James Fernau, MD, FACS
Board Certified ENT
Board Certified Plastic Surgery
Member of ASPS, ASAPS, ISAPS, The Rhinoplasty Society, AAFPRS, OTO/HNS, ASLMS, International Federation for Adipose Therapeutics & Science

James Fernau, MD, FACS
Pittsburgh Plastic Surgeon
4.9 out of 5 stars 86 reviews

Breast lift

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Thank you for the question and the photos. Based on the photos, I'm really not sure what to recommend. You do have some mild sagging and asymmetry, but to be honest, I am hesitant to say you need this or that. 

1. You are still VERY young. There is a good chance that someday in the future you may decide to have children. If that is in your future, you should wait and have a breast lift after pregancy, not before. Otherwise, you will wind up having to do this more than once. 

2. the sagging or ptosis you have is very mild. Not sure it's worth the scarring. Generally the scar is thin and hard to see, but still should be on the list of considerations in the pro / con decision making. 

3. you don't seem to want to be any bigger so that really rules out the implant. Any implant will make you larger than you are now. 

One option that I have seen with good results, is to consider fat grafting to the breast. With fat grafting you can direct the fat to the areas of the breast which will help give you the most lift and perky effect with the least increase in size. This is done with a combined procedure of liposuction and then once the fat has been purified and separated from the fluid / blood it is injected into the breasts. Remember that some of the fat does NOT survive this process. About 60% of the fat remains so you will wind up smaller a year later than you had right after surgery. 

Best to you

Bennett Yang, MD
Rockville Plastic Surgeon
4.8 out of 5 stars 21 reviews

Implant vs. Lift

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Without all the necessary information, such as your current breast size, here are my thoughts.  An implant does not lift the breast, it may offer a hint of less sag.  There are three aspects to sag:  1) breast tissue dropping below the inframammary fold  2) the level the nipple is dropping  3) hallowing of the upper breast area.  A small implant to give fullness above and a vertical breast lift to raise the level of the nipple.  I hope you find this information helpful.

Thomas Hubbard, MD, FACS
Virginia Beach Plastic Surgeon
4.7 out of 5 stars 41 reviews

Lift or Implant

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Thanks for your question.

A lift would move the Nipple up on the breast and could tighten the skin. This would improve the shape of your breasts but you would not have fullness in the upper part of the breast for long after this procedure.

If you want upper pole fullness as well then a small implant is the best way to achieve this but it carries some extra risk.

Another way to go is to have lift first and then an implant as a secondary procedure but this is 2 lots of surgery and recovery and more cost, although safer.

There are new imaging solutions to help you preview the effects of different implants and lifts. See the video below.

best wishes 

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.