Will I need a lift to get the best result? (Photo)

Question

I am looking to get a breast augmentation to increase volume as I am a large A, small B cup. I am 36 years old, 5’7, 126 lbs. Have one child and don’t plan on more children. I’ve always wanted bigger breasts (full c/small D) but now I am curious if I need a lift. I’ve done 4 consults. 2 said just an implant, one said a donut lift and the other said full anchor. I would like to avoid scars but also want an ideal result.

Moises Salama, MD · Answer

Thanks for your question. From these pictures, you seem to be a good candidate for just a breast augmentation. I recommend scheduling a consult for a proper evaluation. Please always consult with a board certified plastic surgeon. Take care, Dr. Moises Salama, board certified plastic surgeon.

Carlos Marciales, MD · Answer

Hello, thank you for asking, from your photos, without taking measurements, you can see that you only require implants for the moment, I would not do any type of lifting yet, they would look very good only with implants.

Daniel Barrett, MD · Answer

Dear caits36,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Ramin Behmand, MD, FACS · Answer

Your breasts have maintained a good appearance even after pregnancy, so the most sensible approach is to simply add volume to breasts that already have a good shape and are not droopy. There's very little to lose by opting for augmentation alone. You can always consider a lift later, after completing your family. This way, you avoid potentially unnecessary lift scars on your breasts for the time being.

Dr. B.

Dr. B.

Justin Yovino, MD, FACS · Answer

I agree with Dr. Minniti. I think an implant would suffice. The best access is through the lower breast fold. Warning: Donut lift can result in a widened areolae.

Ted Eisenberg, DO, FACOS, FAACS · Answer

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

Gary M. Horndeski, MD · Answer

I recommend augmentation or augmentation with a donut lift.  The donut lift will tighten the skin envelope and allow access to place the implants.  This may be the best solution for you.

Best Wishes,

Gary Horndeski, M.D.

Gerald Minniti, MD, FACS · Answer

It appears that your nipples are above the inframammary folds, making implants alone sufficient in achieving an aesthetically pleasing result. If you did opt for a donut lift, I urge you not to allow the surgeon to insert an implant through that periareolar incision; it will increase your risk of capsular contracture. An short inframammary incision is the optimal site for implant insertion.

Fernando Ovalle Jr., MD · Answer

Hello and thank you for your question! Your photos show some asymmetry between the two sides, specifically with the position of the nipple/areolar complex (NAC). In my opinion, while you may have a very good result with breast augmentation alone as you do not have significant ptosis (sagging) these mild asymmetries in the NACs will persist and in some cases amplify depending on how big of an augmentation is performed. To help balance and improve the symmetry it is not unreasonable to consider a small donut/periareolar mastopexy. I do not believe you need a full anchor pattern breast lift, but every surgeon is different and in their hands, they may be able to achieve their best result with a different technique.

Matthew C. Camp, MD · Answer

Based on your photos, you have ideal nipple/areola position, and do not need a mastopexy/lift. A conservative breast augmentation will give you a nice boost in volume, with minimal scar. Find a board certified plastic surgeon, and best wishes with your surgery!