Will I get round/perky breast with implant only, no lift? (Photos)

36 year old, med build, 5'3", 148 lbs. 0 children. Current bra size is Btwn full D & small DD. Was a DDD. Lost volume in top of breast since weight loss & aging. Consult discussed being close to needing a lift but implants should be good for now but a lift likely needed in the future. Discussed silicone implants mid 400 cc's up to 500 cc's. Wondering if the size of implant will give me the round and perky breast I'm hoping for or will the weight of the implant pull down the shape of my breasts?

Doctor Answers 31

Breast augmentation alone or with lift?

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Thank you for your question. Based on your photos and desired results, it looks like you would be best served with a combination of breast lift with augmentation. A breast lift reduces the skin envelope while reshaping the breast tissue into a more youthful and perky shape. Implants are added for more volume, The parameters of both the breast lift and the position of the breast implants should be designed to keep the implants relatively low while lifting the breast tissue and nipple to sit directly over the implants.  Many techniques exist in breast surgery, and combined lifting with augmentation is especially tricky.  The key is working with an expert, board certified plastic surgeon to get the best plan for you.

Implant vs lift

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If you want your breast fuller and are happy with the shape of them, then an implant will be fine. Keep in mind an implant will only "fill our breast up" it will not "lift them up". They will look just like they do now, they are just bigger and fuller with an implant only. If you feel this will meet your goals, then an augmentation should be fine. If you are unhappy with the position of your breast and feel they are too low, then an implant will likely not satisfy you and you will want to consider the lift. A lift will "lift them up" and put them in a higher position, change the size of the areola and "lift" them off of your chest. Often times both of these procedures are combined to achieve an optimal result. By lifting them and adding volume, the breast will not only sit higher on your chest but will also have the nice fullness from the implant. In your case, you will be better off with both a lift and an implant.
Dr Scott Ennis

Lawrence Scott Ennis, MD, FACS
Pensacola Plastic Surgeon
5.0 out of 5 stars 158 reviews

Implant without lift

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Agree with doc below who suggested X high profile style 410 gummy bears. You will always be able to have a small lift later if you wish. Would need measurements and a physical exam to give best advice.

Richard Sadove, MD
Gainesville Plastic Surgeon
4.9 out of 5 stars 31 reviews

Wanting perky breasts

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Hello, breast implants will usually significantly improve upper breast fullness and improve the apparent nipple position on the breasts,  However, you PS is in the best position to discuss the result that would most likely be achieved.

Augmentation Mastopexy

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The photos taken with your arms in the air, which pull your breasts upward, still indicate you have sufficient ptosis to warrant a breast lift and implant combination.  You are definitely not 'close to needing a lift', and implants would not be good for now.  Instead, you will be disappointed you with your droopy, unappealing result. If you want round, full breasts with optimal shape and nipple position, go visit a few ABPS certified/ASAPS member surgeons that are expert in all types of cosmetic breast surgery, not just implants. 

Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 97 reviews

Round perky breasts with implants.

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Greetings,  Implants can provide fullness to your breasts but the implant's weights can result in lowering of your breasts with time.  Discuss your expectations clearly with your plastic surgeon.

Some patients are satisfied with the new appearance without breast lifts.  Others are willing to accept the scars required for a breast lift, if they want a higher, perkier appearance.

Best Regards, 

Douglas J. Raskin, MD
Colorado Springs Plastic Surgeon
4.9 out of 5 stars 68 reviews

Breast augmentation and lift candidate, some advices:

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Thank you very much for enquire.
After having analyzed all the information and photos provided to us, I realize that you have very sagging and small breasts. In this regard, you need volume (implants) and projection (the lift): Breast Augmentation w/Breast Lift.
I recommend you to use microtexturized highly cohesive silicon implant ("gummy bear" implants), with high projection, and 350-400ml will be excelent on you, to fill the breasts properly.
Finally, to perform the breast lift I recommend a Periareolar Round Block Breast Lift ("Benelli mastopexy"), which has an unnoticed scar around the areola, and if we see (in the surgery) that we can't obtain adecuate projection just with the Benelli Lift, we have to perform a "Lollipop breast lift".
Dr. Emmanuel Mallol Cotes.-

Emmanuel Mallol Cotes, MD
Dominican Republic Plastic Surgeon
4.7 out of 5 stars 334 reviews

Implants with or without lift

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While it's difficult to get an accurate assessment of the current sagginess of your breasts based on the less than ideal pics you have provided and only a physical examination can give us enough information to give you the right recommendation, it does appear that you have a moderate degree of breast ptosis and your breast foot print is sitting lower on your chest than ideal.  If your main goal is to achieve maximum perkiness, you would have to consider either a peri- areolar (doughnut) vs. a vertical (lollipop) scar mastopexy, along with implants.  The vertical scar mastopexy will give you the maximum perkiness while raising your inframammary fold at the same time, thereby raising the foot print of your entire breast.  If avoiding additional scars is more important to you than achieving maximum perkiness then I think implants alone may give you enough improvement to make you happy.  I just don't know enough about your goals and expectations to tell you which option to choose.  I do find it helpful for patients to show me pics of what shape and volume breasts they desire (in addition to implant sizing maneuvers).  If you are not sure yourself, then it's reasonable to just do the implants first to see if the perkiness adequate for you and then you can proceed with a lift in the future if you wish.  The other advantage of staging the implants and the lift procedure is the risk for capsular contracture and infection is a little less.  

Your case is a great example of the importance and challenge of matching a patient's expectations with the correct option (from a myriad of options- all of which have their advantages and disadvantages).  It can be really challenging trying to figure out each individual patient's ideal image of themselves.  I have to spend a lot of time getting to know my patient and discussing all the available options, advantages and disadvantages with them to make sure that we are on the same page with what we both expect to achieve.  I would recommend you see several board certified plastic surgeons who have a lot of experience in performing all the different types of lifts as well as implants before you make your decision as this is one of the more challenging combinations of procedures that we do. 

Best wishes.

Will I get round/perky breast with implant only, no lift?

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Based on your photos, you will not achieve "perky" round breasts with implants alone. You currently have some degree of ptosis which is masked by the elevation of your arms. With implants alone your breasts will be larger, but may appear somewhat matronly. If you are trying to avoid incisions that accompany breast lift surgery, you could achieve a round perky look when wearing your bras. Thank you for sharing your photos and question. Best wishes. Dr. Gregory Park, San Diego Plastic Surgeon.

Gregory Park, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 174 reviews

Implants, ptosis, and lift

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Hi erin

Your nipples are somewhat low (ptosis), and your pose with your arms up makes evaluation and recommendations difficult.  The sizing of breast implants really is dependent on the width of the chest (think of the bra number rather than letter, for example 34, 36, etc.).

That said, it is worth a try with implants now, and if desired, lift later.  This staged approach is safer and more predictable for results.  Your nipples will be a bit low, but you only need to be happy, not perfect.  I also like to say that you can always do an additional operation later, but you can't undo one.

Best of luck to you.


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