Breast Augmentation with or with out Breast Lift? Need a Second Opinion (photo)

Can an implant alone fill in/ give volume, round shape, to sagging breasts by getting a size big enough to pull all the extra skin? while being pregnant I went to a D-cup then dropped down to a B-cup which left me with no volume + saggy breasts, recently I started doing my homework+ looking for doctors to consult with get different opinions in hopes to get my work done before summer.. Should I go with that advise or do breast lift+augmentation? I Thank you all in advance for your response.

Doctor Answers 19

Breast augmentation or breast lift for saggy breasts?

Based on your photos, you will need a breast lift. A breast augmentation will give you the size you desire. A breast lift is what combats the sagging and low nipple placement and a breast augmentation can somewhat improve the volume, but the nipples will eventually start to descend and you will not end up with the desired result.

Beverly Hills Plastic Surgeon
4.8 out of 5 stars 18 reviews

The goal is to restore beautiful, well shaped, re-volumized breasts

Hi, Thank you for taking the time to write your question.  As you know, your breasts have seen a dramatic change related to your pregnancy.  Associated with the increase in size, there was a stretch of the skin envelope and the supporting ligamentsts in the breast.  It appears that you have regained your pre-pregnancy weigh and as a result you have lost some of the fatty tissue that was in your breasts when you were pregnant.  In addition, many moms have post partum breast atrophy whereby they lose some of their original breast tissue after they have kids.  All these factors often result in an empty, droopy breast.  The goal in aesthetic breast surgery is to restore both the shape and the volume.  The first issue issue in achieving this goal is to assess your volume.  In a really supportive bra, that has no pads, are you satisfied with your breast volume?  If so, then your surgeon may discuss a mastopexy with you.  This is a reshaping operation whereby all your breast tissue is saved, reshaped and elevated through minimal incisions that will settle over the next few months.  If you feel that the volume is not enough, then you will need to discuss breast augmentation with your surgeon.  An implant does not lift a droopy breast or elevate a very low areola and nipple.  However, a minimally low nipple and areola can be elevated by internal manipulation of the breast tissues and no additional scarring would be neeeded on the outside of your breast.  From your pictures it is not possible to give you a definitive answer but it appears that your breasts will need to be reshaped to give you the best possible outcome.  As a plastic surgeon, I do a thourough examination including a full breast assessment.  This assessment includes many measurements.  Once this is done, your surgeon will be able to give you all the options that may be available for you. Remember, when choosing your surgeon, ask friends, family and your doctor for their opinion and results.  Your surgeon should spend time explaining your options and what is involved with each option.  If you chose breast augmentation, ensure you do your sizing and have confidence in the implant type, size and shape that you chose.  Your goal is to have the best shaped, most attractive breasts that are possible for you.  Once this is achieved, self confidnce increases significantly as well.  Take your time and find a surgeon that can achieve your goals.  I hope this information is helpful.  Dr. Scott Barr

Scott Barr, MD
Sudbury Plastic Surgeon
4.8 out of 5 stars 39 reviews

A breast lift with implants is likely your best option.

Thank you for your question and the photos.

A breast lift with implants is likely your best option. Implants alone do not lift breasts. Breast implants restore lost volume but do not provide lift.

To be sure, 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.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 182 reviews

Lift + augmentation


I would consider you to be a good candidate for a full mastopexy (breast Lift).  If you also desire more breast volume, I would suggest a breast lift  + augmentation.


George John Alexander, MD, FACS
Las Vegas Plastic Surgeon
5.0 out of 5 stars 38 reviews

Breast implants alone can sometimes cause more sagging

In some cases, yes, an implant alone may fill in, give volume and round shape to sagging breasts. However, this surgical strategy will only address a slight sagging. In more pronounced cases, an implant alone may actually accelerate the rate of ongoing ptosis, especially if it is placed above the muscle. From the photos it appears that you would fall into this latter category.


For sagging breasts and loss of fullness in the top portion, the best approach is often a lift in conjuciton with an augmentation. We perform this combination on a frequent basis and the down time for a breast lift with implants is no more than if either procedure was performed alone. We also find that when mastopexy and augmentation are done during the same surgical session, less skin ultimately has to be removed, which results in less scarring.

Be sure to see a board certified plastic surgeon experienced in the breast lift with implants procedure for an examination and consultation for a true second opinion and choose the doctor you feel most comfortable with.

Ricardo L. Rodriguez, MD
Baltimore Plastic Surgeon
4.5 out of 5 stars 94 reviews

Breast lift and augmentation together

1. Based on the nipple position seen in your photos, it appears that you would benefit from a breast lift (mastopexy) along with breast augmentation. 

2. Breast augmenation alone is not a substitute for a breast lift when the nipple position is as low as those in these photos. 

3. Set up a consultation with a board-certified plastic surgeon to find out exactly where the resulting scars would be after a lift so you know what to expect.


Best of luck to you!

Joshua Cooper, MD, FACS
Seattle Plastic Surgeon
5.0 out of 5 stars 44 reviews

Breast Augmentation with or with out Breast Lift? Need a Second Opinion

Based on the posted photos no question a lifting is in order. Best to ee additional in person opinions.

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

Breast Augmentation and Breast LIft


There is no way whatsoever that your breast can look pleasing and lifted with just an implant. The inframammary fold defines the (proper) lower limit that an implant should be placed, more or less. The majority of your breast and the nipple lie far below your fold, and no implant can 'pull' the nipple and breast tissue up to where the implant is placed.  

As far as getting different opinions regarding lift or no lift, be certain that anyone telling you 'all you need is an implant' is not a qualified or experienced surgeon. Regarding how to lift your breast might have a few different opinions that are viable; in my mind however, your breast is far too large (you're a B cup??) and far to ptotic for a 'limited incision' lift.  Regarding whether to also use an implant depends on your desired shape and size, and whether a reduction will also be employed.

These are all complex issues that require an in person consultation with surgeons that specialize in this type of surgery.  You are very close to one of the most experienced and skilled surgeons in the area, Richard Zienowicz.  He specializes in all aspects of cosmetic and reconstructive breast surgery, and is an innovator of many surgical techniques. He will give you an honest assessment and explain the issues.

Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 89 reviews

Breast lift with or without an implant?

I reversed your question based on your photos. Sagging or ptosis of the breast is graded from 1 to 3. One can be corrected with an augmentation alone. Unfortunately, you are a three. The nipple areolar complex is at the buttom pole of your breast. You will need a lift and an augmentation if you would like to return to a D cup as during your pregnancy. Most surgeons do this operations together, I personally do the lift first and procede with an augmentation later. An augmentation pushes the breast out and down, and a lift tightens the skin envelope and places the nipple areolar complex to a more aesthetic location. These two surgeries work against each other, and the patient often finds that she needs one or more revisions to "get it right". You can see the many unhappy patients after their combined augmentation/lifts who show their photos on this site and are asking for advise in correctiong their 3rd or 4th revisions. Based on your measurements, skin elasticity you might do better with a C cup, which is easier for your tissues to support and have a longer successful result.

George Marosan, MD
Bellevue Plastic Surgeon
4.8 out of 5 stars 38 reviews

Breast lift ...yes

Based solely on your photos, I think you need a lift. An implant alone will  fill but will not lift the breast. Sorry. Go for some consults with qualifited surgeons.  Good luck!

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 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.