Can Breast Augmentation Be Used Instead of Breastlift for Small Sagging Breasts?

Basically there are two things that I don't like about my breasts. 1) I've always had very big areolas. 2) I've lost 66 pounds and my breasts are sagging. I was wondering if there is a way for me to avoid breastlift (e.g. by using implants that are large enough to fill the empty space). If breastlift is necessary, is there a way to avoid the vertical incision? What about the areolas? Please suggest an 'ideal' and an 'adequate' solution and include estimated prices. Many thanks!!!

Doctor Answers 31

Breast Implants and Breast Lift - Can I Get By With Implants Alone? Avoid the Vertical Incision?

HI Maria in Miami,

No - an augmentation is nothing more than that:  it fills up the pocket.  It may give the APPEARANCE of a lift, and it certainly makes the entire area look "better" - but it doesn't actually "lift" the breasts.  Many people can get a good enough result with implants alone so that you can get away without the scars (and risks) of a lift, particularly when combined with implants.

But there is a limit to what can be accomplished with implants alone.  The combination of your appearance and the fact that you lost weight (and have undoubtedly lost more of the elasticity of your breasts) indicates to me that you would probably need implants AND a lift.  And the lift would include not only the vertical limb but, possibly, also a horizontal extension in the crease so that it would be an anchor-shaped scar.

Sorry about that.  If it's any consolation NOBODY wants those incisions, so if you're seeing those results, you know that people decided to go ahead with the surgery despite the incisions and resultant scars.

I hope that this helps, and good luck,

Dr. E

New York Plastic Surgeon
5.0 out of 5 stars 125 reviews

Breast lift or augmentation

. Lollipop lift (vertical lift), donut (periareola) lift, Benelli lift, crescent lift, anchor lift (inverted T ). Most commonly, we prefer the lollipop or donut lift because of the shape, small scars and easier healing. Although the “anchor-shape” or inverted “T” incision is still more popular in the United States, it represents an older technique with extensive scarring and a less optimal result in many cases. These newer techniques are utilized in the vast majority of cases, the rare exception being extremely large breasts. The nipple-areola complex is repositioned higher, the excess skin is removed, and the breast is reshaped in a pleasing contour and in a more normal position.
The crescent lift removes a small amount of skin at the top of the areola. We find that there is very little lift and the areola becomes oval in shape and distorted with this method.
The Benelli lift as performed by most surgeons is just the donut lift, removing a donut shaped piece of areola and skin then using a #Pursestring or double purse-string suture to tighten the skin. A true Benelli actually will expose much of the breast through this incision and then the breast itself is shaped and lifted with sutures. This is a more complex procedure and is often not done as describe by Dr. Benellil.
The insertion of an implant as well, may be advisable to restore superior fullness, which is lost with aging and after pregnancy despite the rest of the breast being overly large. Fat grafting can be used instead of implants to improve the contours of the breast. This is the #NaturalBreastLIft or #CaliforniaBreastLift

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 110 reviews

Lift with implants alone

You may find that an implant with a smaller base width to make your breasts project more forward from your chest wall and body can be sufficient, making a breast lift unnecessary. Consider the Allergan Inspira TruForm 2 implant and an areola reduction. This would range from $8500-$9500 depending on the surgeon. 

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 179 reviews

Saggy Breast Options

Thanks for the pictures, they are very helpful. A breast enlargement above the muscle could be considered an "adequate" option. You will see some improvement in your sagging but may need a bigger implant than you may want to give the modest lifting affect you will see. The implants will also be a bit lower going above the muscle and this will not address your areola size. This procedure costs between $5400-6000 in the Minneapolis area.The "ideal" procedure for you would be a full mastopexy with a modest sub muscular implant. This will give you the fullest, most perky and firmest breasts. It also will allow you to have smaller areoles. This procedure costs between $7400-8000 in the Minneapolis area. Good luck.

Douglas L. Gervais, MD
Minneapolis Plastic Surgeon
4.8 out of 5 stars 176 reviews

Breast lift and augmentation

Thank you for the question and photos.  Breast implants alone can only increase the volume of your breasts and not fix the sag (ptosis).  Breast lifts can fix the sagging by removing excess skin and reducing your areola as well.  All of this would depend on what you want the end results to be.  Best of luck, Dr. Michael Omidi.

Michael M. Omidi, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 95 reviews

Breast Augmentation for Lifting Breasts

Based on your pictures you appear to have significant breast ptosis. Attempts to correct this problem with subglandular breast implants alone, might temporarily fix this problem. Unfortunately over the course of time, the weight of these implants would accelerate the progression of your breast sag.

Eventually, your breast sag will need to be addressed. Unfortunately, the changes that have occurred with subglandular implant placement can result in thinning of the soft tissue. Soft tissue thinning significantly increases the risk associated with correction of breast sag.

For these reasons, the best option for treatment is submuscular implant placement with mastopexy surgery. It’s important that you consult a board-certified plastic surgeon who can help you with this difficult problem. The cost of this procedure would range from $5,000 to $7,000. The exact procedure performed would depend on your findings during physical examination.

Richard J. Bruneteau, MD
Omaha Plastic Surgeon
4.9 out of 5 stars 194 reviews

Minimal Scarring Breast Lift/Augmentation

This is a common question as we all want to minimize the incisions and scars if at all possible. There are several types of lifts that can be used to treat the specific needs of each patient.

In your particular case you could do what I s called a periareolar mastopexy augmentation. This is where the scars from the lift are limited to just around the areola. This type of lift in combination with an implant can give the correct patient a very attractive breast with minimal scarring.

I would make sure that you spend some time with your plastic surgeon going over sizes and your aesthetic desires. You should also consider taking him or her pictures to make sure that you are both on the same page about the results you are hoping to achieve.

I would also discuss this with a board certified plastic surgeon that performs the periareolar mastopexy augmentation procedure frequently.

Johnny Franco, MD, FACS
Austin Plastic Surgeon
4.9 out of 5 stars 123 reviews

Breast Augmentation

An in person examination would be needed for actual advice.  Having said that, I doubt that an implant alone will make you happy in the longterm.  It may look good for a short while, but you run the risk that after a year, your tissues may stretch out again and result in a ball in sock appearance.  I think the best results would be obtained with a vertical lift with or without an implant, depending on your volume goals.


Asif Pirani, MD, FRCS(C)
Toronto Plastic Surgeon
5.0 out of 5 stars 35 reviews

Breast Lift

The cost for Breast Augmentation like other cosmetic surgery varies considerably across the country and even in the same area. South Florida tends to have lower fees then more expensive areas such as New York or Los Angeles. We charge $2800 + MD Anesthesia related costs for breast lift with saline implants. Gel Implants tend to be about $1000 to $1500 more. Since you can get quality work at lower costs, patients will travel from throughout the state, the country, and internationally to have surgery in South Florida.

To ensure that you are receiving quality work with personalized care at the most cost effective prices, consult with board certified plastic surgeons that own their own nationally accredited facilities. The quality must be maintained at the highest level to maintain accreditation. The surgeons also have incentive to hire and train quality staff (to ensure that surgery is efficient and enjoyable), to ensure comfortable and private facilities (to encourage referral), and to eliminate waste (to ensure that these facilities can compete effectively).

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 42 reviews

Breast lift or breast implants

In your case, I would recommend an uplift, called a mastopexy. This will give you a pretty shape and smaller areolas. Implant will also be necessary to give you the fullness most desire. I would keep the implants a conservative size. Remember that more weight equals more sagging with time. All plastic surgery procedures are a trade-off of some sort. Here you are trading large areolas and sagging for scars with an attractive, youthful breast shape. Implants without a full mastopexy would make your problem worse. Thank you for an excellent question.

E. Ronald Finger, MD
Savannah Plastic Surgeon
4.8 out of 5 stars 80 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.