Could I address volume loss with a breast augmentation alone or will I need a lift as well? (photos)

Dear georgiabuc,
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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Thanks for the question.
You should have a nice result with implants. Schedule a consultation with a board certified plastic surgeon to discuss your options. Best wishes!

This is a great question that many patients struggle with. Making a decision to do a lift is a difficult one as you are accepting more scars. The answer depends on many variables. Based on your photos, you could avoid a lift with larger implants. With smaller implants a periareolar mastopexy would be a good option.

In your case you have desirable nipple position; however you have some sag of your breast tissue. Your surgeon should examine your tissues, take measurements, and discuss the pros and cons of breast augmentation alone versus with a breast lift. Based on your photos it does appear as if you could have a good result with a breast augmentation alone while avoiding a "double bubble" deformity which can come a defined breast crease that is noticeable on the breast after a breast augmentation.

I recommend an in person consultation with a plastic surgeon to discuss your goals and be measured. 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, if interested. 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

Thank you for your inquiry. By looking at your photos I would think that you would be able to achieve upper breast volume with implants alone. I can send you a link to our website that will show you before and after pictures of clients to give you a better idea of where you're at and what you might need. But again, I do not think that you need a breast lift to achieve upper pole fullness to your breasts. If you have any other questions or concerns, please let us know.

Thank you,
Dr. (Joe) Gryskiewicz

An in person exam is necessary to make an accurate determination, but your nipple position looks high enough to make you a candidate for augmentation without a lift.

Thank you for sharing your question and photographs. It appears that you could have an implant alone, but nothing replaces an in-person examination to determine.

Hi, thank you for sharing your question. You are a great candidate for breast augmentation without the need for a lift. The exact size of the implant is best determined after an in person evaluation.

Thank you for your question and photos. An examination in person would be required to properly evaluate you, but from your photos it appears you have pretty and well proportioned breasts without ptosis (drooping). Your nipple/areolae position is good but you may have a small degree of pseudoptosis (too much skin below the nipple causing the nipple to appear as though it is pointing upward).

A properly selected implant of proper width and less projection can provide an overall fuller rounder breast with greater upper pole fullness. Depending on your measurements, a small amount of skin may be able to be removed near the fold with the scar hidden within the fold.

Do your research and select a board certified plastic whose results appeal to your sense of aesthetics. Best of luck to you.