I Want a Breast Augmentation and Not a Vertical Breast Lift.

Is this possible for me? I would rather have a less perfect breast than bad scarring from a lollipop incision.

Doctor Answers 29

Breast Augmentation with Lift

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Hello and thank you for the question.

From examination of your photographs, you would achieve excellent results with a breast augmentation in combination with a modified Benelli breast lift. This would give you the needed "lift" from your minimal ptosis while limiting the scar to the peri-areolar area. I recommend following up with a board certified plastic surgeon in your region to discuss these options. 

Warmest Regards,

Glenn Vallecillos, M.D., F.A.C.S.

How to measure your breast droop

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Yes it is possible. Your photos show less the 1 cm of ptosis (droop) and so you should respond well to breast augmentation. Patients who have 2 cm or more  ptosis in general will need a breast lift in order to have implants placed in a sub muscular position. You can measure your own degree of ptosis at home with a short ruler.

  • Stand upright
  • place a finger in the skin crease under the breast
  • feel the finger through the breast and transfer that measurement to the front
  • if your nipple is above the skin crease you have no ptosis
  • if your nipple is below the crease then you do have ptosis

Mark Preston, MD
Columbus Plastic Surgeon

Breast augmentation

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Your pictures show a constricted pole and breast asymmetry- setups for a bad result from implants alone.

While you might be willing to take the chance of having only an implant and a double bubble issue or an implant that was positioned too high because of a tight lower pole, your plastic surgeon may not be.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 188 reviews

Breast Augmentation with or without Lift

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Hi there-

Without a formal examination, I would feel irresponsible advising you in this matter... There are many nuances involved in these decisions, and I would want to take measurements and test your skin before offering you advice...

Having said that, I can confidently tell you that by far the most common mistake I see women make in your situation is choosing a procedure based on the scar they want (or don't want). It is little consolation to them a few months after surgery that they have the cute scar they wanted when their breasts are funny looking or ugly...

My very strong opinion is that the shape of the breasts is the very most important thing... In some patients achieving a lovely shape requires breast lift scars- but these scars don't have to be ugly or conspicuous. 

Find a good surgeon and follow their advice.

You don't look like you absolutely need a breast lift

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Based on your photographs it looks like your nipples are high enough to do well with a simple breast augmentation without a breast lift.  After the augmentation once the implants settle and the swelling is gone if it looks like you need a lift it would only require a small amount of lifting.  This can probably be done under local anesthesia by just lifting around the areola. 

Staging Breast Augmentation with Lift

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I believe you will get a great result by performing a circumareolar mastopexy with augmentation.   This lift is performed by making a scar only around your areola, thus avoiding the vertical scar.   After the implants settle, you can decide if you desire a more aggressive lift in a second stage procedure.

Paul S. Gill, MD
Houston Plastic Surgeon

Breast Augmentation

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You look like you are a good candidate for a breast augmentation. If after the surgery you are unhappy with the results and you need a lift this could be done using the periareolar techinque instead of the vertical technique. Best of luck.

Breast augmentation and no vetical lift?

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It looks like you are a good candidate for a breast augmentation, but you may need a lift which can possible be done by just raising the areola in a circumareola fashion.  I do this all the time.

Breast augmentation is possible without a lift, but be realistic about the outcome

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Breast augmentation is possible without a lift, but be realistic about the outcome. The most accurate evaluation of your anatomy, in my opinion, would result from a thorough examination and breast measurements, to discuss the position of the nipple (the “north”, ”south” or “equator” location of the nipple) in relation to the breast skin brassiere and chest in general.

From the photographs, it appears that the nipple position is on the lower (southern) side of the breast, but there is the appearance on the lateral (side) view that the nipple is in a position that would permit a breast augmentation to be performed, without the need for a breast lift. The breasts have a conical shape and the amount of skin/sag appears to be more pronounced on the left. The left nipple also appears to be positioned more lateral (outward, toward the outer chest and more in line with the shoulder).

Of course, if you were present, breast measurements would be taken at the time of the consultation to confirm the visual impressions. In this way, I would explain to you, in measurable and anatomical terms, your candidacy for a breast augmentation vs. a breast lift.

If a patient wants a "perky" appearance to the breasts, and has low nipples (south of the equator), then the patient needs to know that a breast lift will help to decrease the amount of skin and give the breast augmentation a lift or perky appearance. If the patient does not want a breast lift, being opposed to more scars on the breast, then the patient needs to know that with a breast augmentation alone, the breasts may look full but have an appearance of being more settled, even more natural and pendulous.

My impression for the photographs, is that this is your case, that there is some degree of excess skin and following a breast augmentation (without a lift), the breasts will look good, as the implants will create a fuller, yet, very natural and perhaps, somewhat pendulous appearance. If this type of breast shape will make you happy and satisfied, then the operation will be successful!

I would need to confirm by breast measurements, but from the photos, I feel, that in your case, the implants, preferably smooth silicone gel implants, will look good if placed on top of the pectoralis major muscle. Most importantly, the submammary (on top of the muscle, under the breast) location will also allow more control of the breast shape and permit transformation of a conical (triangular) breast shape to a round breast shape.

This will be a great change. I think that this would give the best outcome, short and long term, for your particular anatomy

Do I have to Have A Lift?

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The art of plastic surgery is at the heart of your question. Unlike an inflamed appendix or a broken arm, there is a lot more give and take with treatments in cosmetic plastic surgery. Certainly there are times when certain operations are just wrong for a particular patient, but for the most part there is always a compromise. The saying goes that the situation of a happy patient and an unhappy surgeon is much better than a happy surgeon but an unhappy patient.

Philosophy aside, based on your photos you most likely need a lift with your implants. But the beauty of plastic surgery is that there is compromise. The fact that you are willing to accept less than ideal results over increased scarring is perfectly acceptable because the degree of ptosis in your breasts is not the most severe. In addition, you may be a good candidate for a circumareolar lift which keeps the incisions around the areola only.

Hope that helps and good luck!

Dr. Babak Dadvand

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.