Breast augmentation without lift? (Photo)

Question

I've lost weight and had breast lift 5 months ago, I'm not liking my results that much because I think they're still sagging especially upper part and when i lay on my back i kind of don't have volume. I've lost 5kgs post surgery and planning to lose more 5 kgs. I'm thinking of getting implants to have upper pole fullness as it isn't full now.. will implants alone be enough to achieve better/fuller look or will i need another breast lift?

Martin Benjamin, MD, FACS · Answer

Hello! Unfortunately, this is a common problem after breast lift (especially in the setting of weight loss). A breast implant can surely, fill out the upper pole fullness that you are desiring. However, it should be noted that in patients who have lost a large amount of weight, the breast crease may be too weak to support an implant and you may require an internal bra mesh for soft tissue support as well as to support the new implant. The alternative is performing an autoaugmentation lift but over time, your breast tissue will still continue to age and you may lose some of that upper pole fullness (an implant does not age!). Good luck!

Bora Ok, MD · Answer

Hi from Istanbul, thanks for this question. After significant weight loss, implants could be a good option to achieve upper pole fullness. In your case, I think you would benefit from a combination of a slight lift and implants. Removing a bit more tissue from the lower part of the breast might be necessary for the optimal result. This approach can address both sagging and volume concerns more effectively. I hope this helps, best of luck!

Finny George, MD · Answer

Hi, thank you for sharing your question. You seem to be a good candidate for a breast augmentation as well as potentially a correction of the pseudoptosis that seems to have developed. This will correct the upper pole and the sagging.

Gregory Lakin, MD · Answer

If you've experienced further sagging and loss of volume in the upper part of your breasts after your breast lift and subsequent weight loss, implants could potentially help achieve the upper pole fullness you're seeking. Implants add volume, particularly in the upper breast, which can create a fuller look. However, whether implants alone will be sufficient without another lift depends on the degree of sagging and your skin's elasticity. If the sagging is mild and mainly a matter of volume loss, implants might be enough. But if there's significant sagging, especially after further weight loss, another lift might be necessary in conjunction with implants to achieve the desired aesthetic. It's important to have a thorough consultation with your plastic surgeon.

Brian K. Reedy, MD · Answer

Thanks for your question! I do think you would benefit from some form of a breast lift. Your nipple/areola complex looks to be in a good position so you may just need a lower pole mastopexy with an implant. Please be sure to consult a board-certified plastic surgeon in your area. Good luck!

Aftab Siddiqui, FRCS(Plast) · Answer

From the pictures provided, it appears that  you have more breast tissue below the nipple areola complex. Only augmentation will not achieve your desired result. You will need an uplift to address the ptosis or pseudoptosis and further fullness can be achieved with implants.

James Lee, MD · Answer

Thank you for submitting your question and photos. From the photos, it appears that your NAC (Nipple-Aereolar-Complex) are in good position so lifting them further would not be needed. It does appear however that you have lost some tone in your breasts, either from tissue stretch after surgery or from your weight loss, which resulted in your natural breast gland tissue to fall lower creating something that may be pseudootosis; this is where your NAC have not lowered but your natural breast gland tissue has lowered. This will be better addressed during an in person evaluation with a board-certified plastic surgeon. In regards to upper pole fullness, an implant it the way to achieve this. Natural breast gland tissue will always be more mobile and move in the direction that gravity pulls it. Hope this helps.

Daniel Barrett, MD · Answer

Dear sgrmk,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Ronald J. Edelson, MD · Answer

Your breasts have bottomed out. The skin on the lower portion of the breast needs further tightening. If you want upper fullness you would need an implant as well

Gary M. Horndeski, MD · Answer

Unfortunately, the breast lift you underwent did not lift your breasts very high as they still are low on the chest wall. You would benefit from a repeat breast lift. The technique I recommend is The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained if not injured during your previous surgery.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

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