Want to Get Breast Augmentation. Do I Need a Lift?

Hi im 19 years old. When i was 16 i gained alot of weight and lost it very quickly. My boobs weren't the same after. They do have some sagging. They're b 34 right now and i wanted to get my breast done with implants the silicone gel ones to fill them. So i went to a plastic surgeon and he recommended i get mammoplasty as well as the augmentation but i don't want the scars left from the lift. I'm not looking for perfection i just want them more full. Can i still just get implants?

Doctor Answers 17

Lift or augmentation

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it really depends on the amount of ptosis or drop of the nipple.  If you are mostly just deflated, the implants autorotation effects may lift you enough.  If your nipple is too low, having an implant without a lift will have a strange appearance.

All the best,


Rian A. Maercks M.D.

Several options - Duel planar breast augment vs mastopexy

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Without an examination or evaluation of photos it is difficult to give a definitive opinion.

That said, from your standpoint, if you look in the mirror straight on and can see skin visible below the nipple areola complex and on sideways view the nipple areola sits at or above the sweep of the breast, then most likely you can obtain a nice result from a duel planar augmentation alone. The sub glandular lower portion of the prosthesis will fill and rotate the inferior portion of the breast, and the submuscular superior portion of the prosthesis will give a more natural appearance. Proper measurements and the amount of skin laxity will influence the size of the prosthesis.

If on the other hand the nipple areola is sitting too low then some type of mastopexy would be appropriate to obtain an aesthetically pleasing and long lasting result. If only a small amount of elevation is necessary then a donut mastopexy would suffice. If significant ptosis “droop” is present then you would need a vertical mastopexy to obtain an ideal result. These scars over time do quite well and being young you want a result that will last for many years. Also obtaining another opinion from a plastic surgeon in a case such as yours is certainly reasonable. 

Breast lift contributes to fullness

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This depends on the amount of sagging you currently have. If you understand that sagging can become more apparent after a breast augmentation alone, and you're fine with that, then you don't need the breast lift. However, it is important that you understand that a breast lift can contribute to fullness.  

Breast Augmentation and lift

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Based on what you have described it sounds like you need breast implants and a lift as well.  It may be possible to perform a breast augmentation and breast lift with limited scars such as a circular scar around the areola, or a " lollipop" shaped scar around the areola and vertically down the breast.  

Andrew P. Giacobbe, MD
Buffalo Plastic Surgeon

Do I need a breast lift?

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The goal in every patient is to provide the best result with the fewest scars. Patients and surgeons should never rush into a breast lift unless absolutely necessary.

An experienced cosmetic breast surgeon can often produce a good result in a mildly to moderately sagging breast with an augmentation alone.

The surgical plan is specific to each patient and depends on an assessment of the breast tissues and measurements. This is done during the course of an in-office consultation.

Saline implants are about 20% heavier than silicone gel devices, and are almost never the preferred implant in a sagging breast.

I suggest you wait until you are 22 years-old and are eligible for silicone gel implants.

Is a lift necessary?

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I cannot offer any advice without photos and measurements. Having the opprotunity to examine the breast tissue itself is also very helpful. Gels are not FDA approved for under 22 yrs.

Mark D. Epstein, MD
Stony Brook Plastic Surgeon
4.9 out of 5 stars 244 reviews

Breast implants at 19

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I would probably recommend a small uplift that I doi through which I put the implant in-at the top of the areola. I call it my happy face lift. I agree that at your age, or any age, it is best to try and do the least amount of scars possible. Watch my videos.

Edward J. Domanskis, MD
Newport Beach Plastic Surgeon
4.5 out of 5 stars 28 reviews

Lift needed?

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If you need a lift, get a lift.  Almost every patient I have done a "lesser procedure" on because the patient could not accept the breast lift scars has been disappointed and often has ended up with a lift anyway.  A vertical lift (the kind I do) usually leaves very acceptable scars where the sun don't usually shine.

Lisa Lynn Sowder, M.D.

Lisa Lynn Sowder, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 77 reviews

Breast implants and lifts

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Breast implants do not lift the breast or the nipple-areola. They can only simulate this by filling out the lower pole of the breast below the level of the nipple-areola. 

If the nipple-areola is too low relative to the level of the inframammary crease behind it, then an implant alone is doomed to failure and a lift will be necessary later. It's also possible that a lift isn't needed now but it will become necessary later with further changes in the breast from aging, weight, pregnancy, hormones, or heredity. 

I agree that a definitive answer cannot be given without an exam and measurement of the level of the nipple to the inframammary crease behind it. The plastic surgeon has to use his or her judgment to determine the issue of a lift rather than a pure patient choice but it is important to understand what implants and lifts do and do not do. 

Scott L. Replogle, MD
Boulder Plastic Surgeon

Breast augmentation may or may not require a lift for optimal results

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Breast augmentations are frequently done without a lift, but make sure you understand that you may require a lift in the future.  It's hard to give you a more exact answer without actually seeing you.  The larger the implants, the more of a "lift" you'll get with the implants alone.  Therefore, you may want to consider a slightly larger implant than initially desired.  Yet, you don't burn any bridges separating the lift from the augmentation.  Just know that if your plastic surgeon recommended a lift with the implants and you only get the implants, your results may not be as optimal as possible.

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.