Breast Implant Options for Saggy Breasts Without Breast Lift?

Hi there-
I wish I could tell you what you want to hear... but I can't...
Judging from your photo, there is no technique or implant that would give you a pleasing, round, and perky shape without a breast lift.
Variables such as the implant type and fill volume are going to affect the overall appearance of size you achieve, but will have much less of an affect on the shape and position of your breasts than the amount and quality of skin present.
Given your current, significant degree of ptosis (sagging), and the position of your nipples, as well as the position of your breasts, you are unlikely to achieve a pleasing outcome without a breast lift. And here's the thing... if you search hard enough for someone willing to do the operation you are shopping for, you will find someone- but then when your breasts don't have the shape you wanted, having it corrected will cost even more of your valuable time and money- if correction is even possible at that point.
I think you are much better off looking for a surgeon certified by The American Board of Plastic Surgery who can show you photos of his/her breast lifts and implants that would make you happy in the first place and with only one surgery... Are the scars necessary? Yes they are... but it is not necessary that the scars be a problem fro you. There are many things that can be done to modulate scar maturation so that the scars fade to a very inconspicuous and thin line.

If you have a clear understanding of what the outcome will be after an implant alone, and you absolutely do not want a lift, then your breast shape can be improved and the size made larger with an implant alone. I would use a high profile implant to maximize your lift.

Thanks you for your photos.  The key thing here is the position of your nipple in relation to the fold of your breast.  It appears that you are very low.  Even with the largest of implants, the breast/nipple position may still appear too low.  The profile of the implant will not significantly affect this.  In fact, the higher profile you go, the more unnatural this may look.  There are many options to minimize scars during a lift/implant combo.  Its best to seek th eadvice of a board-certified plastic surgeon.  Best of luck to you!  Dr. Pacella

While an implant can allow patients with a small amount of sagging to avoid a breast lift, unfortunately you won't be able to achieve a satisfactory result without a lift. An implant alone, no matter the size or how it is placed, will not give you a result you will be happy with. Best of luck. 

Thank you for your question. There are some women who will benefit from adding a breast lift to a breast augmentation. In general, if your nipple is located at or above the crease below your breast then a lift is typically not needed. In addition to nipple position, measurements are also used to determine when to add a lift. Breast sagging is a spectrum and women with mild/moderate sagging can sometimes go either way. In this situation, I typically recommend breast augmentation as an initial procedure, waiting six months, and then only performing a breast lift if it is truly needed. When considering breast augmentation make sure you find a board certified plastic surgeon who will take the time to answer all of your questions and explain all of your options, so that you can decide which procedures are right for you. 

Thank you for your photo. The photo shows that your nipple and areola are below the breast fold where the wire of your bra would be. This is an easy well to tell whether you need a breast lift. When the nipple is that low, placing even large implants will result in a large, saggy breast. You should reconsider having a breast lift with implants. Good Luck!

Although many women understandably want to minimize scars (as do we plastic surgeons). if you have a certain amount of droopiness (grade 2 or 3 ptosis with the nipple just below or lower beneath your breast fold) then a lift is indicated. For women that are full breasted enough, then a lift alone may be sufficient albeit with a slight reduction in volume/cup size/If you are looking for added fullness that the best choice is a combination of a lift and implants. Based on your photos likely you will need a vertical mastopexy ("lollipop lift") and an implant in the range of 400+ CC. A higher profile implant is best when performing a lift especially if you are looking for a D/DD result.    

Thank you for your question and your supplemental photo.  From the picture you provided it appears as though an implant alone will not provide you with much of a lift.  The best way to judge whether or not a lift is required is to assess where the nipple is located in relation to the infra-mammary breast fold.  Implants will only provide a lift for patients with very minimal droop, as the true purpose of the implant is to provide a patient with additional volume.  In order to provide you with a fuller and more perky breast shape, an implant with a breast lift would be required.  Good luck!

When you take your finger and place it under your breast the place where the breast attaches to your chest is called the inframammary fold or crease.  When your nipple is below that fold when you are sitting or standing you by definition have breast ptosis.  The only current solution to lift your breast and get a reasonable outcome is to have a mastopexy.  There is a very common myth propagated by patients and some surgeons that patients with ptosis do not need a lift but just a big implant.  This unfortunately makes the outcome worse and tends to plunge the nipple even lower.  I tell my patients if you cannot accept the scars you should not have surgery.  without a lift you end up with larger saggier breasts or the implant too high and your breast coming down off the implant.  Sorry, if you have ptosis you will have to accept the additional scars to reshape your breast.Dr Bengtson

Thank you for your question.Based upon your photographs your nipples are well below the folds of your breast and are pointing downwards.  This is known as a third degree ptosis or drooping of the breast.  This is a classic indication for a full breast lift.In patients with a mild or moderate degree of sagging the volume of an implant is often enough to fill out the upper portion of the breast and give some elevation of the bottom of the breast at the same time.  Unfortunately, this is not the case in your situation.If you were to place an implant in its correct location on your chest it would sit above the fold of the breast, but your natural breast tissue would sagg off the bottom.  While I know the scars of breast lift are scary and unappealing I feel that this would be likely to be your best choice.I know this answer is probably not what you were hoping to hear, I hope that it makes sense to you.Best wishes.

I would have to see you in person but sometimes a lift is not necessary. This is what I do to maximize lift with a breast implant alone:- use silicone cohesive gel implants. The more cohesive the better. I am not sure if these are available yet in the US, but the Allergan Inspira Truform 2 implants are ideal- use high profile implants. The more projection you have, the more lift you will get- have the implants placed in the submammary pocket (under the breast itself). You should have a pinch thickness at the top of your breast of at least 2 cm