Implants Without a Lift to Correct Excessive Sagging Will Be "UGLY"
Hello back to you! A picture speaks a thousand words....your photo indicates your nipple level is well below your infra-mammary fold (IMF) level. As plastic surgeons, we know that the surgical treatment of that problem is NOT an implant, but a lift. An implant alone, no matter how large, will result in a deformity called "double bubble'' or "Snoopy nose", i.e., you will have the mound of the implant where the breast should be positioned, and your own natural breast tissue will appear to be hanging off the implant....VERY UGLY! Sometimes we can "get away" with placing a large implant for a slightly sagging breast (i.e., the nipple is either at or slightly below the IMF), but we lower the level of the current IMF so that the implant can be positioned lower, allowing for the mound of the implant to be more under the mound of the slightly drooping breast....this gives the "illusion" that the breast has been lifted, but in actuality, it has not.
A lift alone will result in a better positioned breast, but it will not give you the upper pole fullness that it appears you desire. Furthermore, even if you had a lift alone, since you have a moderate amount of breast volume already, the weight of your natural tissue will likely result in faster drooping of the breast. In cases such as yours, one that has a low nipple level and moderately sized breasts, I usually recommend to consider a small reduction (which simultaneously lifts the remaining breast tissue) and an implant to provide upper pole fullness and a more "perky" look. The result is likely to last longer because more of the breast volume is from implant and less from your own natural breast, which will sag over time. Sometimes I suggest these 2 procedures be performed in stages, but that would be up for discussion between the patient and the surgeon (staged procedures increase predictability of the end result). Regardless, I know this is not what you wanted to hear, but I think you would be sorely disappointed in the end result if you underwent implant only, regardless of size/projection/etc. Good Luck!
Breast implants without a lift
Women with sagging breasts who do not want a lift, do require a large implant to fill out the breast. A high profile implant will look like someone put a ball in your breast. The implant needs to be a mod or a lo profile implant. An augmentation without a lift will create a larger sagging breast. It provides a minimal amount of lifting, and is not a substitute for a formal lift. It can be used successfully in someone with a little droop, but is cautioned in someone with a lot of droop such as yourself.
Severe Breast Sagging Requires a Lift - NOT large Breast Implants
I completely agree with Dr. Soto. Your degree of breast droopiness requires a Breast Lift (Mastopexy) for improvement. Trying to get around this by putting in a huge breast implant will NEVER give you upper pole fullness but WILL result in more skin stretching and more breast drooping under the weight which eventually will require a more challenging breast lift.
Breast augmentation without lift
In general, the larger the implant, the more lifting effect you achieve. So yes, if you place a large enough implant, you won't need a lift. The only way to tell how large the implant should be is to have a physical exam.
There are many factors that a surgeon takes into consideration when deciding breast implant size (i.e. amount of native breast tissue, nipple position relative to inframammary fold, breast diameter, skin quality, etc). One option for people such as yourself who probably would benefit from a breast lift is to just perform a breast augmentation (usually subglandular) without the lift.
After everything settles out after a few months, you can always perform a lifting procedure secondarily but may not need to if you're happy with your initial result. As far as which implant to choose, moderate plus vs. high profile--this requires a physical exam for all the reasons mentioned above. Good luck!
Can sagging breasts achieve a more attractive shape and position without a breast lift?
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.
Saggy Breasts Need a Lift-Implants Alone Will Not Look Good
Thank you for your question. From your photos you have Breast Ptosis-your Nipple Areola id below the crease under your breast.
Breast Implants alone will make the sagging look worse. See an experienced Board Certified Plastic Surgeon and consider a breast lift with or without implants.
I agree with these other surgeons. Implants without a lift will look worse! Don't do it.
Dr Grant Stevens
I would not recommend breast augmentation without a breast lift in your case. You will certainly be disappointed if you do not have a lift.
Breast Implants will only make your problem worse. You would need huge implants and then you would still be saggy. The rule is, if your nipple is below the infrmammary line then your breasts are ptotic (droopy) and only a lift will help.
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.