Is Breast Lift the Only Option for Sagging Breasts?

I am considering a breast augmentation. I have always been a decent C cup, but in the last year, I have lost approx. 35 lbs, and it has left my breasts deflated and saggy. I have consulted 2 plastic surgeons who insist I need a lift as well. I really don't want the extra scarring. Is there any way to achieve a good look without doing a lift as well?

Doctor Answers 16

Lift vs. implant

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It can be very tricky for the patient to judge beforehand if a lift is necessary.

There are some women whose breasts appear terribly saggy, but an implant alone can help them. This is especially the case for patients who are thin and have had loss of breast tissue after breast feeding. There are many types of breast lifts with differing abilities to correct drooping vs. the amount of scarring produced vs. the ultimate shape of the breast. There is also the artistic style of the surgeon to be considered.

An examination with careful measurements by an experienced plastic surgeon will give you the best estimate.

For many patients, there is in fact no right answer, but choices, each with their pluses and minuses.

If you are seeing several board certified plastic surgeons and they are all recommending you have a lift with an implant, it is likely that will be your very best choice, all factors considered.

Beverly Hills Plastic Surgeon
4.9 out of 5 stars 194 reviews

Sounds like you will need a lift

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If anatomically you need a lift, then there is really no other way to achieve a good cosmetic result without one. It is true that the cost of this is the scars, but in general they heal very well. If you simply have implants placed without a lift, it usually looks quite unnatural, with extra hanging skin, and the majority of patients would be very unhappy with this.

In short, it's your body and if you don't want the incisions of a lift, don't have the procedure, but be prepared that without one, you may be very unhappy with the final shape and look of your breasts.

Shahram Salemy, MD, FACS
Seattle Plastic Surgeon
4.9 out of 5 stars 155 reviews

If unsure about breast lift, have implant surgery first and lift later

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If your weight loss has simply deflated your breasts but the nipple complex remains above or at least on level with the breast fold, a lift may not be necessary. A breast implant alone would suffice to replace the volume lost.

If your nipple complex is below the fold and points south, so to speak, then the breast lift will be needed. In this latter circumstance, an implant alone will create a bigger more droopy and less aesthetic version of your present breast.

However if there is still some doubt in your mind, have the implant surgery first without the lift to see if this satisfies your needs. This approach does not burn any bridges and you could always have the lift at a second operation if you are unhappy with the implant alone.

David A. Ross, MD (retired)
Chicago Plastic Surgeon

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Breast lift

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If you are experiencing volume loss without true sagging, the use of implants can achieve restoration of breast volume which creates the appearance of a full or lifted breast with minimal incisions.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Breast lift

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It sounds like with a significant weight loss a breast lift is what you need. Unfortunately the only way to accomplish this is with incisions on your breast.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Mastopexy scars will not suit everyone

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The mastopexy scar is the number one tradeoff to consider. After all, we have a goal to create a pert well shaped breast which is pleasing bare, or in the nude. The bra is the great equalizer though you may not always want the full cover of one, and the scar may make you feel uncomfortable without.

Breast augmentation will provide the volume that you need and as I have indicated in my other responses about lift or mastopexy, augmentation may lift the nipple a degree if the nipple, the center of it, is at or above the fold under the breast. The implant may otherwise tend to produce a downward tilt to the nipple, a more "mature" look, but this may suit you and your life style just fine. If the scar will make you feel self conscience or unattractive by all means don't do it. Even if all surgeons say you will look "better" with the lift, stick to what is right for you. A lift can always be done at a later date if you wish.

With your loose skin, breast augmentation requires special care reguarding implant selection, placement, and size. The implant needs to be placed with consideration as to the tissue cover, and be of a size adequate to take up the loose skin. The pocket should create a soft smooth augmentation with a good marriage between breast and implant to that they feel as one. Take time to choose an experienced surgeon who has your interests at heart.

Best of luck,


Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Visual method to determine if you need a breast lift

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I have a relatively simple system for determining if you need a lift. Breast sagging can be categorized into three groups

stand in front of a mirror and see which group best describes yourself

Group 1: I can see the bottom of my areola and a rim of non-pigmented breast skin from the front, my nipple is at the level of the crease behind my breast

Group 2: I can not see the bottom of my areola but I can see a rim of non-pigmented breast skin from the front, my nipple is just below the level of the crease behind my breast

Group 3: I can not see the bottom of my areola and I can not see a rim of non-pigmented breast skin from the front, my nipple is greater than 11/2 inches below the level of the crease behind my breast

Group 1 can be corrected wtih an implant alone

Group 2 can usually be corrected wtih an implant alone but not always

Group 3 always needs a lift + and implant

This information plus an examination and evaluation of the lenght of your breats, the quality of your tissue and the existing breast volume will give you an accurate answer.

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

A simple test will give you your answer

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Dear SLP,

Many women share your concerns regarding their breasts.

The ideal situation would be to improve the shape and size without any scars.

However, if you don't like the location of your nipple, the only way to move it to a better location would be to make an incision around it.

The way to determine if you need a lift or not, is to imagine that your breast was bigger, but your nipples stayed in the same location. Would that look attractive to you?

Based on your two previous consultations, I would guess that even if your breasts get bigger, they will still look droopy because the nipples are too low.

Keep in mind that breast scars generally heal very well. Furthermore, you may find that once you have the lift, you may not necessarily want to be any bigger.

It is always more appealing to have an attractive-looking small breast than an unattractive large breast.

There are many new options for breast lift that can reduce the scar significantly. For example the "donut" lift or the "lollipop" lift can minimize the scarring. But keep in mind that these options are not appropriate for all patients.

Good luck with your surgery.

A. Peter Salas, MD
Manhattan Plastic Surgeon

Get the lift if you care about your shape

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Nobody wants to have scars but they DO want the best shape they can get. This only comes from having a lift done if your nipples have sagged down to the level of the crease below the breast or are below it or are pointing down. Unfortunately, there is just no way around what mother nature has dictated for you.

Your's is such a common senario. Never yet have I seen a patient who would be happy without a lift if they needed one from an anatomical standpoint. I even have pictures of patients who came to me after augmentations elsewhere without lifts and never yet have I met a patient who sees those photos and says they would be happy with that result just to avoid a lift.

Just make sure your surgeon is excellent so you get the best shape and then the scars won't seem so bad. Also, don't try to overwhelm the need for a lift by going huge with the implants as this will cause many problems later.

You definitely need a lift, but it can be a minimal scar breast lift.

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Hi! Some of the most common bad results that I see are in women who tried to get their sagging breasts corrected just with implants. So I urge you not to do that.

1) You probably need a "donut" lift that leaves you only with a circular scar around your nipples, together with implants.

2) If you have really bad sagging, you might need a "lollypop" scar. But you never need the "anchor" or "upside-down T" scar for a lift.

3) How the lift is done really matters. The key is NOT to rely on tightening the skin to get the lift. The lift should be done from the inside. That way, you get good long term shape, and the scars fade.

4) I can tell you that women worry a lot about the scars before a breast lift, but after surgery they are usually very happy.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

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.