Do I need a breast lift and what size implants? (photo)

Hi My doc says im borderline needibg a lift. I was a e cup whilst breastfeedibg but now in a c cup. He says i need to fill the skin with 500ccs+ but u dont need a lift. He also said to go subglandular. Im worried such large implants will make me even saggier in the long run. Would u suggest a lift/what position/and what size? Help!!!!

Doctor Answers 5

Breast Lift with Implants

Hi, and thanks for your question.  Based on your photos which demonstrate some evidence of skin and breast tissue below the breast crease I would believe you will get the best results with a lift and an implant.  It also appears that there is some volume loss to the upper pole of your breasts combined with some loss of skin tone or elasticity.  In these case I find that performing a breast lift (mastopexy) combined with an implant of the right size gives excellent results.  In patients with some thinning of the breast tissue I do prefer to place the implant under the muscle with a dual plane technique because I believe it gives more natural and durable results.

When it comes to breast surgery I believe that an in person consultation with an experienced plastic surgeon is essential.  During the consult the implant size can be best determined.  I believe that a 500 cc implant would be very big on you, and would suggest an implant likely in the 350-375 cc range.

Fort Worth Plastic Surgeon
4.9 out of 5 stars 93 reviews

Do I need a lift?

I think you will get a better result with a smaller implant and a lift. 

You have a very thin chest wall.  A 500+ cc implant will be very big on you.  Placed above the muscle, this will hang the breast pocket and ultimately sag further over time.  

With your thin chest wall and tissue coverage, I think the transition at the top of you breast would be very obvious. 

I think a submuscular implant with a lift is a much better option. 

Gordon Lewis, MD
Midlothian Plastic Surgeon
4.8 out of 5 stars 23 reviews

Do I need a breast lift and what size implants?

Thank you for the question and pictures. Although precise advice would necessitate in person consultation and a full communication of your goals, I will try to provide you with some advice based on the limited information here. In my opinion, most patients in your situation benefit from sub muscular (dual plane)  breast augmentation, breast lifting, and the use of silicone gel breast implants.

Generally speaking, the best online advice I can give to ladies who are considering  breast
augmentation surgery ( regarding breast implant size/profile selection) is:

1. Concentrate on choosing your plastic surgeon carefully.  Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you're looking for. Ask to see lots of examples of his/her work.

2. Have a full discussion and communication regarding your desired goals  with your plastic surgeon. This communication will be critical in determining  breast implant size/type/profile will most likely help achieve your goals. 

In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as  “natural”  or “C or D cup”  etc means different things to different people and therefore prove unhelpful.
 Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup  size may also be inaccurate.

 The use of computer imaging technology may also be very helpful during this communication process.

3.  Once you feel you have communicated your goals clearly,  allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals.  Again, in my practice, this decision is usually made during surgery.

I hope this (and the attached link) help.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,488 reviews


I think you would benefit from a lift in addition to an augmentation.  Sizing can only be determined after a thorough consultation and sizing session.  See a BC PS.

Asif Pirani, MD, FRCS(C)
Toronto Plastic Surgeon
5.0 out of 5 stars 35 reviews

Breast augmentation w/ lift

Based on the photos provided I believe a lift with implants will give you the best long term results.

As a general rule when my patients size their implants I like them to look at themselves with the actual implants in place in a testing bra. This is not a perfect teaching tool because implants can lose some projection particularly when placed under the muscle, but because we size with actual implants, to me it is the best teaching tool.

It is not uncommon in my own practice for patient to bring a friend or family member and a variety of different blouses and spend a good deal of time looking at the implants well before surgery.
So here's some basic thinking that may be of help to you:

When you look at implants on your frame don't just think about the size of the breast, but think about how it balances with the width of your shoulders as well as your hips. If an implant as to wide it will make you look top heavy, if an implant is too narrow it will look like a torpedo. In my own practice I try to focus on this relationship, and to me the width of the implant is almost more important than the volume itself.

Once you find the width of the implant that gives a nice overall balance with the hips then you can change the cup size by going high, moderate or low profile.
If you're agonizing between two sizes I generally recommend you go slightly larger, because it is very rare to hear patients say," I wish I had gone smaller".
Sometimes a patient who needs a breast lift is encouraged to go with a larger implant to to try and avoid the lift. I think that this is a mistake. I personally feel that it's better to get the size breast you want and let the lift happen if it's necessary.

Lastly, as a slender person it is always harder to have a more natural result. Patients with less breast tissue do not provide as much camouflage to help hide the implant. I always prefer a submuscular implant because it adds one more layer of tissue to help hide the implant from the outside world. In very slender patients I prefer silicone gel implants because they tend to look more natural as well. Even though you are slender, pick an implant that is wide enough to fill the chest appropriately. If you go too narrow, it can sometimes looked even less natural, smaller is not always more natural looking.

I hope these things that I've said are making sense, I hope I've been able to add some clarification in sizing for you. Best of luck with your upcoming surgery.

Marwan R. Khalifeh, MD
Chevy Chase Plastic Surgeon
4.7 out of 5 stars 106 reviews

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.