Breast Lift? Breast Augmentation?

In early '11 I gained weight and got up to 159 lbs. In May of '11 I lost 35 lbs and got back to my normal/current weight of 125 lbs and went from a bra size of 38 DD to a 36 D. The significant amount of weight loss decreased my breast volume to a less than desirable point and they began to sag. I am only 20 years old and have significant drooping, back pain, and the nipple/areola are below the skin line where the breast skin meets with the upper abd skin. What would you suggest I do?

Doctor Answers 11

Ultimate Breast Lift alternative provides internal bra support

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If you want larger breasts then you will need implants.  However, if you want to stay the same size then you need a lift.  There is a new procedure called The Ultimate Breast Lift, which avoids the vertical scars such as the lollipop or boat anchor shaped incisions.  Using this technique, it is possible to reshape your breast, elevate them higher on the chest wall to increase your cleavage and upper pole fullness.  Back pain is eliminated because the weight of the breast is transferred to the underlying muscle by the internal bra.

Best Wishes,

Gary Horndeski, M.D.

Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

Breast Lift? Breast Augmentation?

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Without a photo it is hard to assess the issues properly. It does sound that you would do well to have a breast lift. If the current breast size is satisfactory, that is all you should consider. If more volume is also in your goal, implants would be considered. 

When you ready for an in person consultation, RealSelf has listings of surgeons in your area. You should consider cross referencing the listings from the The American Society of Plastic Surgeons (plasticsurgery dot org). A listing in the ASPS website assures you that your surgeon is not only board certified,  but also is a member in good standing of the major plastic surgery organization in the U. S.

Thank you for your question, best wishes.

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

Breast lift or Breast Augmentation

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Your history of weight gain and loss indicates you may have ptosis or sagging and will need some sort of lift. The implants may give you a better final result.

Norman Bakshandeh, MD, FACS
New York Plastic Surgeon

Breast lift?

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It sounds like you may need a lift.  Of course, an exam in person is critical so that the appropriate surgical plant can be provided for you.

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

Breast lift? breast augmentation

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Based on your description, it sounds as if you may benefit from a lift.  If you are happy with the size of your breasts, an implant may not be necessary.  However, it is difficult to guide you without an examination.  As others have suggested, I would also recommend that you have a consultation with a board-certified plastic surgeon -- he or she will then be able to discuss options with you in more detail.  Good luck!

Anureet K. Bajaj, MD
Oklahoma City Plastic Surgeon
5.0 out of 5 stars 21 reviews

Breast lift, implants, or both?

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Based on what you described, it is difficult to determine exactly what would be best for you.  The best course is to make an appointment and see a board certified plastic surgeon who can examine you and make recommendations. 

Adam Hamawy, MD
Princeton Plastic Surgeon
4.8 out of 5 stars 57 reviews

Sagging after weight loss

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Going from a DD to a D would not generally produce the kind of sagging you are describing. However, if this is the case, to elevate the nipple-areolar complex, a mastopexy would probably be necessary as an augment would leave you with larger breasts which could sag. My concern is with the skin tone and the effect of an implant. You aren't small to begin with so I think a lift would be the procedure to consider. See a board certified plastic surgeon to discuss your alternatives.

Breast augmentation, lift, or both

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Thanks for your inquiry and good description of your past year.  Congratulations on loosing your weight.  Without a picture it is hard to answer your question completely, but I will highlight some points.  If you desire increased size, volume may be added with a breast augmentation.  However, if your nipple/areolar complex lie below your breast crease I would reccomend you also have a breast lift.  Many surgeons like myself do them together in one step routinely.  Finally, as far as your back pain, an augmentation may actually worsen your symptoms and a lift alone may not help because the cause of back pain is multi-factorial.  You can go to many websites including mine at to learn more about what is entailed in a breast lift with augmentation, and of course seek the opinion of a board certified plastic surgeon to get more information and cousel.  Good luck, Dr Rumalla

Breast lift

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I am hearing conflicting information in your question. On the one hand you state the volume of your breasts is less than you would like but on the other hand you are experiencing back pain. Although there are numerous causes of back pain, large breasts can be a contributing factor.

A breast lift can remove the excess skin and reshape the breast. The nipple will once again be over the most projecting part of the breast and no breast skin will rest on the abdomen. This will not make you larger. A implant will be required to restore upper pole fullness to the breast which sounds like what you are after.

I would encourage you to seek out a board certified plastic surgeon to evaluate you and help you understand the possibilities that exist for achieving your desired goals. I hope this was helpful and good luck.

Robert W. Kessler, MD, FACS
Corona Del Mar Plastic Surgeon
5.0 out of 5 stars 130 reviews

Breast augmentation is not the answer for sagging. Vertical lift works best.

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If your main concern is sagging of your breasts, there is no substitute for a breast lift, but it has to be a vertical lift, not a "donut" or "crescent" lift.  The inverted-T or anchor-scar lift involves too much scarring.  The vertical lift design provides the most effective lift.  Remember that breast implants do not elevate the breasts.  Sometimes patients think implants will take up the slack, but this does not happen - your breasts would stay saggy but just be larger if you had implants without a lift.


Usually for a young woman who wants to look her best, a combination of implants to restore the pleasing upper pole fullness and a vertical lift to correct sagging is the best option.  I've attached a part of my website that shows photos of results.  Remember, some breast tissue is removed with the lift, so you don't have to be any larger - but this way you can have fullness where you want it and not where you don't.

Eric Swanson, MD
Kansas City Plastic Surgeon
4.7 out of 5 stars 62 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.