Do I Need Mastopexy with Breast Implants?

Can I lift the breasts with just the implant or do I have to get a mastopexy? I also need to decrease the size of my areola and correct my some-what inverted nipples but I would hate to have horrible noticeable scarring everywhere.

My breasts grew a bit during pregnancy but they deflated as fast as they came, so they're now pretty flat full of stretch marks and still a 34A. I want soft, perky, scar less (if possible) natural breasts with small areolas and perky nipples. What do you recommend? Thanks.

Doctor Answers 11

It depends on the shape and amount of droop of the breasts

Implants can give a slight lift to breasts with just a minimal amount of droop, in particular if the implants are placed above the muscle, however this determination needs to be made by a plastic surgeon with a good judgement. If you have too much droop or ptosis, and a lift is not performed, then you will have a poor aesthetic result.

The areola can be made smaller as part of the breast lift as well, but all of this needs to be discussed with your plastic surgeon after he has examined you-- have a frank discussion with him about your concerns and goals for surgery, and he will be able to give you the pros and cons of each option.

Good luck,

Dr. Salemy

Seattle Plastic Surgeon
4.9 out of 5 stars 149 reviews

Implants and lifts

Of course nobody wants to have a lift if they can just have an implant.

However, augmentation of a saggy breast can produce a large saggy breast. It may be preferable to perform a periareolar (especially if the areolae are large), lollipop or even full breast lift to attain the best result.

An experienced plastic surgeon can tell you what the likely results of each approach are. If you see three experienced plastic surgeons and hear the same thing three times, that is probably the wisest choice of action.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 177 reviews

Breast lift with implants

Usually you can not achieve the lift you want just with implants. This is something evaluated in person during an exam.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

You probably need breast implants and a lift


From the way you describe things I'd bet you are going to be best served by implants as well as a breast lift. Of course you are only going to really know this after having an examination by the board-certified plastic surgeon you ultimately choose. Breast lift surgery can be done in a fashion to reduce the appearance of scars, but without those incisions, really droopy breasts don't achieve very nice correction. Implants alone really don't lift much.

John P. Di Saia, MD
Orange Plastic Surgeon
5.0 out of 5 stars 27 reviews

Breast lift, smaller areolas, nipple projection, breast enlargement: Can't all be done without scars


As plastic surgeons, we all try to achieve the best results (for example, pretty breasts) with the least scar or other side effects or risks. Many of the things you wish for cannot be done without some kind of scar.

All scars are not "horrible noticeable scarring." When a scar is needed to achieve a patient's request, we try to minimize the visibility of the scar (location, length, color, texture, etc.). Some scars cannot be hidden when a breast is completely exposed, but may be preferable to the current situation (such as sagging). You should discuss each of your concerns with experienced plastic surgeons, during in-person consultations, and choose the best way to get the breast appearance you desire with the least scar.

Sutton Graham II, MD
Greenville Plastic Surgeon
4.8 out of 5 stars 5 reviews

"You can't always get what you want"

You can't shrink the areolas without scars, and you can't lift the breasts without scars. The implants will add volume and they won't lift you. They will also make your areolas larger without a lift. So go to an honest and excellent plastic surgeon who will tell you what you need to hear and not just what you want to hear and follow their best advice for your body and your goals and expectations.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

I recommend you choose what you want, and what you can't live with.

Only an exam can answer all these questions.

The breast augmentat will enlarge and give SOME lift to the breast but may not be enough, especially if your nipple falls below teh crease where the underwire of the bra sits. To get the areola to shrink, will take surgery to reduce, and that will require scars, but they will fade. Inverted nipples require a different procedure all together.

It sounds like for sure you will need to get implants to take care of most of your concerns, you may want to just do one step at a time and see how things turn out.


Scott E. Kasden, MD, FACS
Dallas Plastic Surgeon
4.7 out of 5 stars 101 reviews

Mastopexy is determined by nipple position

Breast augmentation will correct a small degree of ptosis, or droop of the breast. The key however is the postion of the nipple, the center part, in relation to the fold under the breast. You can place your finger in the fold as you stand in front of a mirror and see where your nipple falls. For an augmentation to be effective and aesthetically pleasing the nipple should fall level with the fold or anywhere above. If the nipple lies below there is a chance that augmentation will push the nipple down as the breast is enlarged. The look is not the best, and mastopexy of some form is the solution.

The scar with mastopexy is a concern and issue though we have had good success with round block mastopexy for small degrees of ptosis, say one inch or less. With the round block or periareolar mastopexy the scar line runs around the nipple only, and the size of the areola can be reduced as the nipple is lifted over and upward on the breast. Mastopexy is easily combined with breast augmentation when needed. You can find examples on the internet to help you understand the scar and healing.

If no scar is acceptable to you we suggest transaxillary augmentation or an underarm approach, and an implant that will take up the skin well enough to provide a soft natural result.

Best of luck,


Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 42 reviews

How much sagging?

Assing volume can correct a certain degree of dagging. Rather than speculate, seek a consultation from a plastic surgeon. In general, if your breast hangs more than 1 cm. below your inframammary fold, you might noy correct this with just an implant. Also, while you can decrase the size of your areola with just a circular scar, it tends not to be long lasting, especially in the face of augmentation. he most effective way to reduce the diameter of the areola is with a lollipop-type scar.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 11 reviews

You only need a breast lift with your augmentation mamoplasty if your breast are sagging

Augmentation Mamoplasty is a procedure to enlarge your breast. If all you need is to fill out your breast, even if they have really collapsed as long as your nipple areolar complex is still at or about you fold under your breast. Mastopexy or breast lifting procedures lift and reshape the breast. This can be done with or with out augmentation mamoplasty. If your breast sag and your nipple areolar complex is bellow the inferior breast crease then you would be best served with a lift and augmentation either separately or at the same time. Make sure your surgeon has had a significant experience with doing both together before agreeing to have them done together. In my practice I place a gel filled textured implant under the breast and do a vertical mastopexy simultaneously.

Carl W. "Rick" Lentz III, MD
Orlando Plastic Surgeon
5.0 out of 5 stars 15 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.