26 yo/130lbs/5'4"/34DD: Do I need a breast lift or can I get good results with just implants? (Photos)

Great question!  Congratulations on the weight loss journey!  Unfortuately with weight loss comes excess skin and droopy breasts.  On a cursory look at your photos and your wish photos, you can see that the nipple has quite a ways to go higher on your chest that an augmentation just will not do.  Therefore you would need a breast lift to get that nipple and breast tissue to a higher perkier position.  Yo udon not necessarily need to get big implants, but again, looking at your wish photos, you would need an implant to give you the fullness you desire.  With a breast lift procedure, there is always a small chance that there could be issues with breastfeeding in the future since the breast tissue is being cut and manipulated.  There is a lot to think about so the best recommendation is to have a consultation with a board certified plastic surgeon so that your concerns can be addressed and the correct procedure providedBest of luck and hope this information helps!
- Dr. Roger Tsai  @DrRogerTsai
Board Certified Plastic Surgeon 

I recommend a lift with an implant.  The implant selection should be based on a combination of your desired size, soft tissue dynamics, breast base diameter and skin elasticity.  I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with.   Finally, make sure your surgeon is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery (ABPS), a member of the American Society of Plastic Surgery (ASPS), a member of the American Society of Aesthetic Plastic Surgery (ASAPS), and a fellow of the American College of Surgeons (FACS).Best,Dr. DesaiBeverly Hills Institute for Aesthetic Plastic SurgeryHarvard Educated, Beverly Hills & Miami Beach TrainedDouble Board-Certified, Double Fellowship-Trained Beverly Hills Plastic Surgeon

Based on your photos, I think you are a better candidate for a breast lift with implants, as you appear to have a significant amount of breast tissue below your infra-mammary crease. Implants alone may result in a situation where your breast tissue droops off of the implants leading to an unfavorable result. A breast lift will address the breast tissue position, while the implants will increase your overall breast size and increase superior breast fullness. An in-person evaluation would be necessary to give a proper recommendation. I recommend consulting with a board certified plastic surgeon to discuss treatment options. Best wishes for a successful procedure.

This really involves an in person consultation to evaluate skin quality and to do proper measurements for mastopexy, breast augmentation or the need to do both together. We look at skin quality and stretch marks, nipple position relatively to the inframammary fold, breast volume and many other measurements. All this is combined with surgeon experience to give the best possible outcome. If patients feel uncomfortable with the scarring of a mastopexy then it is reasonable to put in the implant and let it settle overnight. Then the decision can be made later to do the mastopexy. Make sure to find a board certified plastic surgeon with experience. 

You may benefit from a breast lift at the same time as having small breast implants inserted, watch this brief video which addresses this exact question.Best wishes,Dr.Bruno

hello thank you for your question and provided information as well.. based in your question and the picture you showed you are a good candidate for breast augmentation with implant., in your case its recommended get a consultation in personal with a plastic surgeon to determinate how many cc do you need to get a very well result.

Your breasts are too low on the chest wall and you would benefit from a lift more than augmentation.  The technique I recommend is The Bellesoma Method.  This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage.  Vertical scars are avoided, nipple sensation and the ability to breast feed are maintained.  At the same time or later, fat transfers can be performed if additional volume is desired.  Implants are not lifetime devices and half are removed by 9.5 years.  Fat transfers are permanent can incorporated into the body.Best Wishes,Gary Horndeski, M.D.

Hello,You photos indicate you’ll need a lift to achieve anything similar to your desired breast appearance. Go visit a few ABPS certified/ASAPS member surgeons who specialize in breast surgery. Best of luck!

It's a great question. Thank you for your photos. Based on your photos it does appear that you would require a breast lift if you plan to have an augmentation. Although an in person exam and measurements are needed to make a final determination most likely a lift will be needed to wrap your breast around the implant. Techniques for lifts vary, but there are techniques that will not separate the connections (ducts) between your breast tissue and your nipple. These technique should not change your chance of being able to breast-feed in the future. It is important to understand that not every woman will be able to breast-feed even though she tries. As you continue the journey, make sure to find a qualified surgeon who performs many lift/augmentation surgeries.

Patient concerns regarding the appearance of their breasts can typically be divided in two pools: volume, ptosis (droop). The procedures to address these issues are as different as the issues themselves. However, these concerns are not mutually exclusive (some want smaller less droopy breasts and others want larger less droopy breasts).
There are two factors which can help to answer the question of which surgery will deliver the most satisfying result: mastopexy, augmentation or both. Patients must first consider the position of the NAC (nipple areolar complex i.e. the pigmented portion of the breast) as it relates to the inframammary crease. If the nipples are at or below the level of the crease the patient may benefit from a lift or mastopexy. The breast lift is designed to elevate sagging breasts to a more youthful position. It also helps to reshape and tighten the skin of the breasts. This is typically accomplished via a periareolar (around the nipple) incision with or without a vertical incision.
Mastopexy is an effective way to address sagging breast, however, the changes which accompany weight loss or pregnancy can also decrease volume of the breasts. When a woman wants the volume restored (in the upper pole), or increased, a breast augmentation will also be needed in conjunction with mastopexy. Augmentation can help restore the volume loss which is well known to women following children. There are a number of options available to women considering augmentation ranging from size and implant type to access incision.   
Based upon your photo alone, you would likely benefit from a lift in concert with an augmentation. This should not affect your ability to breastfeed as the connections between nipple/duct/gland are not interrupted.
There is a procedure for every problem. To determine which technique is right for you, consult with a board certified plastic surgeon (ABPS). Patients should discuss their concerns with their physicians in order to make an educated decision.