Do I Need a Breast Lift with Implants or Augmentation Only? (photo)

Based on my pics do you think I need a donut/benelli lift with implants, or a lollipop lift with implants? Could I get away without a lift at all or would I end up just looking larger, but droopy?

Doctor Answers 20

Recommendation for breast lift or implant alone

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Thank you for your questions and the pictures.

There is really no need to over-analyze this or get to cute and gimmicky. Based on your photos, I think you would be happy with a breast augmentation alone.

If you do not like the size of your areola/nipples and want them smaller, than add an areolar reduction (donut) to the procedure.

I hope this helps. Best of luck.

Nashville Plastic Surgeon
5.0 out of 5 stars 221 reviews

Breast Lift Necessary?

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Thank you for the question and pictures.

Although hard to know for sure without examining you and discussing your goals in detail,  I think you will probably be better off with breast tissue alone ( without breast lifting).

Best wishes.

Augmentation with crescent lift

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You indeed have a deficiency of skin in the lower pole of the breast.  Lowering the fold would probably give you a double bubble appearance.  A donut mastopexy would further decrease the skin of the lower pole, since by definition it is taking out skin  circumferentially.  I prefer to excise a crescent of skin above the areola to raise the nipple.  This can be done for up to 2 cm.  This limits the scarring to the periareola.  I would insert the implant thru the inferior margin of the areola. This has worked well for me for the last 20 years and doesn't burn any bridges.

Randy Proffitt, MD
Mobile Plastic Surgeon

Implant and lift choices in breast augmentation

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Your photos show the right breast to be a bit bigger and lower than the left but I would agree with Dr. Stone and Dr. Stratis that you have pseudo ptosis (deficiency of the lower pole of the breast) rather than true or significant sagging (ptosis) that would require a lift instead of an augmentation or a lift with an augmentation. I would also agree with Dr. Stratis that a donut or any type of lift is not necessary and will add little to the result except periareolar scars. 

Breast implants are pillow volume and do not lift the breast but they can simulate a lift by filling out the lower pole of the breast and an upper pole scallop. They can also increase forward projection of the breast which makes them look more perky. The minimum size increase with an implant in most cases is one full cup size. 

In general, periareolar mastopexies (lifts) do not truly lift the breast but move and reshape/resize the nipple-areola. Even a proper lift with a lollipop incision does not give forward projection or specifically fill in the upper pole of the breast. 

I would recommend an augmentation alone and adjust the volume difference with a slight implant volume difference and accept the difference in the size and position of the right nipple-areola relative to the left one. 

Scott L. Replogle, MD
Boulder Plastic Surgeon

Breast augmentation versus augmentation mastopexy, that is the question?

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It is really impossible to determine whether you could benefit from a simulataneous augmentation mastopexy without examining you in person. You may want to also consider liposuction of the armpit area so that your breasts will have a better contour along their sides. The bottom line with mastopexy is that you will have visible scars and that is an important consideration.

Laurie A. Casas, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 110 reviews

Breast lift or breast augmentation only

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I would recommend a small sub-pectoral implant with a donut lift. The scars around the areolas can be almost invisble if sutured skillfully. In your case, however, it may be necessary to repeat the lift 4-6 months later. It is important not to be overly aggressive with donut lifts as the more skin is resected to lift the areola, the more 'pleating' you will have. This is not a pretty look. I will also caution you not to choose a large implant to 'take up the slack' as large implants will stretch out your tissues/muscle and create a larger problem in the long run. I hope this helps. Best wishes, Dr. H

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

Breast lift or augmentation?

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Implants alone would give you a good result if you wait to go larger. A donut lift with implants would make the nipple areola complex smaller and more even and give the breasts a more perky lift although the trade-off is scaring around the edge of the areola.

Donna Rich, MD
Webster Plastic Surgeon
4.5 out of 5 stars 33 reviews

Do I Need a Breast Lift with Implants or Augmentation Only? (photo)

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Thanks for the posted photos. My opinion is a "composite augmentation/donut lift". That is Implants/donutlifting/fat gratfs. 

Breast augmentation with or without lift

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Choosing to do a lift with an implant is dependent on a number of different factors.  A patient's expectations are the primary guide, however the anatomy is also very, very important.  While I cannot provide any definitive advice without a face-to-face discussion and an examination, it appears from your photographs that an implant alone will provide an adequate improvement.  This will likely improve not only the size and fullness of your breasts, but also the shape.  Doing any type of lift will result in scars on your breasts.  While a lift may centralize your nipples to some degree, the tradeoff will be scars on your breasts.  

Ask your plastic surgeon to review photographs of other patients shaped like you who have undergone breast augmentation with and without lift.  This should help you make a decision.  Good luck.

Eric T. Emerson, MD, FACS
Charlotte Plastic Surgeon
4.7 out of 5 stars 29 reviews

Breast lift and/or implants?

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It is interesting to read the opinions of the plastic surgeon responders because there is so much difference in opinion. Ultimately the decision is up to you! If you are interested in increasing volume, then an implant would be a great way to go. With a more generous size and projection goal, I think lift will be well accomplished with just an implant and no lift. You have some asymmetry, so different sized implants may be considered. If you are not interested in going larger, then a lift alone is the way to go. It looks to me like a moderate-sized implant would be a great way to go for you. In considering your size goals, you should be fitted with different-sized implants in a preoperative consultation to determine what you like best - this is a great simulation for postoperative outcome.

Michele A. Shermak, MD
Baltimore Plastic Surgeon
4.8 out of 5 stars 57 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.