Do I Need a Breast Lift With My Implants (photo)?

After losing quite a bit of weight and breastfeeding two babies my breasts have become rather deflated (flat on top). I would very much like to gain back some of the fullness in the upper part of my breasts, but I'm not quite sure if a lift would be required as my nipples aren't pointing to the floor or anything! I measured from my collar bone to nipple and it is 19cm. I've attached some photos for you to evaluate. Thank you for your time

Doctor Answers 9

Breast Lift Necessary?

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Thank you for the question and pictures.  Although your breasts do demonstrate an aesthetically pleasant shape,  I do appreciate the lack of volume that you mentioned ( superiorly). Also, there appears to be a significant amount of ptotic ( “sagging”) skin along the lower poles of the breasts.  

 Therefore, I think you will most likely benefit from breast  augmentation as well as breast lifting surgery. Breast lifting involves some degree of tightening and lifting of the breast skin envelope.  In order to tighten the skin envelope, skin excision is necessary;  this results in the presence of scars. 

Sometimes, the presence of scars is a “dealbreaker”;  patients would prefer to leave their breasts unchanged than to have scars. At other times, patients  prefer to have the improvement in breast position, shape, and (possibly) size  and are willing to accept the trade-off of scars. 

It is difficult without direct examination to  provide you with more specific advice as to what type of breast lift will be necessary to achieve your goals.I think you will benefit from in-person consultation with board-certified plastic surgeons.  Ask to see lots of examples of their work and communicate your goals clearly.

Best wishes.

Do I need a breast lift

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There are multiple issues here and some reasonable responses to some of them. I would caution that an augmentation or lift (mastopexy) is an elective, cosmetic procedure and no one "needs" one from a medical standpoint. It's an issue of achieving surgical goals and what is feasible/reasonable. 

A breast lift does not "tighten" the skin or the breast and it does not specifically fill in the upper pole of the breast (above the nipple level). Breast implants are pillow volume and must be seated behind the breast properly. They do fill out the upper pole but the minimum overall size increase is about one cup size. The only way to fill in the upper pole without an implant is with fat grafting which I can't recommend in young women for cosmetic reasons without long term data on the issue of breast cancer and detection. 

If the breast is too low to get an implant behind, then a lift is required if an implant augmentation is considered. The measurement from the collarbone to the nipple is irrelevant (although still used by surgeons). The key measurement is where your nipple sits in relation to the inframammary crease behind it when you are upright with arms down. Yours looks to be very borderline and I disagree with the response about pseudoptosis. You have borderline ptosis for an implant alone procedure and an exam is needed to define this accurately. 

If you are happy with the size/volume of your breast then I would consider a true lift with a lollipop incision and see if you want to add an implant later. If you are concerned with the upper pole contour and would like more forward projection/volume, then I would consider an augmentation alone if your nipple-areola is not too low or a combined lift/augmentation if it is.

Scott L. Replogle, MD
Boulder Plastic Surgeon

To Lift or Not

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Based on your pictures you appear to have pseudoptosis (fair amount of breast tissues is below the crease). Placing an implants will not have the breast tissue centered over the implant so a lift would be necessary to achieve harmony between the implant and the natural breast tissue.


Dr. ES

When is a lift 'required' with an augmentation?

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The answer is it really depends on what your goals and desires are.  You should discuss your expectations and desires in detail with your chosen surgeon as the final decision is really yours.  Your doctor should be able to provide you with the options and the pros and cons of each option.  Then you can make an informed decision as to which would work best for you and your situation.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Do I Need a Breast Lift With My Implants

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Thank you for your question and for the attached photos. 

The photos are quite helpful, but not comparable to an in person evaluation by a plastic surgeon. I am seeing a borderline setting in terms of recommending a lift. 

A lift is done for one or both of two reasons--

  • to reposition the nipples and areolas
  • to tailor and remove excess skin.

I think that a modest size implant will fill out the excess skin and then only nipple areolar position is at question.

This nipple looks slightly low. The measurement we usually use is from the top of the breast bone in the midline to the nipple, and "normal" is 20-22 cm. What we usually use as a standard is the position of the areolar compared with the breast fold, and the 6 o'clock position on the areola should be at or above the fold. 

As a general rule, I prefer not to do a lift if the indication is borderline, unless the patient tells me she only has one time slot to do this , so do all that may be needed at once. 


Thanks and best wishes. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

Do I need a lift with my breast augmentation?

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Great question.  My recommendation would be to perform a breast lift (mastopexy) with simultaneous placement of a saline or silicone implant.  I think this would give you perky, full breasts with the upper pole fullness you are seeking.  You do have other options, though, if you want to avoid the cost and scars associated with a breast lift.  You could opt for subglandular (on TOP of the muscle) placement of a silicone implant.  I generally recommend silicone when I am not placing the implant under the muscle because silicone will feel more like natural breast tissue.  You also have the option of a subglandular saline implant or an implant placed under the muscle (dual plane approach).  I am fearful that placing an implant under the muscle without a lift will give you the dreaded "double bubble" where you have one contour from the implant and a lower contour from your breast tissue.

Andrew Jimerson, MD
Atlanta Plastic Surgeon
4.4 out of 5 stars 557 reviews

Do I Need a Lift?

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Ultimately it depends on your goals.  If you simple desire fuller and larger breasts then it is not necessary for you to get a lift.  To accomplish this you will need a "periareolar" incision to get the implant centered beneath your nipple appropriately and avoid a "double-bubble" result (terms that you can research).  Adding a lift will tighten up the lower portion of your breast tissue, but keep in mind that it will be at the expense of additional scars and cost.  Best Wishes!

Brian Howard, MD (retired)
Alpharetta Plastic Surgeon

Do I Need a Breast Lift With My Implants

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Great question and good posted photos and information. Consider these options: Replace implants to larger size, 2. Fat grafting to increase upper pole fullness + the liposuction you get, 3. Both 1 & 2. 

Do I need a breast lift with implants?

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Based on these photos, it is most likely that you would be best treated with both a breast lift and implants. Breast augmentation alone would likely result in a situation in which your breast tissue would drape over the front of the implant. 

Wm. Todd Stoeckel, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 87 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.