Will I Need a Second Breast Lift (Nipples Still Low, Implants Might Be Too Big)?

I asked my doctor for "perkier" breasts but feel like they are still riding low on my body (4 months post-op). I also requested to be a C cup but I am now a 32DD! (Previously had been a 32/34 B cup). I had a Periareolar lift on my left breast and Implant only on right breast. My main reason for getting a lift, which I explained to my doctor, was to look good in a t-shirt without a bra (however my nipples are still too low to do this). In addition, will a second lift cause a lot more scarring?

Doctor Answers 17

What you are looking for may not be possible with implants or mastopexy

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There are several problems here.  Some are likely due to miscommunication with your surgeon and some are unrealistic expectations on your part.  It is never a good idea to ask your surgeon to be a specific cup size.  He will rarely be able to deliver.  Cup sizes are not standardized and vary from bra company to bra company.  I have my patients try on the implants before surgery so they can tell me what size looks good to their eyes.  This is the best way to avoid surprises when it comes to size.  I don't know if you had the chance to try on implants.

Second, you have a long torso with low set breasts.  There is no procedure that will move your breasts up on your chest.  All the lift procedures move the nipple up, not the whole breast.  They will also tighten the skin under the breast to hold the implant higher.  However, over time, the implant will settle again.  The crease of your breast is not moved upward therefore your breast is not moved upward.  If you are looking for your breasts to be higher on your chest, you will be disappointed with any procedure.  Also, by placing implants, you are making your breasts heavier and they will then try to go even lower with time.

I think you would have had somewhat better shape to your breasts with a vertical or lollipop shaped breast lift.  This would have lifted your nipples a little higher and tightened the lower part of your breast more.  If you are going to have another procedure, I would consider adjusting the size of the implants so they are closer to the size you are looking for and having a vertical mastopexy to further raise your nipples and tighten the lower part of your breasts.  Discuss all of this with your surgeon in detail to make sure you understand what surgery can and can not do for you.  Good luck!

Dr. Parham Ganchi

Wayne Plastic Surgeon
4.8 out of 5 stars 172 reviews

Still not perky?

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18 year olds are perky, your breasts are not riding low. your torso is long, the implants are where they need to be. you could go smaller and increase the lift by adding a vertical incision below the areola (lollipop). this would also improve your shape (cone vs. flat). my plan, smaller implants with lollipop lift. good luck

Rafael C. Cabrera, MD
Boca Raton Plastic Surgeon

Second lift

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I would recommend a "vertical" lift for you in order to bring the areola to the center of the breast mound.  If desired, a smaller implant can be exchanged at that time.

Samer W. Cabbabe, MD, FACS
Saint Louis Plastic Surgeon

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Breast lift vs large implants

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To achieve what you wish you need a full lift. This might entail a small incision under the breast in the crease, but should be doable with just a periareolar and vertical scar. You then have the choice of keeping the same implants (the least expensive option) or exchanging them for smaller ones. The latter will entail more skin removal and intraoperative readjustment of the nipple position, but most good Plastic Surgeons should be able to accomplish this. (Thanks for the excellent pictures.)

Robert T. Buchanan, MD
Highlands Plastic Surgeon

Long torso and

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As many have said, you will probably always perceive you have "saggy" breasts due to your long torso and low set breasts on your lower chest.  God makes so many different body shapes and breast shapes, a standard "look" is really impossible.  Every woman's breasts are shaped different...some are wide, some are low, some are saggy, some are deflated.  This is such a hard thing to get across to patients.  I show many patients..."this is your chest...and these are your breasts, there is no way your breasts will ever be up on your chest.  You can improve the sagginess below the fold and the position of the nipples but you can't change how God made your torso and shape.  I agree also that a more aggressive lift such as vertical or even anchor incision would have taken some of the lower skin out.  We all try to minimize scarring and most women don't want scars all over the breasts, but often it takes one of the more aggressive lifts with scarring to get a better shape.  Better breast shape often comes with more scarring.  It's a trade off of what you would rather have.  Hope this helps.   Dr. Rob                                                                                                                                     

Breast Lifting Results?

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Thank you for the question in pictures.

I agree with you that your nipple/areola are too low  and that additional breast lifting is indicated. Additional breast lifting will require more incisions ( vertical)  and more scarring. This is the classic trade-off that should be considered by all patients undergoing breast lifting surgery.

In regards to achieving your breast size goals communication with your plastic surgeon will be key to achieving the results you are looking for. Unfortunately, the use of words such as  "natural look" or C cup means different things to different people.  Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.

In my practice I use goal pictures to communicate with patients.  With this technique patients are able to demonstrate what they are trying to achieve and what type of looks they do not like as well. 
I also use  intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison. 
I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible. 

I hope this helps.

Breast implants breast aug revision, breast aug, breast lift, mastopexy, Dr. Whitfield, whitfieldplasticsurgery

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I do not think your interval result is bad.  You had low set breast and you still do.  Getting breast isuue to stay up and add volume is difficult and will not last despite what any surgeons tries to tell you.

Redo lift

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It may be as simple as lifting the left areola a bit more.  Not a big deal to do can even be done under local.

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

Breast lift and implants

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In order to achieve a perky moderate sized breast in your condition, a more agressive lift will be required and this will involve significantly more scarring. The original condition is more likely related to your long torso, low set breast crease and prolonged nipple to fold distance. The overall position of your breast on your chest is difficult if not impossible to truly change. However, the position of the nipple on the breast can be rotated with relatively small scar if this is your true desire.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Significant Breast Lifting CANNOT be done with a combination of Large Breast Implants and an Aroung the Areola Lift

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I am sorry for your predicament. Unfortunately it is all too common and the blame for it rests on both the patient and the surgeon. Patients demand to have large perky breasts with upper pole fullness WITHOUT scars and some Plastic surgeons try and comply depite knowing that a real breast lift cannot be accomplished and last by the flawed but seductive combination of a large breast implant and a periareolar (around the areola) Lift. Your BEFORE picture demonstrate BOTH significant breast sagging, loss of volume and a significant asymmetry of the breasts. In my opinion, there is no way that a durable, attractive Augmentation Mastopexy could be accomplished without using breast implant sizers (temporary for accurately choosing implants DURING surgery) and using either a Lollipop or and anchor scar Mastopexy. The good news is that your result CAN be improved upon. The bad news is that to do so you are looking at having another operation. Good Luck. Dr. Peter Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon

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