Breast lift required or only breast augmentation? Also which cc's? (Photo)

Question

Hi, do you think I'll require a breast lift or can I get away with only breast augmentation? Also what is the biggest cc's you will think I can go for? Thank you

Gary M. Horndeski, MD · Answer

The technique I recommend is a mini lift. Using a circumareola incision, your breast tissue is reshaped, elevated higher on the chest wall and more medial to increase your cleavage. At the same time, fat transfers or small implants can be placed totally submuscular.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Semih Yildiz, MD, FEBOPRAS · Answer

Your photos show some breast tissue laxity and a lower nipple/breast position, so this is a borderline situation where the goal matters a lot. If you only want more volume and are comfortable with a natural, slightly lower breast shape, augmentation alone may give improvement. If you want the nipple and breast mound higher, a rounder upper pole, or a perkier result, then a lift with implants is more likely to give the shape you are looking for. Implants can fill the breast, but they do not reliably lift loose skin or move the nipple upward.

The largest implant size cannot be chosen safely from photos. It depends on your breast base width, skin stretch, tissue thickness, chest wall shape, and how much your tissues can support long term. Choosing an implant that is too large can increase the risk of bottoming out, visible implant edges, asymmetry, and needing revision surgery. During an in-person consultation, your surgeon can measure your breast width, assess nipple position relative to the breast fold, and let you try sizers. In many patients with your starting shape, a moderate implant combined with a small lift gives a more predictable and longer-lasting result than trying to avoid a lift by using a very large implant.

Tommaso Addona, MD · Answer

Thank you for your question. 
Due to the volume of your breasts, I do not believe you will need a breast lift. A breast augmentation should give you the aesthetic and results you desire. I would speak with a board certified plastic surgeon to discuss your goals and for further evaluation.

Ted Eisenberg, DO, FACOS, FAACS · Answer

I recommend an in person consultation with a plastic surgeon to discuss your goals and be measured. After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants, and they choose what looks right for them. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what size and style breast implant is right for them. If your breasts are mildly droopy, a saline or silicone gel implant placed behind the pectoral muscle might help create the illusion of perkiness. That’s because as the implant fills out the top of the breast, it also fills out the bottom, making it look as if the nipple has moved higher.Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Jose A. Munoz, MD · Answer

Hi and welcome to our forum!From your photos, I note that appear to demonstrate petite, relatively symmetric breasts. There is some loss of superior breast pole volume. The nipples reside well above the fold beneath the breasts. There is extremely minimal sag. Breast augmentation will fill out the breasts, increasing superior breast pole volume. I don't think a lift is required. Implant size choice is totally subjective. The key is to choose an implant which is approximately the same diameter as your breast (base width diameter). Then choose your desired size. We recommend that you choose a size proportionate to your body frame. Bigger isn't always better! Best wishes...

Finny George, MD · Answer

Hi, thank you for sharing your question. You are a good candidate for breast augmentation alone without the need for a lift. The exact sizing and implant characteristics should be discussed with your surgeon after a formal evaluation.

Daniel Barrett, MD · Answer

Dear simiku,
determining whether you need simply a breast augmentation versus a breast lift can be somewhat complicated. It depends on a number of factors including skin laxity and current nipple position. Generally speaking, if the nipples are lower than the inframammary line the patient will most likely need a breast lift. If the nipples are at or above the inframammary line we can generally get by with just a breast augmentation depending on the size of the implant the patient wants. I often still using implant when I perform a breast lift because it provides more upper breast fullness after the lift. To be sure a consultation with a board-certified plastic surgeon will help determine what the patient actually needs.Breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

You don't need a lift, but an augmentation would look nice. I would suggest meeting with a board certified plastic surgeon, being examined and measured, and trying on the range of sizes that best fits your frame and tissue. Then, you can actually see what size you like.

Kevin Tehrani, MD, FACS · Answer

Thank you for your question and posting appropriate pictures. Based on your pictures you do not need a breast lift. Depending on your anatomy you would likely be able to have Implants larger than 500cc if you wish. Yes best to have a virtual consultation initially to decipher your candidacy and discuss options of course.

Douglas Taranow, DO, FACOS · Answer

You have beautiful breasts now and do not require a lift.  If you desire larger breasts with more upper pole fullness...go for it.  The size depends on your desires.  If we are talking about a moderate C cup, then I would venture to guess (without a physical exam or measurements) that a 325-350cc moderate plus X implant may be considered.

Breast lift required or only breast augmentation? Also which cc's? (Photo)

Answers (12)

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