Can I still achieve desirable results without the mastopexy?

Question

I was told I am borderline for needing a mastopexy In addition to just a breast aug surgery. I would like to avoid this additional procedure if possible. Do you think I can still achieve desirable results without the mastopexy? Last 2 pics is idea of desired outcome. I do want a full, but less augmented/overly rounded look in the upper pole. My right areola is noticeably larger which I would like to correct as well

Miguel Mota, MD · Answer

YES YOU CAN! I do not think you need a lift. I see two issues here. First, a slighter bigger areola on your right side as well as a slightly higher breast fold on the same side. These asymmetries can be addressed without a proper lift…. But in order to reduce the areola you will need a scars around it.

Please be aware that these asymmetries are hard to correct. I’m sure they will get better burritos is are to say how much better. None the less I feel you will have good results without a lift.

Best of luck,
Dr. Miguel MOta

Casey Anderson, MD, FACS · Answer

I think you will be able to get a very nice outcome with an implant alone. I do not see enough difference in the areola to justify the scar to reduce it. This is preference of course.

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.

Daniel Barrett, MD · Answer

Dear Glamour0208,
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.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Scott W. Vann, MD, FACS · Answer

Your nipples are above your breast fold so you do not need a lift. A breast augmentation should give you a great result. I would put the implants under the muscle for multiple reasons, but especially since you want a natural slope to your upper breast. Personally I would advise you to leave your slightly larger aerola alone since I think the scar will be worse and more noticeable than your mild asymmetry. Good luck.

Ted Eisenberg, DO, FACOS, FAACS · Answer

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. They then get to 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. Mildly Sagging Breasts: 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. It hasn’t. You can always get a lift later if you feel you are not perky enough when fully settled and healed. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Finny George, MD · Answer

Hi, thank you for sharing your question. You are a great candidate for breast augmentation and can likely avoid a lift. A dual plan augmentation will give you fullness and bring your nipple position more centered on the breast. I hope this helps.

Connie Hiers, MD, FACS · Answer

You should do well with just an augmentation. Naturally, your breasts sit somewhat low on your chest and that position cannot be changed.

Garrett A. Wirth, MD, MS, FACS · Answer

Based on your photos, you might be able to achieve your goals without a mastopexy at this time.  This might require a slightly larger implant or more projected implant.  A full consultation to evaluate your tissues, measurements, etc. would be necessary.  I recommend you work with a Board Certified Plastic Surgeon.

Lourdes Rodriguez, MD · Answer

Hello, thank you for your pictures and question.

In your case the best treatment option is a breast augmentation with a periareolar lift, if we only place the implants and don’t remove skin is only matter of time for the breast to drop more sooner than later.