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

I'm thinking on having breast surgery and I'm going big, 700cc to 800cc silicone mod plus do you think my nipples will be to low? Do you think I will need a lift?

Doctor Answers 26

Breast augmentation -getting it right the first time

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Your posted photos show flattened breasts with more breast tissue at/above the nipples than below them and the nipples well above the inframammary fold with the left breast slightly smaller and outward/downward shifted relative to the right breast. It is therefore unlikely that you would need a lift. I would strongly advise you against picking an implant that is that large and to focus more on finding an implant that fits your body frame in terms of diameter and projection. Also, if you just put in an implant the larger the implant the more it will magnify the asymmetry between the right and left breasts. You need to see a qualified surgeon face to face in order to have the appropriate breast measurements taken and then formulate a appropriate surgical plan. You can't do that just from photos placed online.

I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Los Angeles Plastic Surgeon

Make an informed decision before "going big" to use your words - Breast Augmentation

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Thank you for your question and the photos.  Obviously, it is your body and your decision.  Here are some things to keep in mind when choosing large breast implants for breast augmentation.

1. As you get older, your breast skin will age, stretch and become thinner even without an implant.  The larger any breast, augmented or not, the worse it will look over time due to skin stretching.

2. Adding any implant to your breast adds weight and will produce stretch and irreversible thinning of your breast tissues over time.

3. The larger the implant, the greater the amount of breast tissue stretch that will occur.

4. Adding excess weight to the breast almost guarantees that it will look worse over time, with increased stretch and sagging.  It is impossible to predict whether or when this will occur in any individual patient.

5. Adding weight to your breast with a large implant may cause you to need further surgery in the future, particularly mastopexy (breast lift) with additional visible scars and risks.  You will incur additional costs, time off work, risks, and trade-offs if additional surgery is necessary.

6. Excessive breast tissue stretch from a large implant can make you more likely to have surgical complications with healing problems if the tissues become very thin.

7. As breast tissues thin, You will definitely be able to feel your implant and portions of the implant may be visible through your skin and visible rippling or wrinkling may occur.

8. If excessive stretch or complications occur (and this is unpredictable), it may even become necessary to remove the implants, with compromise in the appearance of your breasts and probable visible scarring if breast lifting (mastopexy) is necessary when the implants are removed.

At the present time, no you do not "need" a lift; but if you go really big, it is highly probable that you will need further surgery down the road...maybe much more surgery than you bargained for.  Discuss this with your surgeon and make an informed decision. I hope this helps.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 221 reviews

Do I Need a Breast Lift Along With Large Implants?

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Thanks for the photos posted. My approach is staged series of operations. Stage I is doing the lift, allow healing for 2 to 3  months. stage II is implant placement with as large as possible. 

Probably do not need breast lift at this time

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I think that you are planning to get implants in the 750-800 cc range, with the mild to moderate amount of drooping you have now, you probably do not need to get a breast lift at this time.  There is always the option later after your breast implants of getting a breast lift if you and your surgeon feel that your breasts droop too much.  But with the rather large size implants that you want, they should fill out your breasts adequately.

James Tang, MD
Houston Plastic Surgeon
3.4 out of 5 stars 18 reviews

Breast Lift Needed?

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Thank you for the question and pictures.

Based on your pictures (especially the side view),  I think you will do well with breast augmentation alone. Of course, direct physical examination will be necessary to give you precise advice.

In planning your breast augmentation procedure it will be very important to communicate your size goals with your surgeon.  in my practice I find the use of goal pictures to be very helpful.   I have found that the use of words such as “natural” or “D cup” or "fake looking"  etc. means different things to different people and therefore prove unhelpful.

Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate. Placing breast implants on top of the skin ( pre-operative “sizing”) is not necessarily accurate either.

I 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. 

Be careful with your selection of plastic surgeon;  make sure that he/she is a well experienced board-certified plastic surgeon and see lots of examples of his/her work.

I hope this helps.


Breast lifts and implants

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Be careful with that implant choice as it will be really large and will seriously stretch out your skin and be associated with increased other risks like numbness.  From the front your nipples are a little low but not so much in the side view.  You can always do a lift later if needed and with the size you are going for, a lift at the same time wouldn't be a great idea.

You may be able to have breast augmentation without breast lift.

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Thank you for your question. From your photographs it appears your nipple areola is above your inframammary fold and that you have what is called glandular ptosis.

In this situation it is often possible to have breast augmentation with breast implants without having a breast lift.

However 700-800 cc breast implants are considered very large and require the dissection of a large pocket to make them fit. The risk of such a large implant in a breast with glandular ptosis is that the pocket will be dissected to low and interfere with your normal inframammary crease or breast fold. Search for questions and photos of double bubble deformity.

Choose your plastic surgeon carefully. Consult plastic surgeons who are certified by the American Board of Plastic Surgery, experienced in breast surgery, members of the ASAPS, and who have an excellent reputation in your community.

Implant Selection Process

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Generally speaking, the bigger the implants, the higher the risk of complications.  In order to make an accurate size recommendation, I would need to assess your chest wall and breast mound measurements and characteristics.  Unfortunately, there is not a general rule of thumb or objective criteria to implant selection.

Your plastic surgeon will perform several measurements of your chest wall and breast anatomy and determine a range of implants that both fit your chest wall and reach your desired goals.
The next step is to try on this range of implants in the office with your doctor.   The key to this success is showing your surgeon the body proportion you desire with a bra sizer and allowing your surgeon to guide you to the right implant.   It will be much easier to communicate in implant cc's than cup size when determining the appropriate implant for you.
I wish you a safe recovery and fantastic result.
Dr. Gill

Paul S. Gill, MD
Houston Plastic Surgeon
4.8 out of 5 stars 95 reviews

Lift needed for large augmentation

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Without implants, you would benefit from a lift.  If you augment your breasts with 700 cc implants, you will definately require a lift.  If you do a breast augmentation without a lift, you will then need a 2nd operation several months later.  It makes more sense to do it the first time.  The lift can be done through a circumareola approach and the implants can be placed through the same incision.  If you placed 800 cc implants in front of your pectoral major muscle, the weight of them will force them down over time.  If you put 800 cc implants beneath the pectoral major muscle, contraction from the pectoral mjor muscle will push them down and out and will descend.  I would not recommend such a large implant or you will have future problems with descent.

Best of Luck,

Gary Horndeski, M.D.

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

Breast implants and lifts

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Breast implants do not lift the breast and larger breast implants do not lift it further. Clearly from the side view you do not need a lift for a properly filled out and natural looking breast but the nipple and lower part of the breast will fill out giving the illusion of a lift. The way to size the implant is to make sure the width of the implant matches the inner diameter of your breast and you choose the forward profile of low, medium, or high in order to increase by 1 - 2 cup sizes. I see no way that a 700-800 cc implant will fit your breast and you are a setup for short and long term problems caused by forcing too big an implant into your breast just because you chose a certain number of cc's. This is like forcing a foot that is far too big for a shoe into it anyway. Start with the proper dimensions of your breast and your profile choice and find out how many cc's of implant that is. 

Scott L. Replogle, MD
Boulder Plastic Surgeon

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.