Please Help ( Breast Lift)

I've had my two lovely children but my breasts have sagged miserably. I wear a 38D bra. Please ADVISE ON THE FF: Can I have a lift alone without implants? Will silicone or saline be preferably? Will scars show more on black skin? Finally, what kind of lift will be the best for a youthful and natural look

Doctor Answers 20

Breast Lift

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I would need to examine you to give you a definite recommendation.  As you may know, there are four types of mastopexy: 1) Periareolar, 2) Circumareolar (donut), 3) Circumvertical (lollipop), 4) Wise-pattern, full lift (Anchor).  Depending on the degree of ptosis (sagging), you will need different types of mastopexy.  In general, as one needs more lift, the scar pattern becomes more complex.  Please visit with a board-certified plastic surgeon so that she/he can evaluate you and review the options for you.

Breast lift/ breast reduction

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Thank you for the question about what may be best for you and your shape.  You clearly are concerned about future sagging, and with this thought in mind I would believe that a breast reduction would be necessary and appropriate.  This reduction would also allow the surgeon to balance the size of your breasts.  It would appear that your right breast is smaller than your left breast, and this should be corrected during the lift/reduction.  By the way, you don't need implants, in my opinion.


Good luck to you.


Frank Rieger M.D.  Tampa Plastic Surgeon

Breast lift with reduction will benefit large, sagging breasts

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Hi Sieze,

Thanks for providing the photo.  You would benefit from a reduction, which will also lift the breast.  You can discuss with your surgeon on how much volume will be removed.  If you have only a lift, the breast will be too heavy to support the lift, and the breasts will sag again.  I know that size is not your concern, but a small to medium reduction is needed to get the result you want.  You absolutely do not need an implant.  your own breast tissue will be used to perform an "auto-augmentation".  Your own tissue will be repositioned, lifted and shaped to give you a good contour.  I prefer a superior pedicle procedure but other surgeons may have a different preference.  We want to minimize the scar length as much as possible and produce a result with a nice shape and upper pole fullness.  So I would consider a superior pedicle with a lollipop plus short horizontal scar.  Of course, a physical exam is necessary to know for sure.  Scars in pigmented skin can have some issues such as hypertrophic (thick) or hyperpigmented scars.  However, there are things that can be done to help manage these issues.  If you have other scars that healed well, this is a good sign.  Hope this helps. 

Tracy M. Pfeifer, MD, MS

Tracy Pfeifer, MD
Manhattan Plastic Surgeon
4.8 out of 5 stars 29 reviews

Breast reduction and lift/ scars in African Americans

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
From looking at your photo it appears that your left breast is larger than your right one and you have a great degree of ptosis(sagging).  A breast reduction can help correct this discrepancy and give you a lift.  Most of my patients of color have undergone vertical breast reductions and have had favorable scars.  Usually the vertical incision and one around the nipple areolar complex heals well.  The horizontal incision can at times be problematic which is why I like to avoid that incision.  With the vertical technique I have been able to achieve a full youthful appearance.  A lot depends on how much superior fullness a woman has to begin with.  

Quintessa Miller MD FACS
San Antonio Plastic Surgeon

Quintessa Miller, MD, FACS
Fort Walton Beach Plastic Surgeon

Please Help ( Breast Lift)

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
You would benefit greatly from a mastopexy/breast reduction. The benefits would be multiple including lifting and reshaping of your breasts and areolas. Indeed, this requires the standard "anchor scar" seen with breast reductions, which take one year (or longer) to fade, but in my experience, women do not regret having the breast reduction in situations like this. NO implants needed. Good luck, you will not regret it!

Joel Patrick Maier, MD
Cincinnati Plastic Surgeon
5.0 out of 5 stars 33 reviews

Breast Lift to correct sagging

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

You have a number of options which will depend on your current anatomy.  Breast lift plastic surgery can improve the profile of sagging breasts, making breasts look more youthful and perky.Breast lift surgery is done to improve the profile of sagging breasts, changing their position on the body to appear more youthful. If you have lost volume in your breasts as well, the breast lift can be combined with breast implants to restore fullness. Please visit with a board certified plastic surgeon to learn more about your options.

Lift without implants?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Thanks for your question. You would be a great candidate for a lift and you are large enought to not need an implant. That said If you like your general size then a lift would be the procedure of choice and you would loose very little volume. The best way to evaluate ptosis (sag) is by physical exam but a picture can give a preliminary idea. The best picture is a side profile. In general breast lifts are done to not only raise the nipple but also to make the areolar/nipple complex smaller and raise the breast tissue to a more natural youthful position. Of course, the key to a great breast lift is patient selection and technique selection. Areolar lifts are generally good for women with good skin quality, breast tissue reasonably placed and a nipple/areola that are sagging no more than 2 cm. Once the breasts sag past that point, it is necessary to perform a lollipop lift which not only repositions the sagging breast tissues but also the nipple and areola. The final and most aggressive lift is an anchor lift which places both a vertical and horizontal incision. Again the determinant is the degree of sagging, skin quality and amount of breast tissue. Last, if there is a deficiency in breast tissue, an augmentation can be done either together with the lift or as separate procedures. Make sure you visit with a board certified plastic surgeon get get specifics on your situation.

Breast lifting and augmentation simultaneously?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I think you may be a good candidate for a 2 staged procedure. The 1st stage a breast reduction will place the breasts  in a better position on the chest wall. The second  procedure will augment the breasts  and create the look that you are trying to achieve.

This is not a question agreed-upon by all plastic surgeons. There are good plastic surgeons who will insist on doing the procedures separately and there are good plastic surgeons who can produce excellent outcomes in a single stage.

The combination breast augmentation / mastopexy surgery differs from breast augmentation surgery alone in that it carries increased risk compared to either breast augmentation or mastopexy surgery performed separately. Furthermore, the potential need for revisionary surgery is increase with breast augmentation / mastopexy surgery done at the same time.

In my opinion, the decision  to do the operation in a single or two  staged fashion becomes a judgment call made by a surgeon after direct examination of the patient.  For me, if I see a patient who needs a great degree of lifting, who has lost a lot of skin elasticity, or  whose goal is a very large augmentation then I think it is best to do the procedures in 2 stages (in order to avoid serious complications). However, doing the procedure one stage does increase the risks of complications in general and the potential need for further surgery. This increased risk must be weighed against the practical benefits of a single stage procedure (which most patients would prefer).
Conversely, if I see a patient who requires minimal to moderate lifting along with a small to moderate size augmentation (and has good skin quality), then doing the procedure one stage is much safer. Nevertheless, the potential risks  are greater with a 1 stage  procedure and the patient does have a higher  likelihood of needing revisionary surgery.
I hope this helps.



Breast Lift, with or without breast implants?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Breast lifts can be performed with or without breast implants.  It depends on your goals.  If you are satisfied with the size of your breasts, then a breast lift alone will be a reasonable choice.

You are correct when you are concerned about scars, because darker pigmented skin is more prone to problem scarring. For you personally, one clue is how any scars you have now look.  If you have bad scars, then a bad scar is more likely for you.

Fredrick A. Valauri, MD
New York Plastic Surgeon

PHOTO: Breast lift and reduction SEE VIDEO BELOW:

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Darker skinned individuals do have a higher tendency and risk for hyperpgimented or keloid scars. I would likely recommend a vertical and horizontal lift with slight reduction as well avoiding use of an implant at the first stage.

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