Do I Have to Have a Breast Lift?

I am 36 years old and have had two children. My nipples do not point to the floor, but I can hold a piece of paper under my breasts without it slipping out. I wear a B bra now. I want my breasts to be fuller. They are shaped like torpedoes and there is some extra skin. I had a consult and the surgeon told me I needed a lift. The lift scar is so ugly; looks like Frankenstein boobs. Will implants alone cause more sag?

Doctor Answers 19

Do I have to have a breast lift?

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Yes, implants alone will cause more sagging and are contra-indicated in your case.The Ultimate Breast Lift is a technique that was developed using engineering principles to rejuvinate aging breasts. The results are natural and provide a long term solution to the effects of gravity. Breasts are lifted higher than any standard technique providing upper pole fullness without requiring the unattractive vertical scar. Women now have a successful alternative to the standard vertical scar lifting techniques. It's worth looking into.

Best wishes,

Dr. Horndeski


Texas Plastic Surgeon
4.5 out of 5 stars 229 reviews

You Will Likely Need a Breast Lift to Address Your Issues

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The fact that your nipple does not point straight down but your breast tissue can hold a piece of paper against your chest means that you have something called glandular ptosis.  Generally, the best way to address this is through a breast lift that uses a "lollipop" pattern incision.  I understand your concerns about the scars, as many women do not want a scar running down the bottom of their breasts.  However, these scars tend to heal very nicely (depending upon your own ability to scar) and it provides the best mechanism to lift the breast tissue off the chest wall.

With respect to you wanting to be fuller, you would likely need an implant to add to the volume of your breasts.  Implants alone are not a good option for glandular ptosis if your primary goal is for them to be lifted. 

Gary D. Breslow, MD, FACS
Paramus Plastic Surgeon
5.0 out of 5 stars 44 reviews

Breast Lift?

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Thank you for the question.

Unfortunately, it is not possible to give you good advice without direct examination or pictures.

Generally, if you are happy with the size of the breasts but wish to raise the position of the breasts and the nipple/areola complexes on the chest wall. You will achieve these results with the breast lifting operation;  the trade-off will be scars ( probably around the areola and vertically). If you feel that the scars look like “ugly  Frankenstein"  breasts  you should definitely not have the procedure performed.


It would be in your best interest to meet with well experienced board-certified plastic surgeons to discuss your goals. I recommend showing  your surgeon “goal pictures” to communicate your goals as clearly as possible. If, for example, you find breast pictures with more volume/fullness superiorly you may want to consider breast implants as well.

Your plastic surgeon will be able to guide you depending on what you communicate to him/her.

I hope this helps.

Consultation Recommended

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With out a physical examination or at least a photograph, it is difficult to render an opinion. Your case sounds unique and deserves a consultation with a skilled and experienced plastic surgeon. Many Doctors, including myself, offer complimentary consultation so you can have your questions answered personally by a professional.

Ivan Thomas, MD (retired)
Los Angeles Plastic Surgeon

When should I consider a breast lift?

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A picture says a thousand words, and unfortunately this question is 914 words short... 

Just kidding...

But in all seriousness, there are several items to discuss here:

  • Lift or Implants (or both)? An analogy: A breast lift will turn a "tube sock" into a "bobby sock" but not change the size of the "foot". Breast implants will make the "foot" bigger but not change the size of the "sock". Breast implants with a lift do a little of both. Each procedure has it's benefits and limitations. Talk to your plastic surgeon to learn more detail. 
  • Which is worse? Torpedo boobs or scars? Scars will fade over time, and breast lift scars heal very well. Please note that most plastic surgeons' Post-Op pictures are taken only 6 weeks after the patient's surgery. It is very difficult to get a patient to come in 1 year after surgery for a photo. But it takes one year for a scar to fully mature.
  • Will more sag occur? Maybe. Gravity doesn't go away just because you had surgery to correct your sagging breasts. You have to wear a bra after surgery and forever thereafter. Adding implants compared to a breast lift alone will increase the possibility of sagging later on. 

In your case, if you have "torpedo" breasts, but want increased fullness, I would recommend a breast lift with implants (augmentation/mastopexy). It will address the excess skin from the sagging, while giving you "fuller" breasts you desire. 

Breast lift options

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Without a photo it is difficult to give a precise answer but if the underneath portion of the breast skin is touching your chest, then an implant alone is probably not sufficient. If you only need a mild to moderate lift and there is not a great deal of excess skin, then a dual plane augmentation with a donut mastopexy could be a very reasonable compromise. This will avoid the vertical incision in a lollipop mastopexy and may give you sufficient tightening so that the skin no longer touches.

Large implants to avoid a breast lift

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From your description, it sounds as if you would have larger, saggier boobs,. Your fears of ugly scars is a common concern which causes many patients to avoid a breast lift.  If you search photos, you certainly will find examples of women who should have undergone a lift and did not. IF this is acceptable to you, this approach could be an option.

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

Breast augmentation with or without a breast lift?

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The decision between having a breast augmentation, with or without a breast lift, in a patient with mild to moderate ptosis (breast sagging) is a choice between trade-offs. Will it look better to you if the breast is fuller but the nipple still points downward and there is some sag? Or would you think it looks better to have a fuller breast with the nipple centered on the mound without any sag but with scars? For some that is an easy decision if you already know you will hate the scars. For others it is less clear. When in doubt, do the breast augmentation alone and let the result prove to you that a lift is or is not needed. A breast lift can always be done later if desired.

Will implants without a lift cause more sag?

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The average breast implant weighs about 12oz (350g). This additional weight on the chest may accelerate the rate of ongoing breast ptosis.

In some cases with just slight sagging of the breasts, an implant alone without any additional mastopexy (breastlift) may lift the breast. However, in most cases, the implant is placed beneath the pectoral muscle and the breast lift is then performed. The shape of the breast mound is usually better when both breast augmentation and breast lift are performed together.

Ricardo L. Rodriguez, MD
Baltimore Plastic Surgeon
4.5 out of 5 stars 97 reviews

When do you need a breast lift and your options

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To perk up a drooping breast, your surgeon will remove excess skin, reposition the nipple, and redrape and tighten the remaining skin to support the breast. The areola may also be reduced in size. A mastopexy (breast lift) raises droopy breasts from one to several inches and excess skin is removed. If you're sagging or asymmetrical, and are looking for perkiness, you'll need a lift--or, if you also want more volume, a lift and implants.

A breast lift raises droopy breasts from one to several inches and excess skin is removed. If you just want to go bigger, the only way to do that is with implants. The great thing about these techniques is that they can now be down with minimal scarring and performed as an outpatient procedure without the need for general anesthesia.

When women with saggy breasts want to go bigger, I usually advise doing a breast lift along with the implants. Otherwise, the implants create what we call a “double bubble,” where the breast droops off the end of the implant like a sock. Some of my patients, however, don’t want a lift because they want to avoid additional scarring, so sometimes implants alone can fill out the skin and eliminate the saggy appearance.

Michelle Copeland, MD, DMD
New York Plastic Surgeon
4.6 out of 5 stars 10 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.