What Do You Recommend? Breast Lift/Aug/Both? (photo)

Hello i would like to have breastimplant and i would like to have them over the muscle is it possible? I have breastfeeded 2 children in total 2 years so they are really sad looking at:-( Do i need a breastlift? and if yes what kind of lift and is it possible to breastfeed again after a lift? Kia

Doctor Answers 12

The over and under regarding lift with augmentation

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

Augment with lift is the obvious choice, but the type of lift could be either a "donut" (peri-areolar) of "lollipop" (vertical), which is difficult to determine by photos alone.  Placing the implants over the muscle should have a better long term result, since there is a tendency for some recurrence of your ptosis over time, although not usually as much as at present.  When this happens, implants over the muscle will fill your tissue while submusculars will tend to give you a "Snoopy dog" shape in a few years.  Dual plane runs the risk of moving your folds down lower than they are now with significant bottoming out in shape.  These techniques should have minimal impact on your ability to breast feed in the future.

Seattle Plastic Surgeon

What Do You Recommend? Breast Lift/Aug/Both? (ph

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

Thanks for the posted photos they are very helpful, My choice a lift+augmentation in combination. Best to be seen in person. 

Breast lift, augmentation, or both?

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

Based on your photos, I think that you would be very disappointed with breast implants alone without a lift. And I also think that subglandular implants would be a big mistake. I prefer to place the implants under the muscle in most patients as a rule, but find it even more important in patients that have little native breast tissue and a thin skin envelope. I would suggest a vetical breast lift procedure with silicone gel implants placed under the muscle. The risk of having problems with breast feeding after this surgery is very low, but not zero. Most breast lifting techniques leave the nipple areolar complex intact and do not disturb the breast tissue and ductal tissue needed for breast feeding. 

Breast lift with augmentation

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

From observing your photographs it appears that you would need a breast augmentation with a breast lift if you are desiring any aspect of superior fullness.  It is possible, if you are happy with your current breast volume that a breast lift using a dermal pedicle could give you a nice, but smaller shape.  

Best Option for Breast Surgery?

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

Thank you for the question and pictures.

Although it is not possible to give you precise advice without direct examination, a full communication of your goals, and a review of the pros/cons of each option, I think you will be best served with a sub muscular (dual plane) breast augmentation along with breast lifting.

I would suggest that you do your due diligence carefully in the process of selection of plastic surgeon.

Best wishes.

Breast lift procedure

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

Thanks for the pictures, A side view always needed. It appears that you have volume loss, ptosis and minor asymmetry. A submuscular augmentation and a lift procedure is probably the way to go. A subglandular implant in you in my opinion will not solve anything and may make you look worse. Please consult with a board certified plastic surgeon.

Breast lift and augmentation

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

Lifting the breasts and placing implants should restore a more youthful look.  An exam in person is key. Good luck.

Breast Aug, Breast Lift, or Both? The Key Indicator is....

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

Dear kia123-


Thanks for the great question.  It's a pretty common question, and the key indicator is generally the position of your nipple in relation to your breast fold, or inframammary fold/ IMF.


In general, with aging and kids, your breasts lose breast fullness and your nipple position may drop over time.  If both happen in a small amount, then you may only need a breast augmentation.  However, if you have significant nipple position drop, along with lack of fullness, you may need a breast augmentation and a breast lift.


Of course, you should consult in person with a local plastic surgeon, but based on your photos, it seems that your nipple position may be relatively low to the rest of your breast. Only a consultation in person can determine this.  So, talk to your plastic surgeon!


Best Wishes,

Roy Kim

Roy Kim, MD
San Francisco Plastic Surgeon

What Do You Recommend? Breast Lift/Aug/Both?

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

Although we cannot tell for sure without examining you and seeing where your nipple and the bottom of your breast lies in relation to the inframammary crease below your breast, it does appear that you have significant overhang below this level.  Since the bottom of the implant is at the level of the inframammary crease, it will not fill out tissue that is much below this point, and the bottom of the breast will hang off of the implant.  If the nipple is below this point, it may point downward as well.  Breast augmentation does NOT lift breasts, it fills them out where they are.  Therefore, it does appear that you will need a breast lift as well as augmentation.


Empty breasts

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

An important landmark which we cannot see is where the fold is under your breast. If your nipples are above this line, then your best choice might be augmentation alone. The nipples are actually about where they should be in relation to your chest, about midway between the shoulder and the elbow. If the nipples are at or below the fold then there might be too much sag causing an unsightly appearance afterwards unless a lift is done. Of course, there is the asymmetry present in your body and breasts with the right shoulder and right breasl being significantly lower than the left whcih you should discuss regardless of what procedure you choose.

Victor Au, MD (retired)
Chapel Hill 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.