What do I need to achieve fullness and symmetry? Do I need a lift? (Photo)

I am 26, 5'7 and about 150 pounds and wear a size 34B bra. No kids. I've flucuated in weight about 30 pounds over the years and my breasts have always been droopy and never full. Would implants alone give me a full and symmetrical look or would I need a lift too? I don't want to be huge just have upper pole fullness and nipples not so droopy.

Doctor Answers 10

A lift can help improve overall breast shape and symmetry

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Breast implants will make your breasts larger, but won’t change their shape or their position on your chest. If what you want is a fuller, perkier look, you might want to consider combining a breast lift with small implants. The breast lift will reshape your natural tissue for a rounder profile while implants add volume through the upper pole. Your nipples can be resized and centered at the same time if that’s a concern for you as well. I recommend looking for a breast augmentation specialist for the best possible outcome, as not all breast enhancement surgeons are created equal.

Charlotte Plastic Surgeon
4.7 out of 5 stars 61 reviews

Breast lift with implants candidate?

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Hello and thank your for your question.

It appears that you are an excellent candidate for a mastopexy (breast lift) with implants. The breast lift will restore your breasts to a perky position on your chest while also reducing your areolae. A breast implant will give you fullness in the upper part of the breast.

Seek consultations with board certified Plastic Surgeons to discuss your options. Best wishes!

What do I need to achieve fullness and symmetry? Do I need a lift?

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It appears that you are a good candidate for mastopexy with implants- preferable silicone. In the right hands you should expect a very pleasing outcome. Seek an experienced Board Certified PS.

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To achieve fullness and get your breasts, symmetrical, what are your options?

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Based on your photos, you are going to benefit from a mastopexy along with breast implants.  The only way to get your nipples "not so droopy" is by a lift, and the only way to achieve upper pole fullness is with an implant.  Although it is more surgery, I think that you will have a lovely result.  Please make sure to consult with a board-certified plastic surgeon in your area.  Best of luck!

You Have Classic Tuberous Breasts & Therefore Its Mandatory That You Get A Lift - Implants Optional

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Your breasts are tuberous because there is a constricted base.  Your breast falls over the inframammary fold because the fold is so tight that, as your breast tissue has grown, it can't slide down your chest as most breasts do.  It must turn downward. 

Also, your breast tissue has herniated into your areola giving it that rounded or pouty appearance.  When there is a relatively loose inframammary fold, the surgeon can lower the fold slightly by dissecting below it.  This allows the creation of a new lower inframammary fold and a more normal position of the nipple areola complex.  With tuberous breasts, the fold is so tight that one cannot lower the fold, therefore one must move the nipple upward, i.e. A LIFT IS MANDATORY.

If you were my patient, I would recommend a circumareolar (Benelli) mastopexy with a transaxillary breast augmentation.  I would do the lift first and during the lift, make five deep cuts into the inferior most segment of the breast tissue allowing it to splay out therefore allowing for a slightly lower inframammary fold.  Then, I would through a transaxillary breast augmentation create the pocket and place the implant.  This dual approach to an augmentation/lift allows varying the size of the implant and the size of the outer circle separately, and since the transaxillary scar is normally invisible and since we tattoo all our periareolar incisions around 3-4 months post op, this lift/augmentation becomes almost scarless.  

Breast fullness and symmetry

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Hello, and thanks for your question.

You have touched on the most difficult most breast problems when considering augmentation.
Briefly, fullness is gained by implants. Low lying breasts need a lift(giving the same type of results as hitching up your bra by the straps). Also, most women have some level of asymmetry.

I believe you need a detailed examination because you have many factors contributing, and each part of the surgery will have trade-offs.

So, there is an answer to your question, but to get there, you need to have a face-to-face consultation(your photos and brief question don't give us Specialists enough to come up with realistic options for you). We need to examine, listen to you, consider and then discuss with you which ways you can go.
Your case is not simple, and deserves all due consideration. As Plastic Surgeons, we have many years of Specialist Surgeon training behind us, with a variety of skills and many years of experience to go on.

Once you are appropriately informed, you are equipped to make a decision.

I trust this has been of value.

Will a Breast Augmentation Help Droopy Breasts?

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Consult with a board-certified plastic surgeon, who can examine you to determine if a breast augmentation alone will help you achieve your goals or if you'll need a donut mastopexy to get the results you'd like. 

Both the link below and the video accompanying this answer will explain more about lifting nipples with a donut mastopexy.

All the best.

Heather J. Furnas, MD
Santa Rosa Plastic Surgeon
4.9 out of 5 stars 33 reviews

What do I need to achieve fullness and symmetry? Do I need a lift?

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Thank you for the question and pictures. Based on your description and pictures, you will benefit from breast lifting plus/minus breast augmentation surgery.    You will do best by seeking consultation with well experienced board certified plastic surgeons. Ask to see lots of examples of their work and communicate your goals clearly.  Patients who are considering breast augmentation/lifting surgery should understand that this combination surgery is significantly more complex than either one of the procedures done separately. In other words, 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 increased with breast augmentation / mastopexy surgery done at the same time.  This revisionary rate may be as high (or higher) than 20%. Patients should be aware of this higher revisionary rate;  obviously, the need for additional surgery, time off work/life  considerations,  and additional expenses  our “factors” that should be considered before undergoing the initial operation.
  Personally, I find that the breast augmentation/lifting procedure to be one of the most challenging  of the breast operations I perform, even compared to somewhat complex revisionary breast surgery. On the one hand,  when performing breast augmentation/lifting surgery we are increasing the breast  size with breast implants;  on the other hand, we are reducing the breast “envelope” in order to achieve the breast lift. These two “forces” must be balanced as perfectly as possible in order to achieve the desired results. Removing too much skin/ breast tissue is problematic;  removing too little breast skin/tissue can also be problematic.  Remember also that patients presenting for breast lifting surgery and general have lost some skin elasticity/thickness making potential incision line healing problems and/or recurrent drooping/sagging important concerns to communicate.   The analogy I use in my practice is that  of a thinned out balloon,  being expanded with additional air, while at the same time removing some of the balloons rubber surface.  I hope that this analogy helps patients understand some of the issues at hand when performing the combination breast augmentation/lifing operation. To achieve  a surgical result where the breast implant and breast tissue “come together” and behave like a single breast is one of my goals but can be difficult to achieve.  Essentially, we are trying to create a breast implant/breast tissue interface that feels and behaves as naturally ( as a single unit)  as possible. Generally speaking, making sure that the breast implant has some sub muscular and some sub glandular component ( dual plane)  and tailoring the overlying skin/subcutaneous tissue/breast tissue as precisely as possible over the underlying breast implant is key. Despite these efforts, breast implants are after all a foreign body that don't necessarily stay where we wish they would;  therefore, breast implant related problems such as positioning ( too high, too low, lateral displacement etc.) can occur  and may be a reason for returning to the operating room for revisionary breast surgery.
I use a “tailor tacking” technique that allows a determination of what breast implant should be used to SAFELY produce the results the patient is looking for. This technique involves use of a temporary sizer and temporary “closure” of the overlying breast skin over the sizer. 
The use of the tailor tacking technique is very helpful.  Breast lifting involves removal of skin ( and tightening of the breast skin envelope)  while breast augmentation involves expansion of the breast skin envelope. These 2 forces are counteracting each other.  
Again, despite these efforts, breast implant and/or tissue/skin complications may arise causing minor or significant complications.
  Generally speaking, it is difficult to achieve the “perfect” result with breast augmentation/lifting surgery, despite best efforts.  Patients should be aware of the complexity of this combination procedure, achieve REALISTIC EXPECTATIONS prior to proceeding, and understand that additional surgery ( along with the additional recovery time, stress, expenses etc) may be necessary in the short or long-term. Patients should understand that the results of the procedure will not necessarily match aesthetically the results of patients who have undergone breast augmentation surgery only. For example, some patients who wish to maintain long-term superior pole volume/"roundness" may find that this result is not achieved after the initial breast augmentation/lifting operation.  An additional operation, possibly involving capsulorrhaphy, may be necessary to achieve the patient's longer-term goals ( with superior pole volume/roundness).  It is helpful if patients understand that this breast implant capsule used to provide the support for the breast implant is not present during the initial breast augmentation/lifting operation.  The capsule (layer of scar tissue) forms around the breast implant and may be a good source of supportive tissue during revisionary breast surgery,  Including correction of breast implant displacement/malposition problems ( such as bottoming out, symmastia,  lateral displacement etc).
  Potential risks associated with breast augmentation/lifting surgery include infection, bleeding, incision line healing problems, loss/change of nipple/areola complex sensation, and blood flow related issues  to causing skin or tissue necrosis.   Poor scarring,  pigment changes, areola/nipple asymmetry etc. are also potential problems. Again, patients may experience implant related problems such as encapsulation, leakage, displacement problems ( too high, bottoming out, lateral displacement, asymmetric positioning etc.), rippling/palpability of breast implants etc.  Patients may also be dissatisfied with breast size, shape, and/or how the  breast implants and overlying breast tissues “interface” with one another.    Occasionally, a breast implant may even have to be removed and the patient will generally be “implant free” for several months at least.  Obviously, this situation can be quite physically, emotionally, and psychosocially stressful to the patient involved. Given the complexity  of the combination breast augmentation/lifting operation and the greater risk of revisionary breast surgery needed, there are good plastic surgeons who will insist on doing the procedures separately.
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 in 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. Having discussed some of the downsides  and potential risks/complications associated with breast augmentation/lifting surgery, most patients (If properly selected and who are doing the operations at the right time of their lives  psychosocially) accept the scars associated with breast augmentation/breast lifting surgery as long as they are happy with the improvement in contour, size, and symmetry.
 I hope that this summary of SOME  of the issues surrounding breast augmentation/lifting surgery  is helpful to you and other women considering this procedure in the future.
 The attached link may also be helpful. Best wishes.

What do I need to achieve fullness and symmetry? Do I need a lift?

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A breast lift would improve the look and shape.  I would search for the board certified plastic surgeon who you feel is most likely to give you the best results and who performs hundreds of these procedures each year. I would look at patient reviews as well as before and after photos on that surgeon's website.

Kenneth Hughes, MD

Los Angeles, CA

Looking for symmetry and fullness

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Your breasts are sagging and can be labeled as minor form of tubular beasts .Your left breast is a little more sagging than the right .You should consider periareolar mastopexy (incision only around the areola) , which will reduce the size of the areola and allows lifting of the breasts without the vertical scars.At the same time small implants can be inserted in order to give you the upper pole fullness and increase in volume.

Erel Laufer, MD
Dunedin Plastic Surgeon
4.7 out of 5 stars 35 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.