Confused! Do I need a lift or could an implant work? (Photo)

I want to have a full breast again that is not as saggy. I have lost 20 kilos and lost my breasts! My main aim is to have fullness at the top and feel confident again without a bra on. I haven't had children yet and it probably won't be for at least 3 years. I really really don't want the scars from a lift (happy to after I have kids) but I want something done now that will look good for my wedding dress! What are your suggestions? Thanks

Doctor Answers 11

Do I need a lift or could an implant work?

If you are willing to go larger, then an implant may achieve what you are looking for.  If not, then you will need a lift.


San Francisco Plastic Surgeon
4.4 out of 5 stars 7 reviews

Breast Lift

Hello,
If you want to go braless and 'feel confident', implants alone will not help you, no matter how big, high profile, or overfilled (Inspira). That's because your nipples will NEVER rotate up into an optimized position on the mound without a lift.
Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 79 reviews

Confused! Do I need a lift or could an implant work

an implant alone at this point might leave your nipple a little lower on the new breast mound than ideal, but if you are willing to accept that, then I think you can proceed and do the lift at a later date.

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.8 out of 5 stars 26 reviews

Breast Augmentation and Mastopexy (lift): Information

Dear Ms. Lissy5587,

Thank you for your story, questions and photos.
Nothing substitutes for a personal evaluation and a face to face discussion of your options.

Unfortunately without a examination I can advise you in general terms, however I hope you will find them helpful.

Based solely on your photos your are borderline if you would need a mastopexy (lift).
The more "natural look" you want the less the likely you would require a mastopexy.

My response/recommendations:
1) the reason your breast sags is that the "skin covering" is proportional larger than the breast tissue.

2) the majority of your breast tissue is below where the breast mound should anatomically be located.

3)if you refill the volume only(breast implant)... the nipple areolar complex (NAC) will tend to rotate over the top of the implant like a waterfall resulting in a full breast mound but unfortunately a downward rotation and location of the NAC.

4)the only method known to create a aesthestically acceptable breast will require trading
incisions/scars on the breast for a pleasing contour and relocating the NAC.

5)depending on your desires (shape and size) the scar may vary from:
A) just around the nipple (doughnut)
B) to a added vertical incision (lollipop)
C) to include a horizontal incsion in the breast crease (anchor).

6)while breast incisions/scars are required....there are ways to modulate/improve the
appearance of the scarring process.

7) you could always start with a augmentation only and if you like the appearance= great
if you want a more sculpted breast with a higher NAC then you could undergo a lift ( often just under local anesthesia).

8) select 3 nude model photos of breast you consider your goal breasts and bring with you to your consultation.

Please make a appt. with several experienced Plastic Surgeons who are Certified by the American Board of Plastic Surgery and ideally a members of the American Society for Aesthetic Plastic Surgery (denoting by membership as having met additional criteria and a focus on Cosmetic Plastic Surgery).

My best wishes,

R. A. Hardesty, MD, FACS
Diplomate and Certified by the Am. Bd. of Plastic Surgery
wwwimagineplasticsurgery.com
4646 Brockton Ave
Riverside, Ca 92506
(951) 686-7600

Implants

Implants alone should look great .  I recommend smooth round under the muscle... Allergan Inspira Implants .  This will give you a nice natural result and good fullness in the upper pole. Go to a BCPS with lots of experience in breast surgery.  

Good luck,

Andrew Cohen MD

Andrew T. Cohen, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 38 reviews

Implants alone or lift too

Based on the photographs I think you will get a nice result with implants alone . A round implant should achieve that goal. Make sure to seek out a board certified plastic surgeon 

Michael H. Wojtanowski, MD
Cleveland Plastic Surgeon
4.7 out of 5 stars 5 reviews

Get a consultation

to determine what results you would have with and without a lift and you can then decide on what will work best for you and your expectations.  If in the gray zone, my patients are always told to get the implant first and then decide later if they really need the lift (with the additional costs, risks, and scarring).

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 32 reviews

Confused! Do I need a lift or could an implant work?

Based on the photos I think you can gt a very nice look with implants alone. We do this frequently in patients with your anatomy. 

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 24 reviews

Breast Implants / Breast Augmentation/ Cohesive Gel Implants / Silicone Implants / Revision Breast Surgery

Thank you for your question.

From your photos, it appears that a breast augmentation may be sufficient without a lift.  I would recommend Anatomic Gummy Bear Implants.

These highly-sought-after, anatomic implants offer a look that more closely resembles the natural silhouette of a breast, and, therefore, are a very attractive option for individuals seeking a natural-looking, aesthetic primary breast augmentation. Additionally, these implants are an especially excellent option for patients undergoing restorative or corrective breast surgery because they provide more stability, shape, and reduced incidence of capsular contracture. Compared to other types of silicone gel implants, the silicone in the cohesive gel implant is more cross-linked; therefore, should the implant shell “rupture,” it maintains its shape and silicone does not leak.

During your breast augmentation consultation, you should feel the different types of implants available, and try on various implant sizers in front of a mirror to help you to get an idea of how you will look following the surgery. You should also bring pictures of the look you would like to achieve, as well as a favorite top to wear when trying on implant sizers.

In my office we also use the VECTRA system. It takes photos of you from different angles to create a 3D image. It leaves you with a 3D image of your breasts you can see from angles you have never seen before. I have found it incredibly useful for my patients when discussing breast augmentation. What I love about the VECTRA is how it helps my patients. It helps YOU see your breasts. Really see your breasts. Photos can be unforgiving, and a 3D photo really shows it like it is.

VOLUME: Is one breast larger than the other? This has 2 different ways of looking at volume, which takes into account ribcage and position differences.
WIDTH: Is one breast wider? Is your chest ribcage asymmetric?
CLEAVAGE: What is the natural spacing between your breasts? Cleavage is an area many of my patient really want to improve and fill when they do an implant. For sure implants help this area, but there are natural differences in the cleavage spacing which we can’t control. Vectra does an analysis of this to show where your natural breast ends.
IMF: Our fancy doctor term for the bottom of the breast fold is the inframammary fold. The IMF is where your underwire would go, i.e. where your breast starts from. Turns out our breasts don’t usually start at the exact same place. This difference in position can make the breasts look different and affect nipple position.
NIPPLE POSITION: This one tends to be more noticeable. Where are your nipples? Are they even?

The best way to assess and give true advice would be an in-person exam.
Please see a board-certified plastic surgeon that specializes in aesthetic and restorative plastic surgery.

Dr. Schwartz
Board Certified Plastic Surgeon
Director-Beverly Hills Breast and Body Institute
#RealSelf100Surgeon


Breast implant candidate

From the appearance of your breasts on the photographs, you may be able to get away with an implant alone. In my opinion, a tall shaped silicone implant like an Allergan 410, with a full projection and full height would be your best bet. As far as size goes, some measurements would have to be taken at consultation in order to determine that. I recommend you find a board-certified plastic surgeon in your region with experience in shaped implant .Good luck.

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 46 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.