Breast Lift with Implants 34B to 34D? (photo)

Thank you for providing the photos. They are not complete but it gives some ideas to your treatment options. Since your are thinking about 2 cup enlargement, a circumareolar breast lift should be enough. In general I like to place the implant under the muscle especially when you are also doing a breast lift at the same time. It's true that the circle lift will not give you as much lift as the lollipop or anchor breast lift but in your situation it's important to determine how much of it lift that you want to have. At the same time, you most likely will need a good size implant to satisfy your 2 cups size increase. Adding a large implant and doing lollipop or anchor lift is filled with risks postoperatively. You are at very high risk for bottoming out with large, heavy breasts. The bottom line is you have to find an ideal compromise. Find a reputable surgeon who is willing to work with you to achieve your goals.

Best Wishes,

 

See my previous answers on the Benelli or areolar lift: this is a poorly-designed operation that does not provide much lift and can lead to severe distortion of the areolas.

You would do best with a vertical or 'lollipop' breast lift.

There are pros and cons to going under the muscle when you are having a mastopexy at the same time.

I recommend you find a very experienced aesthetic breast surgeon to help you get the best result.

Good luck!

 

You definitely need a lift with an implant.  You are an ideal candidate for the lollipop version of the mastopexy.  I would probably use an implant size in the mid 300's.

Your photos are very helpful but a definitive answer would require a formal consultation and an understanding of the size implant being used.With lax breast skin the implants should be placed partially under the muscle.  I am concerned that your degree of skin laxity will require a more powerful lift than the periareolar to give you an optimal result. The next step up is a circumvertical lift which has the same incision around the areola but a vertical incision from the areola to the breast fold.This will yield a better final breast shape. I do not believe an incision under the breast would be necessary but I would discuss it with you so that there would be no surprises after surgery.

Review these options with your board certified plastic surgeon. I hope this was helpful

    The breast implants should be placed under the muscle to create better camouflage among other advantages.  A full breast lift will provide a much higher, tighter, better projected breast with more superior pole fullness.  Find the plastic surgeon with elite credentials who performs hundreds of breast augmentations and breast lifts each year.   Kenneth Hughes, MD Los Angeles, CA

There is a tradeoff between a full lift and areola lift as the full lift will provide greater correction but leave a more noticeable scar. Your photos suggest that you would be a good candidate for under the muscle placement. Consult in person with 3 experienced and expert board certified plastic surgeons to understand your options.

The pictures are very helpful. In your case I believe periareolar or benilli lift along with breast augmentation will not get the desired result. You need a more effective breast lift technique that be consistent with the level of your breast sagging. That would not hurt to ask for a second opinion. 

Hi Imma,

Thank you for your question and photos.

You seem to have stage III ptosis (breast sagging) from your photos.  An areolar lift provides very minimal lift and I would avoid that if I were you.  You will do well with a vertical (lollipop) lift in experienced hands.  There are pros and cons to going over/under muscle, and type of implant.  Going under muscle gives you more coverage to the implant, but only over the top portion of the implant.  Going over the muscle (but I would recommend under the fascia or coverring of the muscle) avoids 'breast animation' (lifting and compression of the implants with contraction of the pectoralis muscle).  If you were my patient, I would most likely recommend a shaped gummy bear implant under the muscle fascia (but above the muscle) with a vertical (lollipop) lift.

Best Wishes,

Pablo Prichard, MD

Based upon the posted photos and your desires I doubt you can obtain a D cup with a full lifting. The full lift is what I believe you will need. 

Easier answer is under the muscle. Most prefer this (almost) all the time, certainly for larger implants on smaller breasted women.

And yes, you do need a lift. What type will depend on findings during an in person consultation. An ideal photo from which to evaluate would be a frontal and side view with arms at the side, and none of these are quite there. Lifting the arms lifts the breasts, and the photos don't show the true situation. I do suspect that a consulting plastic surgeon will recommend more than just a periareolar lift--that is a very limited procedure with very limited lifting capacity. 

When you are ready for an in person consultation, RealSelf has listings of surgeons in your area. You should consider cross referencing the listings from the The American Society of Plastic Surgeons (plasticsurgery dot org). A listing in the ASPS website assures you that your surgeon is not only board certified,  but also is a member in good standing of the major plastic surgery organization in the U. S. Thank you for your question, best wishes.