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

Question

I am getting my Breasts Lifted with Implants...I am currently a 34 B and I want to be a 34 D...Is this possible with an Areola Lift? or will I need a different type of lift (see pics)...if I need a different lift which one is the preferred? and, under or over muscles? THANKS!

Stewart Wang, MD, FACS · Answer

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,

Eric Pugash, MD · Answer

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!

Ronald J. Edelson, MD · Answer

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.

Robert W. Kessler, MD, FACS · Answer

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

Bennett Yang, MD · Answer

hi

	thanks for post. i would prefer to place under the muscle implants for best long term outcome, reduce complications, and natural look. 

	Your pics show a good degree of ptosis ( sag ). This is NOT a case for the around the nipple lift. I know that is preferred by most patients who want to avoid the vertical scars, but a nipple only lift is only good for a small degree of lift ( typically less than an inch) and often causes the nipple areola size to stretch. 

	You would do best with a full lift. 

	remember before surgery: 

	no smoking!

	no aspirin / motrin

	avoid birth control pills

	avoid any diet supplements

	take a multivitamin and eat healthy

	eat a high fiber diet: the pain meds cause serious constipation! 

	Best to you.

Kenneth Hughes, MD · Answer

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

Kris M. Reddy, MD, FACS · Answer

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.

M. Ryan Khosravi, MD, FACS · Answer

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.

Pablo Prichard, MD · Answer

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

Darryl J. Blinski, MD · Answer

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.

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

Answers (14)

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