Is it possible to avoid a breast lift by getting a larger implant?

Your surgeon is giving you sound advice. The goal should be a proportionate, natural look. If you use large implants to lift your breasts, then you will have large, saggier breasts. Also, I would agree that a 400 ml implant is on the higher end of the spectrum while also performing a lift simultaneously.

Implants can overcome mild and sometimes moderate ptosis (droopiness) of the breasts.  What you look for when doing the consultation is how much the skin envelope is deflated.  Tebbets describes the skin stretch tests.  This generally gives me the idea of the projection needed on the implant to correct each level of ptosis.  Typically the more important information regarding the implant is not the absolutely volume, it's the profile of the implant. This is how much the implant is able to stretch to skin out for me during an implantation.  If a persons skin envelope has 5 cm of stretc, she will need over 5 cm of projection on the implant to correct her ptosis.  Thanks 

Thank you for your question.  This is a very common question and dilemma for many patients: implants with or without lift?  Truth be told, many patient can get away with implants alone, but if they are a "borderline" case, I advise they get a lift as well.  The larger the implants they get, the faster and further they will drop which will warrant a lift further down the road.  Although the scars are unsightly, I recommend going for the lift with implants to achieve larger, perkier breasts.All the best,Dr. ResultsMiami, FL

If the PS you have seen is already saying that your breats would look better with a lift and an implant there may be real limits to the size implant that would make you look better without causing further distortion.  The best implant size is usually chosen by looking at the base diameter of your breast ( fitting the implant to your chest wall). There will be a range of implant shapes and volumes that fit around this measurement.  If your breast requires a lift, this is a question of shape.  Going with a larger implant can compensate for this a little bit but don't go too big or it will just stretch out the breast more and lead to more distortion. If the plastic surgeon is telling you that it won't look right with a 405 cc implant you may just have to accept the scars or decide not to have the procedure. I wish there was a solution that gave you everything you want. Get several opinions from credentialed plastic surgeons before you make your decision.  Good luck. 

Many of us chose implants based on the dimentions of your chest wall -- not your breast.  Therefore, I will often recommend an implant size based on that so that they can expect a long-lasting implant result without bottoming out, capsularcontrature, etc that may be related to using implants that are too large.  Having said that, it may not be enough to totally "fill up" your breast or address a low-lying nipple, so a lift is recommended.  I know the scar is not ideal for many women, but it is to get the best appearance with a long-lasting result.  We have all seen the woman who came in and needed a lift but instead got overly large, often subglandular implants instead.  They looked good -- for about 6 months.  Then they got hard and sagged.  Now they need redone and that operation is complicated and expensive.  Should've just done it right in the first place!  Get a couple more oppinions from ASAPS members in your area and make the decision that's best for you.  Good luck!

It is possible to raise the nipple if it sits at the level of the breast fold and an implant alone may work out. If the nipple sits below the fold the implant will tend to push the nipple even lower. The implant size is not as important as nipple position whch is what breast lift is all about.

Thank you for the question.Photos would be very helpful in terms of getting more specific advice.  In general I agree with the advice from your surgeon.  When performing a combined augmentation/lift, I typically advise against using very large implants.  This can put undo stress on your incisions.  Conceptually you are doing two things that counter each other.  The lift is trying to tighten the skin envelope, while the implant is stretching it out (especially if you are using large implants).  That being said, it can safely be performed in the hands of an experienced board certified plastic surgeon.  Many women are scared of the scars that a lift or mastopexy create.  One thing I always stress is that even with the scars, the improved nipple position creates a much more youthful/attractive breast.  Have your surgeon show you images of patients with the mastopexy scars so you can see for yourself. I hope this helps!Best regards.Spencer Eagan M.D.  

Thanks for your question.  This is a difficult question to answer without seeing your pictures.  However, as a general rule, if you are completely against the breast lift scars, I recommend speaking to your surgeon about using shaped implants.  For women with mild breast ptosis, a shaped implant can give you a modest lift without the extra surgery.Hope this helps.  Best of luck.

An augmentation without a lift will just increase the size of your breasts without moving your nipples. This may give you a very "natural look." If you want "perky and full," you will need a lift. Placing a large implant behind  sagging breast tissue will give you more sagging with time.