I want more volume and lift. I'm 33 yrs old and want to know if mastopexy can be avoided. (photos)

I want more volume and lift. I an 33 yrs old and Breastfed for 4 Yrs total. Will augmentation be enough or does grafting really work well. I don't want surgery if scars are the price to pay. If for an augmentation what size would I need to achieve some lift, if possible. I want to get a natural look but with aesthetic beauty.

Doctor Answers 14

Breast lift with augmentation

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You would most likely get the best result with a full breast lift with breast augmentation. Please seek an in person consultation with a board certified plastic surgeon in your area. Be sure to express your goals and expectations to your chosen surgeon. In my practice in the San Francisco Bay Area I have come to the conclusion that the happiest patients are those that have realistic expectation on what a procedure will and won’t do for them. Good luck!

Dean Vistnes
Vistnes Plastic Surgery
San Francisco Bay Area
#realself #drdeanvistnes #breastlift #breastaugmentation

Breast surgery

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In order to achieve optimum results you will need the enhancement as well as the lift.  It is understandable to want to avoid the scars, but your efforts won't be worth it if you are left with an undesirable shape.  Most scars heal very well and are hardly noticeable over time, yet the new beautiful shape remains.  Our office has had nice results from using scar products such as Embrace to minimize the appearance of scars.

Breast Lift and Augmentation Would be Ideal #breastlift #breastaugmentation

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  • You have considerable glandular ptosis (sagging).  This means almost all of your breast tissue has settled down into the lower portion of your breast, even though your nipple isn't extremely low.
  • Therefore, you'd benefit most from a vertical breast lift ("lollipop lift") and breast augmentation.
  • If you went with a breast augmentation alone, your final appearance would be less than ideal.  You'd end up with an implant that would be sitting in the proper position on you chest wall, but your native breast tissue would be sliding off of the implant and rest in a lower position.
  • Meet with a board certified plastic surgeon to discuss. 
  • Thanks for sharing! 

I want more volume and lift. I'm 33 yrs old and want to know if mastopexy can be avoided

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I do not think an implant or fat injections to your breast will lift the mound of you breast any higher. It might appear that way right after surgery due to swelling, but in time the implant will not maintain any lift, nor will the fat grafting. Either way you would look natural, but still saggy

LIft now or Lift later

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Most women come in wanting breast rejuvenation with as little scarring as possible.  You certainly are from the photos a candidate for increasing your volume with an implant or with fat grafting.  You appear to have pseudo-glandular ptosis which is when the breast tissue slides down the chest wall but the nipple does not point to the ground.   Understanding that nobody wants the added scar of a lift, they also don't want breasts that are not attractive.  My fear is that just putting an implant in looks as though your nipple would be too low and would give a waterfall effect.  Meaning, your nipple and your natural breast tissue is falling off the breast mound created by your implant.  Fat grafting would be a natural alternative that would keep your breasts in their present place with the least amount of scarring and a natural appearance.  Since only approximately 60% of the fat will live, going up a cup size might be reasonable.  Of course, fat grafting means the fat needs to be taken from another area of the body which may increase the cost but is a reasonable option if you like where your breasts are now on your body.  I have on occasion on the right patient who is well aware, put in implants only knowing that in the not so distant future she will need a lift still.  I encourage most of my patients to do this surgery together but sometimes it is a good idea to separate them.  I encourage you to see a physician and let him or her examine you and help you to make the proper decision.  Good Luck!

Michael Zwicklbauer, MD
Newport News Plastic Surgeon
5.0 out of 5 stars 80 reviews

Breast surgery

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Hello and thank you for your question. Based on your pictures you will have a better result with a breast lift with an implant.  The size of the implant is based on your desired breast size/shape, your chest wall measurements, and soft tissue quality.  This decision should be based on a detailed discussion with equal input from both you and your surgeon.   Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.   The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Lifts for Lifts

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Breast Lifts will lift a breast. Breast implants will augment a breast. 

Breast implants will not lift a breast and will in fact make it more sagging. We call this phenomenon a rock in a sock.

In your case, you definitely need a lift as part of any cosmetic breast improvements. However, todays augmentation mastopexy techniques include circumareolar techniques. My Tear Drop technique lifts by pulling up tissue from above- this creates upper breast fullness. The implant as volume and projection. The scar is only around the areola. If your nipple to sternal notch measurement is less than 25 cm's - then you are a candidate.

For more information, read my book, "Cosmetic Breast Surgery - A Complete Guide From A to Double D".

Can I avoid mastopexy.

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You can avoid a breast lift and the scars if you don't want one. Your nipple is at the level of the breast fold and likely to push higher with an implant in place. Your idea of aesthetic beauty should be discussed with your consultation to help you know how close you can get to your goal without a lift.

Lift and augmentation

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More than likely you need a lift along with implants. The implants will only add volume.  Best of luck.

Can I get lift and fullness without mastopexy?

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Your pictures were reviewed. Ptosis is obvious. You have an issue which in my experience requires  a surgical intervention for the best outcome. As is usually the case you need a hands on assessment by a board certified  Plastic Surgeon. Your parameters necessitates a discussion of size and review of augmentation patient outcomes whose breast and chest wall anatomy is similar to yours. My recommendation, if you had not expressed reservations, would be for an augmentation mastopexy, that is implants with a breast lift.

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.