Do I need a lift for implants? (Photos)

You are on the borderline of needing a lift. If you go with a larger implant (350cc +), it will likely get you the volume you need to improve you nipple positioning without the scars from a lift. If you want a small but perky breast, a small implant will probably look best with a lift. Another consideration is placing the implant subglanular so that it has a better chance of settling in the native skin envelope. Assuming you are interested in a large enough implant, I would start with the augmentation and see how everthing settles. You can always go back and add the scarring with a lift if it determined to be necessary after several months.

Hello, for people with only mild-to-moderate breast sagging (i.e. the nipples are not pointing straight down on the breasts), many will seek to have breast implants alone. There is always the option of having a lift later on if they are unhappy with the result. However, the right procedure for you depends on multiple factors, including your expectations of the final result in terms of shape and nipple positions, tolerance of the risks/costs/scars of breast lift surgery, and the advice of your plastic surgeon. For my own patients, I encourage them to look at lots of before-and-after results of breast implants alone, compared with implants + lift. This will give them a better idea which operation will meet their goals. Thanks and I hope your research goes well.

From your photographs, even with large implants, you would probably need a breast lift to reposition your nipples. Larger implants rarely change the position of the nipples much and sometimes make them lower. Another approach is having the augmentation and living with it for a while and deciding whether you want to proceed with a breast lift and the added scars. This is not ideal because you may need to surgeries… A discussion with a board certified plastic surgeon would probably go far to give you more information and realistic expectations of the different approaches.

A lift is recommended when the nipples are located below the breast fold, rather than basing it on the size of the implants. It does appear that your nipples are below your breast fold, so you may benefit from a lift and implants.

Dear kb1009,

determining whether you need simply a breast augmentation versus a breast lift can be somewhat complicated. It depends on a number of factors including skin laxity and current nipple position. Generally speaking, if the nipples are lower than the inframammary line the patient will most likely need a breast lift. If the nipples are at or above the inframammary line we can generally get by with just a breast augmentation depending on the size of the implant the patient wants. I often still using implant when I perform a breast lift because it provides more upper breast fullness after the lift. To be sure a consultation with a board-certified plastic surgeon will help determine what the patient actually needs.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Your breasts are very low on your chest wall, are asymmetrical and the nipples are quite lateral. If you undergo augmentation alone then the implants have to be centered underneath the nipple-areola complex. You will have 2 implants laterally positioned pointing outward and the results will be very poor. The technique I recommend is a lift using The Bellesoma Method. This will reshape your reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Patient concerns regarding the appearance of their breasts can typically be divided in two pools: volume, ptosis (droop). The procedures to address these issues are as different as the issues themselves. However, these concerns are not mutually exclusive. Many patients, whether they are aware or not, will benefit from both.
There are two factors which can help to answer the question of which surgery will deliver the most satisfying result: mastopexy, augmentation or both. Patients must first consider the position of the NAC (nipple areolar complex i.e. the pigmented portion of the breast) as it relates to the inframammary crease. If the nipples are at or below the level of the crease the patient may benefit from a lift or mastopexy. The breast lift is designed to elevate sagging breasts to a more youthful position. It also helps to reshape and tighten the skin of the breasts. This is typically accomplished via a periareolar (around the nipple) incision with or without a vertical incision.
Mastopexy is an effective way to address sagging breast, however, the changes which accompany weight loss or pregnancy can also decrease volume of the breasts. When a woman wants the volume restored, or increased, a breast augmentation will also be needed in conjunction with mastopexy. Augmentation can help restore the volume loss which is well known to women following children. There are a number of options available to women considering augmentation ranging from size and implant type to access incision.
A breast augmentation alone may also be appropriate if ptosis is mild. If the patient is comfortable with the natural appearance of the breasts but desires them to be larger, a breast augmentation alone is the right procedure. Augmenting significantly ptotic or sagging breasts tends to magnify the problem. In these cases, a mastopexy performed in conjunction with an augmentation is preferred.
Based upon your photos, you demonstrate mild pseudoptosis/glandular ptosis (nipple position is preserved with some sag of the breast behind). You also have some upper pole depletion. Ultimately, the 2 procedures are mutually exclusive. The augmentation regardless of size will not lift the breast. However, you do not appear to be in dire need of a lift.
There is a procedure for every problem. To determine which technique is right for you, consult with a board certified plastic surgeon Patient should discuss their concerns with their physicians in order to make an educated decision.

I recommend an in person consultation with a plastic surgeon to discuss your goals and be measured. After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what size and style breast implant is right for them. Mildly Sagging Breasts: If your breasts are mildly droopy, a saline or silicone gel implant placed behind the pectoral muscle might help create the illusion of perkiness. That’s because as the implant fills out the top of the breast, it also fills out the bottom, making it look as if the nipple has moved higher. It hasn’t. You can always get a lift later if you feel you are not perky enough when fully settled and healed. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

At Dr. Caner Kacmaz Clinic in Istanbul, we recommend breast augmentation combined with a minor lift for you as your breasts have lost volume and firmness after breastfeeding.
Since you have breastfed two children, which has resulted in a mild sagging and reduced breast size. By placing implants and performing a small breast lift, we aim to restore a fuller, rounder, and more youthful shape, improving both body proportion and self-confidence.

We strongly advise that the surgery be performed at least 3 to 6 months after breastfeeding has fully stopped. This waiting period allows the mammary glands to cease milk production and gives the breast tissue time to stabilize, which is essential for optimal surgical planning and safe healing.

Pre-operative considerations:

You should be completely finished with breastfeeding for at least 3–6 months.
Breasts must be free of active milk production (no leaking, fullness, or tenderness).
A medical evaluation and breast ultrasound may be required to ensure healthy tissue.
Smoking and alcohol use should be stopped before surgery to promote better healing.

Post operative considerations:

You’ll need to wear a supportive surgical bra for several weeks.
Avoid lifting, heavy exercise, and raising your arms above shoulder level for the first 3–4 weeks.
Mild swelling and bruising are normal and subside gradually.
Scars will fade over time, and final results will continue to improve over 3–6 months.
Regular follow-ups with Dr. Caner will ensure proper healing and beautiful, natural-looking results.

We’re happy to assist you further and answer any questions you may have. You’re welcome to contact us to book a free online consultation with Dr. Caner Kacmaz.

Determining if you need a lift really depends on the results you are wanting. Right now your nipples sit low on the chest wall. With implants you will have a larger version of what you have now and the nipples will still be somewhat low. If you are wanting a perky, lifted look then a mastopexy with implants is the right move.