To Lift or Not to Lift, That is the Question? (photo)

I'm 32 and I have some slight sagging after 4 pregnancies, but my issue is more with deflation. Before children I was a 34 B, while nursing I was a 36 D. I would rather have some sagging than have scars--I REALLY don't want the tell tale lollipop scars at this point. I also like my areolae as they are, and I want to minimize my risk for loss of nipple sensation, too. Am I just fooling myself to hope that augmentation is sufficient? I'm open to a lift down the line, but at 32 I don't want scars.

Doctor Answers 20

Lift or not

If you do not feel your breasts are too saggy now, I do not believe you will think so after augmentation alone either.  It is really a question of aesthetics.  And, as we all know, beauty is in the eye of the beholder.  You.     

Santa Rosa Plastic Surgeon
4.9 out of 5 stars 33 reviews

Augment without lift

I write all the time telling women who are trying to avoid the lift scars that the results will not be aesthetically pleasing BUT I think that you are a good candidate for augment alone.  So long as you recognize that your breasts won't be high on your chest, it should give enough improvement.  I don't think you are fooling yourself.  Best wishes!

Robert L. Kraft, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 39 reviews

Augmentation with or without a lift

This is a very common dilemma for women seeking breast enhancement surgery.  I think you would get the best shape if you have a lift (mastopexy).  However, I have had patients such as yourself you really don't want the additional scarring.  After counseling as to the result, they will sometimes opt for an augmentation only and be very happy.  However, you need to be aware that your breasts will still rest on your upper abdomen and your nipples will be low.  You can have a lift as a secondary procedure at a later date if you wish to. 

Laurence Weider, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 98 reviews

To Lift or Not to Lift, That is the Question?

Great question and catchy title. In fact, I have had many patients with your anatomy who elected to have only an augmentation. I always advise them the overall aesthetics will be beter with a lift, but our job is to make you happy, not do just what we want. As long as you recognize the limitations of foregoing a lift I think you will do fine. You will need a surgeon who uses dual plane positioning of the implants because it is important they sit where your breast tissue naturally is located. I definitely do not agree with the consultants who say you will need a very large implant, but you will need one appropriately sized for your breast transverse diameter. Also, in my experience the high profile implant is certainly not necessary, as I rarely use it and the patients are quite pleased with their results. But it is available if you want to get more extreme projection.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 27 reviews

Breast augmentation without a lift is always an option

I think you have really answered your own question, and you're looking for some backup here. You state you would rather have some sagging, and you emphatically don't want the scars of a lift.  I'm assuming that you are educated about lifts, and therefore, there is no purpose in going into detail about what a lift is or isn't.  I think you are correct that a lift is always an option down the line for ladies such as yourself.  There is no question that you have some ptosis, or laxity, in your breasts, but if you don't mind some residual ptosis, then an augmentation alone with a fairly full volume implant using a dual plane technique may produce enough fullness to satisfy you.  Use an inframammary incision to minimize the chance of alteration of nipple sensation.  If those are truly your priorities, then there is your plan.  It's all very reasonable, I think.  Good luck.

Joseph L. Grzeskiewicz, MD
San Diego Plastic Surgeon
4.9 out of 5 stars 87 reviews

Breast augmentation without lift is possible but lift will improve results

Thank you for your question and photographs. A breast augmentation without a lift certainly possible for you and will give your breasts more fullness and project them further out on your chest. Be aware that you do have some ptosis or sagging of the breast. You may find 6 months after your breast augmentation that you can benefit from a secondary breast lift.

To Lift or Not to Lift, That is the Question? (photo)

It is difficult to say without actually examining you and taking your measurements.  However, based on the photos it seems you do need a peri-areolar mastopexy (donut lift).  This would leave only a peri-areolar scar.  I understand that you "like your areolae the way they are", but in plastic surgery everything is a trade-off.  However, maintaining sensation to the nipple/areola complex has nothing to do with the lift and none of the mastopexy procedures are know to cause nipple/areola sensory loss.  What can result in this problem is a breast reduction, approximately 5-10% depending on the technique, and implants when the lateral dissection is done sharply, around 5%.

Ruben B. Abrams, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 19 reviews

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Ramon Navarro, MD
Mexico Plastic Surgeon
5.0 out of 5 stars 2 reviews

Breast augmentation will correct moderate sagging.


I think you will be fine just with implants.  I would recommend fairly large, smooth walled, round, silicone implants placed OVER the muscle (to improve sagging).

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
4.8 out of 5 stars 9 reviews

Breast Augmentation with or without a Breast Lift

Your question and situation, regarding the option of having a breast augmentation without a breast lift, is commonly seen in plastic surgeon's offices.  From your photos, I believe you will not be happy with the results of a breast augmentation alone.  If the scars, that can and do result from the various types of breast lift (donut, lollipop, or anchor mastopexies) concerns you, you can undergo a breast augmentation without the breast lift.  However, you should be prepared to undergo a second surgery to preform the lift, with its added costs, if you are not pleased with the augmentation alone.  Best wishes. 

Vincent D. Lepore, MD
San Jose Plastic Surgeon
4.8 out of 5 stars 56 reviews

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.