Do I really need or should I get a lift? Would round or teardrop be better shape in cohesive? (Photos)

Question

Wide set/lift? Seeking info such as do I really need or should get lift? Would round or teardrop be better shape in cohesive. If no lift would they just be droopier? I want cleavage even if it needs push up bra to aide in that look.

Daniel Barrett, MD · Answer

Dear Plasticideas21,

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

Gianfranco Frojo, MD · Answer

Yes you definitely would benefit from a breast lift to properly tailor/shape the overlying skin/breast tissue.

Ramin Behmand, MD, FACS · Answer

From the side view, it looks like you might be able to forgo a lift, but the front view suggests that you would likely be happier with one. A lift would provide longer-lasting results and help maintain the breasts in a more ideal position over time. Teardrop-shaped implants need a textured surface to prevent rotation within the breast pocket, while round implants tend to be a better choice, with fewer associated issues. Dr. B.

Gary M. Horndeski, MD · Answer

Your breasts are too low and too lateral. You need a breast lift and the technique I recommend is The Bellesoma Method. This will 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.

Best Wishes,

Gary Horndeski, M.D.

Joe Gryskiewicz, MD, FACS · Answer

It is always best to see an experienced professional in person when making decisions. Based on looking solely at these two photos. For the best outcome it would be most beneficial to add a lift along with breast implants. Breast implants will add volume and give shape but being that your nipple placement is low and breasts are long , you will have a much better outcome lifting them as well. In your circumstance just putting implants in will overtime just make your hang lower without addressing the top upper pole fullness.

Ted Eisenberg, DO, FACOS, FAACS · Answer

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

Sean Fisher, MD · Answer

The goal of a breast lift is to improve shape, nipple position, and symmetry- which can be the key to a great result. From the photos provided, it appears there is a fair amount of asymmetry both in terms of breast volume, but also shape and nipple position. A breast lift can improve these asymmetries before an implant could be added if the goal is for increased volume, projection, or upper pole fullness. 
Performing an augmentation without a lift is unlikely to give you a result that you are happy with. A large volume augmentation can elevate nipple position to a degree, but it is much less powerful than a lift and also would not be possible to correct the nipple position asymmetry or shape asymmetry. 
Sean Fisher Aesthetic Plastic Surgeon Seattle, WA

Connie Hiers, MD, FACS · Answer

I would suggest using smooth round implants placed behind the muscle and a lift for your best look. If you only go with implants, you will just have larger and still sagging breasts.

Camille Cash, MD · Answer

From the submitted photos  it appears you will have the best result from a lift with implants.  This would give you extra volume including upper pole fullness, correct asymmetry, and raise the position of the nipple.  The next step is to visit with a board certified plastic surgeon near you to learn more.

Mats Hagstrom, MD (license on probation) · Answer

The indication for a breast lift depends on the relationship between the nipple and the the IMF infra mammary fold. In your picture, we can’t see the level of the IMF so we can’t tell you if you need a lift or not.
I’m guessing that you do.
You should also recognize that your breast are divergent and wide on your chest wall.
These variables are going to be put on display and amplified with the projection of implants.
This is really important for you to understand so you’re not disappointed with the outcome.
During in person consultations, ask providers to show you before, and after pictures of previous patients who had similar breast characteristics.
Ideally, they should be showing you pictures of previous women whose breast also pointed out to side just like your stew.
If they show you pictures of women’s outcomes, whose breast sat differently on the chest wall, then you will not have a good understanding of what breast augmentation is going to look like based on your candidacy.
Plastic surgeons can lift the nipple position, but cannot change breast divergence, or move the breast on the chest wall.
If the implants are placed close together, but your breast sit far apart, then your breast will not be centered on the implant.
Breast augmentation outcomes are generally based on three variables.
The first is patient candidacy.
Candidacy includes all of the potential issues and variables brought up like breast droopiness, breast, divergence, breast shape, and breast position on the chest wall.
The second variable is implant selection in regards to shape type And size. The third variable is the surgeons ability to put the implant in the correct anatomic location.If a breast lift is added, then there are of course variables that have to do with that procedure as well.
I would say in your case, understanding your candidate see what the procedure is probably the most important thing because it affects your potential outcome.
Without understanding your candidacy for this procedure, you may be disappointed and blame the outcome on the surgeon.
That doesn’t mean you don’t have the potential for having better looking breast.
It’s simply important to recognize candidacy because this affects what is possible and what is not.
I suggest scheduling multiple in person consultations with plastic surgeons in your community.
Bring a set of breast pictures to use as a reference during the consultation.
During each consultation, ask each provider to open up their portfolio and show you their entire collection of before, and after pictures of previous patients who had similar breast characteristics to your own period
Use pictures as a reference during the consultation.
Don’t rely on memory to what your breast look like.
Good luck,
Mats Hagstrom MD

Do I really need or should I get a lift? Would round or teardrop be better shape in cohesive? (Photos)

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