Can I get away with implants, or is a breast lift going to be necessary? (Photo)

I'm 25, and have always had deflated breasts. I've been very interested in getting a breast augmention and have looked into crecent lifts, donut lifts, and lollipop lifts. But am really opposed to the scarring of the lollipop lift, but my first consultation said it would be absolutely necessary. Is there anyway to avoid it? I'm not looking for perfect "porn star" breasts, just fuller natural looking ones.

Doctor Answers 39

To Lift or Not To Lift

Patients, like yourself, with both a lack of volume and sagging breasts are most often offered a combination of a breast lift and augmentation (mastopexy augmentation) to address both issues. The trade off is a scar on the breast around the nipple with a possible extension down towards the breast crease creating a lollipop or inverted “T” pattern. The size and location of the scar depends on the amount of lift needed, the patient’s anatomy, and surgeon preference.

The decision to do an augmentation by itself versus an augmentation with a peri-areolar lift or an augmentation with a lollipop lift is less based on patient preference and more dictated by the nipple position and the ratio between the post-augmented breast volume and the amount of excess skin you have.

The less breast tissue you have, the smaller the implant, the closer the nipples to the breast fold, and the more excess skin you have, the greater the chance you will need a lift and the greater chance you will need a vertical scar to achieve a natural aesthetic outcome.

A detailed examination will help delineate the best surgical option. Consultation with a surgeon certified by the American Board of Plastic Surgery would be the next best step.

Breast lift

Thank you for your question and photos.  Based on the significant sagging of your breasts, a full breast lift with implants would give you an excellent result.  I do not perform any lift technique other than the full breast lift at my practice as I have found that it gives patients the most satisfying results.

All the best,

Dr. Results
Miami, FL

Breast Lift vs Implants

What has happened to your breasts is very natural. Due to weight loss or pregnancy many women's breasts will deflate over time. The solution is either to fill up the excess skin that you do have with an implant, tighten the skin with a lift, or some combination of the two. An augmentation with an implant will result in less scarring but your breasts will still be lower on your chest. The lift is appealing to some women because it is more natural and does not require an implant, but there is much more scarring involved. A board-certified plastic surgeon with experience in cosmetic breast enhancement should be able to help you determine what will give you the results you're looking for.

Breast lift with augmentation

Thank you for your question.  Based on your submitted photos, it would appear that the procedure that would benefit you most and best help you achieve your overall desired goals would be the breast lift with augmentation.  You appear to be an excellent candidate for this procedure to produce beautiful overall results.  Schedule a consulation with a board certified plastic suergeon to evaluate you further, discuss options and any concerns you may have,then work togerhr to build a surgical plan that will best help you achieve your overall desired results.

Best regards,
Dr. Lane F. Smith, MD
Plastric Surgeon
Las Vegas, NV

Lane Smith, MD
Las Vegas Plastic Surgeon
4.5 out of 5 stars 84 reviews

Breast Lift vs. Implants Alone

Thank you very much for your question.

Based on the pictures alone, a breast lift will give you a far better result than implants alone.  Implants alone will sit higher on your breast and your areola will be lower than the implant, and that won't look very good.

With regard to mastopexy (breast lift) scars, the issue is more about ultimate breast shape.  Based on the pictures, the more limited mastopexies (crescent and donuts) may not provide a adequate and lasting lift.  Although you may have more scars (just the addition of the vertical scar, which typically heals very well), the lollipop lift will probably give you the better shape ultimately.  While scars are important, the majority of my patients put more importance on having a phenomenal breast shape, and are ok with the scars to get them there.  

If you aren't happy with the first opinion, you can certainly visit with other plastic surgeons for an in-person examination and get their recommendations as well.  Best of luck!

Daniel Krochmal, MD
Chicago General Surgeon
5.0 out of 5 stars 19 reviews

Breast lift

Based solely on your photos, you need a breast lift. An implant alone will not give you the results that you want. The implant will always sit higher than your nipple which is not a good look. Best, Dr. Nazarian

Sheila S. Nazarian, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 51 reviews

Lift

I would also highly recommend the lift.  If you do not do the lift, the implants will always be higher than the nipples.  Only a periareoalar lift is necessary.  

Lift or not

All depends on where your nipple is relative to the inframammary fold.From your photos you might be able to do a crescent lift with a silicone implant.This would minimize scarring for you.

Robert Brueck, MD
Fort Myers Plastic Surgeon
4.8 out of 5 stars 56 reviews

Lift with breast aug

Thanks for sharing your question. I can appreciate your concern.
Unfortunately you will need to raise the nipple with a lift to obtain a more pleasing look. However if you are not looking forward the scar, you may consider just the augmentation knowing that the outcomes might not be as pleasing with a malposition nipple. You can always do the lift in the future if the scars become less worrisome to you in the long term.

Finally, make sure that your doctor is aware of your process. He should be able to guide you best in your care.

Wishing you the best in your journey

? need for a lift with implants

In my opinion you would be unhappy with your result if you only had an augmentation. The nipples can not be adequately lifted with just an implant. The scars are usually very thin and are certainly worth the improvement in the shape of the breasts.

R. Louis Adams, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 3 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.