Do I need a breast lift in addition to implants? (photos)

Question

I am a 5'5 female, no children. I live a fairly active lifestyle and I am only 104 lbs. I was wondering if I will need a breast lift if I choose to get implants. Currently I'm thinking about 250-300cc. I also wondered if saline implants would give me more upper pole fullness than silicone. I recently met with a plastic surgeon who suggested that a larger implant might eliminate the need for a lift.

Harry T. Haramis, MD, FACS · Answer

Saline implants will give more upper pole fullness.

Without a lift, your breasts will stay very low, even with larger implants.

​Another exam and consultation with your/a plastic surgeon is recommended to further discuss your best options and expectations.

Vishnu Rumalla, MD · Answer

Thanks for your inquiry, if you were my patient I would recommend a peri-areolar lift at least to reduce the ptosis and control the breast envelop. Good luck.

Gary M. Horndeski, MD · Answer

A larger implant will not lift your breasts but will increase weight and your breasts will be lower. The technique I recommend is a lift using 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. Later, fat transfers or small implants can be placed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Finny George, MD · Answer

Hi, thank you for sharing your question. You are a great candidate for a dual plane breast augmentation. This will allow you to have fuller volume and projection without the need for a formal lift. I hope this helps.

Donald R. Revis Jr, MD · Answer

Good afternoon,
Saline overfilled implants do provide more upper pole fullness compared to silicone. I perform over 250 XL augmentations a year, more than any other surgeon in the U.S., and if you go big without a lift you will not be happy- gravity will ensure that you wind up with very large very saggy boobs- not a good look. You are an excellent candidate for a donut mastopexy to reduce your areolas and tighten your skin and a submuscular augmentation. You may choose saline or silicone gel, depending on your preference, even though it sounds like you may lean towards saline. We would determine the exact size and profile when I measure your chest, we review photos together, and you have an opportunity to try on the implant sizers here in the office.

Daniel Barrett, MD · Answer

Dear Eclectic779683,
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

Ted Eisenberg, DO, FACOS, FAACS · Answer

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

Connie Hiers, MD, FACS · Answer

No, you still need a lift or you will just have larger and still sagging breasts. Both saline and silicone implants will give you the same fullness for the same size. I do recommend placing the implants behind the muscle for better upper breast fullness, coverage of the implants, and less stress on the lift.

Camille Cash, MD · Answer

From your photos you will have the best result from a lift and implants.  You can elect saline or silicone and each can give more upper pole fullness to the breasts.  If you elect implants alone the implants will settle behind the nipple.  You will have more volume, but the nipple will essentially be at the same level.  I've included a video on implant selection that I hope you find helpful.

Aleksandr Shteynberg, MD · Answer

Hello Eclectic779683. 
With 250-300 ml implants you most likely will need a lift. It also seems that even with larger implants you still may need a lift. Using large implants without a lift will result in a very rapid bottoming out. Considering your active lifestyle it may be not the best choice for you. In photos, the upper pole appears to be deflated. Lift in addition to implants will provide a very good upper pole fullness and it often results in a very pleasing appearance. The higher position of breasts also improves weight distribution and decreases strain on back muscles which is another consideration for a breast lift. 
Best. 
A.Shteynberg, M.D. F.A.C.S.Diplomate, American Board of Plastic SurgeryNew York, NY.