Can volume after breast feeding and weight fluctuation be restored with implants alone or should I consider a lift?

Question

I have breastfed for years, and had weight fluctuation. I have lost a lot of the volume in my breast. Am i able to correct with just implants, or will i need a lift as well?

Gregory Lakin, MD · Answer

Thank you for sharing your question. Whether volume after breastfeeding and weight fluctuation can be restored with implants alone or if a lift is also needed largely depends on the degree of breast sagging. If your breasts have a mild sag but primarily lack volume, implants alone might sufficiently achieve a fuller look. However, if the sagging is moderate to severe, where the nipples are positioned below the breast crease or point downwards, implants alone may not provide the desired lift and shape. In such cases, combining breast augmentation with a lift (mastopexy) would be necessary to lift the breast tissue, reposition the nipples, and add volume, leading to a more youthful and uplifted appearance. Consulting with a board-certified plastic surgeon can help determine the best approach based on your specific breast anatomy and aesthetic goals.

Daniel Barrett, MD · Answer

Dear bbarry368,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Morad Askari, MD, MBA · Answer

Thank you for sharing your pictures, and question. Implants Alone: Can increase volume but large implants may be needed in your case. However, they will not correct droopiness and can lead to further sagging over time due to their weight. Implants with a Lift: A more comprehensive solution for lifting and reshaping the breasts, alongside adding volume. This approach is often better for achieving a more youthful and lifted breast contour. It will provide better and longer lasting results.Consulting with a board-certified plastic surgeon is crucial. They can evaluate your specific situation and guide you on the best approach, considering both immediate and long-term aesthetic goals.

Brian K. Reedy, MD · Answer

Hello and thank you for your question. Without seeing you in person this is not an easy thing to tell.  I would say more than likely you will need both a lift along with implants to restore the full perkier breast appearance.

Adam Bauermeister, MD · Answer

Hello, 
Based off your photos I would recommend a breast augmentation with implants and lift. With the degree of ptosis (breast sag), an implant alone (even if large) will not provide sufficient lift to the breasts. A breast lift will reduce the nipple areolar complex size and raise it above the fold of your breast and reshape your breasts. The augmentation with implants will provide upper breast pole fullness and cleavage. A detailed exam, review of your history, and discussion of your goals will help target implants used and end breast size/shape. I hope this helps. 
Best regards, Adam Bauermeister, MD

Sean T. Lille, MD · Answer

Dear Bbarry, 
You have very common changes in your breast after nursing. I do think that it is either a donut mastopexy or full mastopexy, depending on your exam in person. A lift would shorten the distance from the nipple to the inframmary fold and downsize the areola. That, along with an implant under the muscle, should be a very nice rejuvenation! Best wishes,

George Marosan, MD · Answer

Thank you for your question and photos. Based on these photos, you will need a lift with submuscular breast augmentation to give you more aesthetic and fuller breasts. With the lift, the stretched out areolas will be made smaller, too. See a board certified plastic surgeon for an in person consultation/evaluation. Good luck.

Ram Kalus, MD, FACS · Answer

Thank you for your question and photos. An examination in person would be required to properly evaluate you and make specific recommendations, however from your photos it appears that you have some loose skin and widened areolae that would benefit from a skin tightening (breast lift or (“mastopexy”).

Absent a breast lift you can develop an undesirable “waterfall deformity” in which your breast and nipple areola appear to be falling off the implant, and the breast takes on a vertical oval or oblong shape rather than a pretty round and projecting youthful breast.

Please consult with an experienced board certified plastic surgeon whose aesthetic appears to align with your own based on his or her Before and After gallery. I recommend using photos of your “ideal” to share with your surgeon. Best of luck to you.

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, if interested. 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

Carlos Marciales, MD · Answer

Hello, in your case you need breast implants to fill the tissue, and due to the position of the areola, you need to lift it to have an optimal result.

Can volume after breast feeding and weight fluctuation be restored with implants alone or should I consider a lift?

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