Are my expectations realistic? (photos)

I have been doing lots of research on breast lifts and augmentation. From what I have gathered there is no way I could avoid a lift. However, what are the chances of them "bottoming out?" I have seen many horrifying pictures. This is something I have wanted for some time and am now terrified. I have 4 different consults this week and am wondering if what I am wanting to look like is unrealistic? Also can it be done in one procedure? I don't have time to take off work for two separate procedures?

Doctor Answers 14

Realistic expectations for breast lift with implants

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Based on your photographs you display a significant degree of breast ptosis and you would be an ideal candidate for breast lift surgery. A breast augmentation would simply add more volume to your breasts.  A lift will lift your breasts back up your chest in to a more rejuvenated position.  You need a formal consultation to determine your options and whether or not implants are necessary to achieve the look you desire.  If implants are required they would likely be small implants.  Typically in my practice, a breast lift with augmentation can be performed in the same procedure.  There are risks associated with any surgery but its important to remember that "bottoming out" is unlikely.  Arrange a consultation with a fully qualified plastic surgeon to discuss your options and goals.

Are my expectations realistic?

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Hello dear, thanks for your question and provided information as well ... The breasts may lose their elasticity and firmness which can be caused by different factors such as pregnancy, massive weight loss, lactation and aging. To reaffirm the breasts and restore the natural look your surgeon can perform a mastopexy or breast lift. I have to say that bottoming out is not common dear, do not be afraid of having this change and also you will be a great candidate, hugs!

Tania Medina de Garcia, MD
Dominican Republic Plastic Surgeon
4.6 out of 5 stars 441 reviews

Risks of bottoming out

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Breast augmentation and mastopexy can be performed in one procedure. Bottoming out is rare, and repairable, so don't be terrified of an unlikely event. You will definitely require a lift. What I'm not sure you need is an augmentation. This is a decision you will need to make in conjunction with a good board certified plastic surgeon who will assess your breasts and expectations in person. Good luck with your surgery!

Trenton C. Jones, MD
Orem Plastic Surgeon

Are my expectations realistic?

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Thank you for your question and for sharing your photograph. I do agree that you will need a breast lift in addition to implant placement to better approximate the size and upper breast shape of your goal photographs.  Bottoming out is a possibility with any implant placement, and if you wanted to minimize this complication as much as possible you may wish to consider the use of an internal breast scaffold to help support your breast tissue and implant.  Be sure you see ASPS board certified plastic surgeons for consultation.  

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 80 reviews

Are my expectations realistic?

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You will need a combination breast lift plus implants. Bottoming out is common following breast lift with implants but can be easily revised. You should be able to achieve nice fullness with a proper operation with an experienced surgeon. It is good to get multiple consults and ask to see their results.

Breast Lift with Implants

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Thank you for your question about breast lift with implants.

Yes, you will need a breast lift.

Yes, breast lift and implants can be done at the same time.

Textured silicone gel implants under the muscle have a much less chance of bottoming out.

To be sure, see two or more experienced, board-certified Plastic Surgeons in your area for a complete evaluation to make sure you are a good candidate and that it is safe for you to have breast lift with implants surgery.

I hope this helps.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 221 reviews

Dr Kayser

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Thank you for your question lacey. Actually, based on your photos, unless you want a larger cup size, a breast lift alone may very well be all that you need. You have drooping which can be correct by a lift. This can be accomplished with a short scar lollipop approach.

The question is whether or not you want your breast volume to be larger. If so, you will need an implant, or better yet, fat transfer! Fat is yours, natural and has the potential to last a lifetime. An implant should not bottom out If done correctly and excessive size is not used but I would strongly suggest that an implant not be placed unless a lift is also performed. Of course, this would not happen with fat transfer.  If scars are an issue and you don't want a lift, an implant alone would likely NOT be a good choice as it could create an irregularity such a double bubble or snoopy deformity.  However, fat grafting could actually be used instead since fat is placed in a totally different way than an implant is. In any case, I would recommend a full consultation with a board certified plastic surgeon in his experience in these techniques. I hope this helps and have a wonderful day. Dr Kayser - Detroit

Melek Kayser, MD
Detroit Plastic Surgeon
5.0 out of 5 stars 43 reviews

While your nipple/areola is lower, you could avoid the lift

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Hello! I am going to go out on a limb and suggest that you do not necessarily have to have the lift procedure. If the implant is larger, it can fill out the skin envelope and swing the nipple up a little to avoid the lift. The thing is, once you have the lift, the scars are permanent, and so you must fully understand the risk/benefit ratio of this. In my practice it is common to do the lift and augment together ( when really needed) and bottoming out is not seen much-- and with the newer high profile implants, I think the augment alone might be your best bet!
Good luck.

Anne Taylor, MD
Columbus Plastic Surgeon
4.9 out of 5 stars 49 reviews

How to minimize bottoming out after lift with implants

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The simple answer is that the bigger the implants and the larger the breasts, the more likely you are to have bottoming out over time, regardless of the techniques used. An internal bra with Galaflex mesh can help. You have fairly large breasts already so don't push the implant size too high.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 59 reviews


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Your breasts are low, you need a lift based upon the photos. Implants will just give you more volume.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 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.