Do I need a lift as I don't want the surgery to be a failure? (Photos)

Question

I'm 5'3", around 190# and scheduled for a BA, and I sent in a couple of photos to the surgeon's office. They said I might need a lift but it's really my choice. I am going for a natural look, so full on the bottom is ok. I don't want a lift, but I don't want the surgery to be a failure. They don't sag as much as the picture looks like, it's hard to get a good picture of yourself, lol. Thoughts?

Alan Gonzalez, MD, FACS · Answer

Hello @Friendly526493 thank you for your question and showing your pictures. I suggest you have a lift because just getting only implant won't solve that the nipple is already looking downwards and that the breast tends to falls. For the most adequate aesthetic result what we want is to raise it and rearrange it, to put it in its place, so that the projection of the breast from the anterior axillary line to the external midline is balanced and that the position of the areola and the nipple in most cases is as central as possible. If you want to keep the volume you have then a combine surgery: breast augmentation and lift would be the way to go. I hope this shed some light. Best wishes!!!

Casey Anderson, MD, FACS · Answer

It appears as though you will likely get a nice result from augmentation alone. Some of this can depend on the size of implant chosen. This is really best determined by measurements and physical exam done in person.

Donald R. Revis Jr, MD · Answer

Good afternoon,
It appears that you do have a little sagging and asymmetry- I would suggest a donut mastopexy at the same time as your augmentation- most patients who are "borderline" really do need a small lift.

Gary M. Horndeski, MD · Answer

The technique I recommend is a mini lift. Using a circumareola incision, your breast tissue is reshaped, elevated higher on the chest wall and more medial to increase your cleavage. At the same time, fat transfers or small implants can be placed totally submuscular.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Daniel Barrett, MD · Answer

Dear Friendly526493,
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

Adam Tattelbaum, MD · Answer

Thanks for your question and photos. Your nipples are at the fold of the breast and facing frontally. You have a little droop, but not a lot. I think it would be reasonable to place implants and give six months or so to let then drop and see what you think. Lifts can always be added and the result may be more predictable. Saline might lift you up a bit more because saline implants tend to be fuller up top and elevate more skin. Be sure you and your PS pick an inplant large enough in diameter to give fullness to the upper pole, but don't go larger than you want just to avoid a lift.

In a situation such as yours you will look a bit scary at first until the implants drop, relax the muscles and settle. Be prepared for that.  You will still have some droop because your natural tissue will respond to gravity which in my opinion is a good thing do be sure your expectations are realistic.

Again lifts can always be added-- no bridged are burned.

Best wishes

Connie Hiers, MD, FACS · Answer

Measurements are needed to be sure, but based on your photos, you may not need a lift.  Once your surgeon has examined you, he/she will be able to tell what is best.

Brian Bruggeman, MD · Answer

It is a personal choice where in your case the nipple is at the inframammary crease. When it is lower you need a lift and when it is above you don’t. In your case I think your tissue is going to be strong enough to hold the implants up. Just a guess but if you implants stay high then the nipple is going to look funny as low as it it in relation to them. If you didn’t have such a strong inframammary fold I would say just implants. However, without any more information I would go for the lift.

Douglas Taranow, DO, FACOS · Answer

You will look much better with breast implants combined with a 'small scar' (periareolar) lift.  Implants alone will leave you with lower nipple areolas which will certainly require lifting at another time in the near future anyway.
Best wishes.
Dr. T