Going from B cup to D cup with 415cc gummy bear implants. Is a breast lift warranted? Will I look fine without lift? (Photo)

Question

I'm 5'7, 152lbs. I don't want a 'fake' look (too round or high). I want a more natural look with some cleavage. Side note: I'll be going in for a mini tummy tuck with lipo of flanks as well.

Gary M. Horndeski, MD · Answer

Your
breasts are asymmetrical.  Implants can
be placed through a circumareola approach, which will correct the asymmetry of
the nipple position.  The other
alternative is a breast lift with fat transfer. 
If you are considering liposuction of the flanks, the fat that is
normally discarded could be used instead of implants to augment your
breasts.  This will give you a more
natural breast without the complications of implants.  The FDA has stated that implants are not
lifetime devices.  Best Wishes,Gary Horndeski, M.D.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. You are a great candidate
for a breast augmentation using a dual plane technique without need for a formal lift.  The size, profile, and shape of the
implant is based on your desired breast size/shape, your chest wall
measurements, and soft tissue quality.  This decision should
be based on a detailed discussion with equal input from both you
and your surgeon.  This entire surgery
can be performed with a small incision technique.  Make sure you
specifically look at before and after pictures of real patients who have
had this surgery performed by your surgeon and evaluate their results.   The most important aspect is to find a
surgeon you are comfortable with. I recommend that you seek consultation with a
qualified board-certified plastic surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D. FACS
Harvard-trained plastic surgeon

Vishnu Rumalla, MD · Answer

Thanks for your inquiry, it is very important you discuss your expectation with your surgeon.  You do have some asymmetry and the nipple areolar position is on the lower side.  I believe lift techniques based just around the areola would be helpful on the overall look.  I have included a before after picture with a patient of mine that had bilateral crescent lifts.  Good Luck with surgery!

Donovan Rosas, MD · Answer

Patient concerns regarding the appearance of their breasts can typically be divided in two pools: volume, ptosis (droop). The procedures to address these issues are as different as the issues themselves. However, these concerns are not mutually exclusive (some want smaller less droopy breasts and others want larger less droopy breasts).
There are two factors which can help to answer the question of which surgery will deliver the most satisfying result: mastopexy, augmentation or both. Patients must first consider the position of the NAC (nipple areolar complex i.e. the pigmented portion of the breast) as it relates to the inframammary crease. If the nipples are at or below the level of the crease the patient may benefit from a lift or mastopexy. The breast lift is designed to elevate sagging breasts to a more youthful position. It also helps to reshape and tighten the skin of the breasts. This is typically accomplished via a periareolar (around the nipple) incision with or without a vertical incision.
Mastopexy is an effective way to address sagging breast, however, the changes which accompany weight loss or pregnancy can also decrease volume of the breasts. When a woman wants the volume restored, or increased, a breast augmentation will also be needed in conjunction with mastopexy. Augmentation can help restore the volume loss which is well known to women following children. There are a number of options available to women considering augmentation ranging from size and implant type to access incision.   
A breast augmentation alone may be appropriate if ptosis is mild. If the patient is comfortable with the natural appearance of the breasts but desires them to be larger, a breast augmentation alone is the right procedure.  Augmenting significantly ptotic or sagging breasts tends to magnify the problem. In these cases, a mastopexy performed in conjunction with an augmentation is preferred.
Based upon your photos, you would likely obtain a very nice result from augmentation alone. Your NAC is well above your fold. The implant will not lift the breast, however, it does not appear that you would benefit from much of a lift.As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Ted Eisenberg, DO, FACOS, FAACS · Answer

You should be able to get a nice result without a beast lift. Although an implant does no lifting, it often gives the illusion of a lift.
Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author

Robert D. Wilcox, MD · Answer

Dear Americasil,
  
Looking at your preop picture, you have what we call a tight inframammary fold.  That means the angle of your lower breast is less than 90 degrees compared to your upper abdomen.  If you do not undergo a lift, a couple of bad results are going to happen.  First, the nipple-areola is going to look low on your breast mound and second, you are going to see the remnants of your current inframammary fold on the lower half of your breast as an indentation or what some people call a double bubble.  You either need to go down in size of that implant or have a lift.  I hope this has been helpful.  
Robert D. Wilcox, M.D.

Ven Erella, MD · Answer

Thank you for your question. Based on the picture you look like a good candidate for implants. I do not think lift needed. Please consult with a board certified PS for evaluation and to discuss your goals.

J. Michael Morrissey, MD (in memoriam) · Answer

Thank you for your question and photos. The position of your nipples is slightly asymmetric with the right side being slightly higher than the left. As the position of the nipples is above the fold (where the breast emerges from the chest wall) I feel you can attain the look that you want with good upper pole fullness with an implant alone. 415 cc implants should easily get you to a full D cup. If improved symmetry is what you are looking for, a crescent lift on the left to match the opposite side can be performed. The implant would be placed from an inframammary approach on the right and from a periareolar approach on the left. Nothing can substitute for a full sit down consultation with a qualified Board Certified Surgeon. Best wishes, Dr. M

Going from B cup to D cup with 415cc gummy bear implants. Is a breast lift warranted? Will I look fine without lift? (Photo)

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