I want to go from a saggy small B to a D/DD, I do not want a lift can I get away with it? (photo)

Where would the best placement be? 

Doctor Answers 29

Avoid a Lift?

Your photos indicate that you have at least a moderate degree of ptosis (sagging) of your breast tissue and a somewhat lower nipple position. Your breasts are also asymmetric in size and shape and you have a wider space between your breasts. All of these issues will make it very difficult to achieve an aesthetic breast shape, position, and symmetry with just an implant. It is important to recognize that implants do not actually lift your breast. In addition, because of your asymmetry, you would need a larger implant on the left side, but your breast is more ptotic with extra skin,f so it is really in need of the bigger implant.

Trying to correct this by just putting in a bigger implant will only result in a large poorly shaped breast that sits low on your chest wall and that will quickly go south over time. It is completely understandable that patients would prefer to avoid the additional scars that come with a breast lift, but if done well most patients find them very acceptable. In the long run you are much better off with the additional scars rather than an overly large implant which sits too low, stretches out your skin, and puts you ask for visible rippling, implant malposition and/or bottoming out.

Kirkland Plastic Surgeon
4.8 out of 5 stars 52 reviews

Augmentation Mastopexy


Here's how the scenario plays out with women in your shoes: asymmetric sized breasts with asymmetric ptosis. You find a surgeon that will do it (that's easy enough!), and he assures you that he can make you look great. He will use two different sized implants, placing the smaller implant into your larger, droopier breast, and the larger implant into your smaller, less droopy breast. After you heal, you feel like not only are you not that thrilled with their overall appearance, they are completely different looking, which surprises you because he was so careful to tailor your implants to your breasts. What happened? The problem is your breasts have two completely different sized skin envelopes, but the surgeon only accounted for volumetric differences.  So the larger implant in the smaller breast made a rounder, overfilled mound.  The smaller implant did not change the mound shape as much on the larger breast though because it had much more skin and much less fill from the small implant. 

My recommendation is to do it right and avoid potentially unfixable complications. Go visit a few ABPS certified/ASAPS member surgeons that perform all aspects of cosmetic breast surgery, not just implants. 

Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 89 reviews

I want to go from a saggy small B to a D/DD, I do not want a lift can I get away with it?

Size and shape of breasts can often play a critical role in a woman’s self-esteem. Fuller and bigger breasts are often associated with reproducibility therefore it is a desired condition. There are different kinds of breast augmentation operation types. Breast augmentation can be performed either with breast implants or autologous fat transfer. There are also different types of breast implants like teardrop or round implants. These implants also can be placed under or above the muscle. As you can imagine there are several different options for breast augmentation. The best way to understand which one is more suitable for you is to get a physical examination by a plastic surgeon.

Bulent Cihantimur, MD
Turkey Plastic Surgeon
4.9 out of 5 stars 90 reviews

B to D/DD without a Lift

Hi.  Yes, I think you can certainly achieve the size you desire without the lift.  There are lots of implant options that can give you improved fullness.  Having implants without a lift may not elevate your nipples as high as they once were, but it is still reasonable to consider this a good option.  There are also some "partial" lift options that might work for you too.  Check with your plastic surgeon to discuss all of these options, and what you can expect in the short term and long term with each one.  If you would like, I would be happy to consult with you for another opinion.  Best of luck!

Jonathan Heistein, MD
Fort Worth Plastic Surgeon
4.6 out of 5 stars 25 reviews

Avoiding a lift with a large implant is usually disappointing

Here is how I think about it: if a woman's skin has failed her with small breasts (sagging or droop), what is going to happen if I put a large implant in? I think the answer is obvious. You are going to eventually have large "saggy" breasts. There is no way your tissue will be able to support your breast tissue and the implants for very long. The breasts might look good for 6mo to 1yr, but eventually gravity will win. 

I would recommend a lift with an reasonably sized implant. If you want a large implant, I would recommend additional support via galaflex mesh or a biologic mesh. Your neck and back will thank you for making this decision! 

Best of luck!

Bradley A. Hubbard, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 125 reviews

Don't want lift

Your pictures are very helpful. Based on your photos you have Grade 1 ptosis or minimal sag ( this is where your nipples are at the level of your breast crease). I think you are a great candidate for a high or ultra-high profile implant. Once you are evaluated by a Board Certified Plastic Surgeon, they can discuss the appropriate size implant to fit your breast anatomy and to get you as close to your size goal as possible. Good luck. 

Mehdi K. Mazaheri, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 32 reviews

Breast augmentation without a complete lift

Thank you for the photos that show us the level of your nipples above the inframammary fold. It appears that with a larger implant, based on the base width of your breasts, that you should be able to get the size you seek.  It may be worthwhile to have a circumareolar reduction of the areolar diameter, which can avoid having too large of an areolar diameter after they are stretched out by the large size implants. Ask your plastic surgeon, who has evaluated your skin elasticity about this.  Good luck.  

John M. Weeter, MD
Louisville Plastic Surgeon
5.0 out of 5 stars 7 reviews

I want to go from a saggy small B to a D/DD, I do not want a lift can I get away with it?

Thanks for your photos.  Your breasts and nipples are somewhat low but if you choose to avoid an uplift then the key will be to avoid placing too large an implant.  Excess upper pole fullness will make your nipples look lower if the volume selected is excessive.  If you would be willing to reduce your size goal to approximately a D cup then I think you would probably be pleased with the outcome.  If not, the alternative would be to consider a Benelli mastopexy with a circular incision line around your areolae allowing elevation of your nipple position by about 1 inch.  This could be enough to make a big difference aesthetically.  I would suggest that you discuss all options with your ABPS board-certified plastic surgeon before proceeding.  For more useful information please watch the video link above.

Best wishes.

Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery
Member, American Society for Aesthetic Plastic Surgery (ASAPS)
ABC-TV Extreme Makeover Surgeon
Beverly Hills, California

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 30 reviews

Lift or Not?

Great Question! Most of the time if you can hold a pencil under your breasts and it stays then you will need a lift. All an implant is going to do is make you a larger version of what you are now. Some patient's refuse to do a lift and are fine with an implant only, but just an implant will not change nipple position much. Good Luck!

Ed Breazeale, Jr., MD
Knoxville Plastic Surgeon
4.5 out of 5 stars 15 reviews

BAM without lift

Hi Dnic6

Your nipples are low and will likely need a lift.  However, you could go in for the aug, give it your best try, let it heal, and see how you like the results.  You can always do a lift later.

Hope that helps.


Scott E. Kasden, MD, FACS
Dallas Plastic Surgeon
4.7 out of 5 stars 101 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.