Breast Lift: Should I Also Get Implants?

So thanks to everyone's advice and my surgeon's information to my previous question. I've decided to go forward with surgery. My doctor is recommending a small implant to fill out the top of the breast and create a roundness.
The idea of an implant (and having to replace it every 10 years) doesn't thrill me, but I want the best result possible. Do you think it would be worth it as opposed to just a lift?

Doctor Answers 10

Breast implants are not necessary if you are happy with the volume or your breasts

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If you are happy with the volume of your breasts in a bra - there is no need to get breast implants.  It is how the breast lift is performed that is important.  The breast tissue is elevated and held in place using an internal transitional mesh bra - auto augmentation (using patients own breast tissue) rather than an breast implant.

Breast Implant Placement along with Breast Lift

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Placement of breast impalnts under the Pectoralis Muslce does help to enhance the results of a breast lift or mastopexy. In almost all of the breast lift procedures that I perform in Beverly Hills, I do use an implant to improve breast projection and volume. Contrary to the general belief, breast implants do not need to be replaced every ten years. Saline and Silicone implants do only need to be replaced if they deflate. therefore, you need to watch them and have your doctor evaluate them on a yearly basis.

Implants with a breast lift

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I will just add that you should get implants with a lift only if you want additional volume. It sounds obvious, but I've seen numerous patients who opted for or were talked into implants for that upper pole fullness and then were unhappy because of the additional weight/volume.

James W. Ward, MD (retired)
Arlington Plastic Surgeon

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Depends on the amount of breast tissue you have.

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If you have very deflated breasts with loose hanging skin then I would totally agree that you need to have implants to get the full upper pole that most people are looking for.  You could have the mastopexy first and see if you are happy and then add an implant later if you are not satisfied, but this would add a step and some expense.  Probably if your surgeon is reccommending the implant you need it. Good Luck, Dr T

When are Breast Implants Indicated in Breast Lift Patients?

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Not every patient who under goes breast lift surgery requires breast augmentation. The decision to utilize an implant is entirely dependent upon the patient's anatomic findings and aesthetic goals When patients have inadequate breast volume and want larger breasts or want increased upper breast fullness for aesthetic reasons, it's reasonable to utilize breast implants.

It's important to thoroughly discuss this issue with your plastic surgeon before proceeding with this procedure. Your surgeon should be able to discuss your concerns and outline a treatment plan that addresses them..

Breast Augmentation Mastopexy?

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Thank you for your question.

 The answer to your question depends on what you mean by achieving the “best results possible”. In general, breast implants are helpful in achieving some superior pole fullness,  for most patients undergoing mastopexy surgery.

Prior to proceeding with surgery it will be very important to communicate your goals with your surgeon.  In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or “C cup” or "fake looking" or "top heavy" means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.
I use  intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison.
I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible.
By the way, the most common regret after this operation, is “I wish I was bigger”.

I hope this helps.

Breast Lift with Implants

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If the nipple is below the fold, you may need a vertical  skin excision, with a round block mastopexy, sometimes called a lollipop lift. If you don't have sufficient breast tissue you may need an implant to give volume to the superior pole of the breast. Implant size should be conservative as big implants are like big breasts and will subsequently make your breast sag more and bottom out. Remember, the quality of the skin is not as good as it once was, otherwise you would not't be needing a breast lift.

Patients with saggy breasts often want extreme superior pole fullness or the "bolt on look".. This effect may be initially achieved, but is often short lived due to the weight of larger implants. The root of the breast is anatomically determined, and is the superior portion of the breast where the slope begins. Implants with a lift can elevate this area, but it often returns to its pre-surgical position.

Implants don't need to be replaced at ten years, this is an urban legend. Only if there is a problem, or they deflate do they need to be replaced. With saline implants, the deflation rate is about 1% per year, so over a life time, you may need a replacement.

Do I need implants with a lift?

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Implants are used either to increase breast size, or to give fullness to the upper portion of the breast, or both.  There are tradeoffs or risks with implants (eventual rupture after many years with a need to replace the implants, capsular contracture causing firmness and shape distortion, etc) and you need to be aware of these.  If you are happy with your breast size and are not too focused on obtaining pronounced fullness in the upper pole, the tradeoff may not be worth it to you.  If you want to be larger, or if filling out the upper pole of the breast is important to you, then it may be worth it to you.  Women who are much smaller than they want to be or who are very deflated will not be happy with a lift alone.

Breast lifting often needs to include impants

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If the breasts are sagging but lack volume then the use of breast implants also become necessary to give proper shape and contour to the breasts. If you only lift skin in the absence of volume the result is quite unattractive. After pregnancy and/ or weight loss the need for implants in association with a breast lift is very common.

Do You Need Implants with a Breast Lift?

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Breast implants are not necessary with a breast lift.  However, many times breast implants will enhance the results of a breast lift.  When a breast lift is done, your breast actually gets a little smaller (maybe half of a cup size).  Breast implants can help to lift the breast and fill in the deflated top portion of the breast.  Breast implants will also make you larger, so they may not be necessary if you are happy with your current size. Good luck with your surgery!

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.