Deflated 34DDD after nursing 4 years....lift and implant together? Or separate? (Photo)

See the link below to see examples of the possible results for this surgery when done at the same time. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Hello, thank you for your question. I would bring in wish pics that are similar to your body type and more than one when trying to discuss with your plastic surgeon. You may still need a lift depending on the desired expectations of your surgery. Typically we do an implant and a lift in one stage but every surgeon is different.

Since you are a 34 DDD, you do not need implants but you do need a lift. The technique I recommend is The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Judging by your photos, you would be a good candidate to have a breast augmentation and mastopexy done together. I commonly perform these procedure as a single stage and have been able to have reproducible results. In some patients it is wise to stage the procedure, commonly those that have a lot of breast tissue and want an augmented look or those that have significant ptosis and need the nipple/areola complex to travel up a great distance. It does not appear that you fall in either of those two categories.
As far as the type of lift needed, yes it would be a full (wise pattern) lift.
There are many doctors that do perform this procedure in a single stage.
Hope that helps.

Plastic surgeons are split in doing a lift with implants all at one time or in separate stages. Many surgeons have learned the hard way that two staging the procedure reduces the risks and gives a better result. I suggest finding a surgeon that does this procedure often and take their advice

Thank you for your pictures and questions. If you "wish pic" is Dr. Watt, then you should probably go see Dr. Watt. That being said, your wish pic is a breast augmentation, not a lift/aug, so it is not a fair comparison or a reasonable goal. I would suggest you start reviewing B/A photos of patients who did implants with a lift to get some better expectations regarding goals and outcomes.
If a surgeon is recommending a two stage procedure, it is probably for a good reason. You chose to see that doctor because of his or her expertise, but then you do not love the answer that they provide with that expertise. They think that doing your procedure in one stage is either too high risk of complications, will produce a poor outcome that you will not be happy with, or for a whole list of other reasons. None of which are because it costs you more money, more time, or more surgeries.
If you are not satisfied with the recommendations you received, then I would suggest a few more consultations. If you keep getting the same answer over and over again, then you will know what you need to do. If someone else offers you an alternative you like better, then maybe that would be a better fit. From the assessment of your photos, you absolutely are going to require a full mastopexy to achieve your desires results. Whether this could be one in one or two surgeries would depend on the findings of an in-person exam.
Hope this helps!
Dallas Buchanan, MD
VIVIFY plastic surgery
Tampa, FL

Dear Original753484,
my preferred lift is a lollipop lift when a periareolar won't do (ie greater than 2cm lift required). The lollipop technique was created by a Canadian plastic surgeon named Elizabeth Hall-Findley and treats the breast as a three dimensional structure instead of two dimensions (anchor - lift). Most importantly it does not require the horizontal component scars that the anchor-lift requires and breasts appear much more natural, lifted, and less boxy. Lastly, the lift lasts longer because the lollipop doesn't rely on the skin to hold the breast up, its actually breast tissue thats being brought together to support the breast and hence improves longevity.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

If you are actually wearing a DD or DDD bra, then I would suggest doing the lift only first. Once healed, you may be happy with the size. If not, implants can be added latter. However, I would suggest not going large or you will just sag again.

From your photos it appears you are a good candidate for a breast lift with implants. This typically can be done in one stage, although an examination and review of your health history is needed to know for sure. I encourage you to visit with a few board certified plastic surgeons in your area for consultations to hear varying perspectives. You can find a list of surgeons on the ASPS website.

A lift and breast implant can be done at the same time.
A full wise pattern may not be necessary,however at least a vertical, incision will