Do I need a lift with implants? Am I a candidate to skip the lift? (Photo)

In my experience, larger implants above the muscle or dual plane (upper half under muscle) can “lift” however, they will still appear low. 250cc moderate in my opinion will not achieve that look.

If your desired goal is fuller, perkier breasts, then implants with a formal breast lift (with T scars) would be favored.

Further consultation with your/a plastic surgeon is recommended

Thank you for your question. Given the differing opinions expressed by the two doctors you consulted, it's understandable to feel uncertain about the right action. A breast lift is recommended to achieve a more lifted and youthful appearance, especially since you have ptosis, which causes your breasts to lack fullness in the upper pole and your nipples to be positioned lower on the breast mound. Low-profile 250cc implants will increase the breast volume but not correct the sagging.

Depending on your specific measurements, you may need a lift. This can only be done with a physical examination. I would recommend seeing a board-certified plastic surgeon with experience in breast aesthetic surgery.

Your nipples are located below your breast fold based on the photos provided, therefore a lift is recommended.

Your breasts are too low on the chest wall. The technique I recommend is a lift using 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.

This is a good question. There are a couple of factors that are missing for those of us who are trying to decide on the best choice. The first factor is that we don't know is your chest dimensions. Do you wear a size 32 bra, or a say size 38? Because for a size 32 bra, a 250CC implant is likely to produce a significant lift. But definitely not so on the larger chest size of 38. The second factor missing is your desired outcome. Do you want this to be a definitive operation, that should last many years with the breast in the lifted position? Then you would go with a breast lift, and the implant size that gives you your desired breast size. Conversely, you may wish to minimize scars on the breast at this time, by avoiding a lift. You would do this with the knowledge that in a few years (maybe 5 years or so), you will need a breast lift, and will accept the lift scar at that time.

Final thoughts: Your breasts are in a lower position than ideal. Making them larger and heavier, to any extent, is likely to accelerate their move downward. From a long-term standpoint, you benefit most from a breast lift, at the same time as the placement of the implants.

Dr. B.

Examination of your breast required. Discussion required, including what you want in terms of breast appearance/nipple position. From the looks of it, you may need one. Be wary of surgeons who say you don't need one, especially if they offer no examples of breast lifts.

After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what size and style breast implant is right for them. Mildly Sagging Breasts: If your breasts are mildly droopy, a saline or silicone gel implant placed behind the pectoral muscle might help create the illusion of perkiness. That’s because as the implant fills out the top of the breast, it also fills out the bottom, making it look as if the nipple has moved higher. It hasn’t. You can always get a lift later if you feel you are not perky enough when fully settled and healed. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Thank you for your question. I think you will be very dissapointed if you donot have a lift especially with smaller implants.
The lift will make your breast look tight and youthful and trust me , the scars fade over time.

based on your photos, you have mild breast ptosis. With your desired implant volume, I think it is very likely you would need some sort of lifting procedure to give an optimal aesthetic result. The ultimate decision for this is based on measurements taken at the time of consultation to assess overall skin laxity to decide if an implant of that volume is adequate. However, based on photos alone I think either a donut or lolipop mastopexy combined with a smaller volume implant would given you the best result.
Sean Fisher Aesthetic Plastic SurgeonSeattle, WA