Do I need a lift? Or just repositioning of implant? (Photos)

I got my breasts augmented 15 1/2 years ago at age 22 now age 37.5. I want to switch my saline under muscle to silicone. Md said I do not need a lift just reposition implant so less upper pole and more lower poll fullness. do you think I need a lift with new implants or just new implants? Don't want to make a wrong decision. Thanks! By the way they are 475 cc

Doctor Answers 9

Lift vs implant repositioning

  • The nipple looks low with the fullness in the upper pole.  A lift would be the most straight forward correction.  Lowering you implant and switching to a tear drop shape would make the breast itself look better....however....if the implant is placed too low it may not look aesthetically pleasing.  Be very clear with your surgeon what to expect for implant positioning after.
  • The trade off is the scar versus the implant position.
  • Dr Rodger Shortt is a plastic surgeon in Oakville.  He strives to be the best plastic surgeon and is one of very few plastic surgeons in Canada with a top 5-star rating on Realself, RateMD, and Ontario Doctor Review.  He is an Assistant Clinical Professor and the Director of Cosmetic Surgery Training for McMaster University.  He serves patients from the GTA including Toronto, Oakville, Mississauga, Georgetown, Brampton, Burlington, Milton, and Hamilton.


Toronto Plastic Surgeon
4.9 out of 5 stars 56 reviews

Small lift?

It looks like you might need a small lift, maybe just around the border of the areola. You would have to be seen in person to determine this.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Dr Kayser

Thank you for your question. Although you would possibly do OK with implant exchange alone, you do have enough drooping to consider a mastopexy. This would reposition the breast to a more youthful location and avoid your current problem of what is referred to as a waterfall deformity where the breast does appear as though it's falling over the implant. The alternative would be to release the current scar envelope and, with the insertion of a new implant, allow the descent of the implant into the lower set breasts. Should you desire not have a scar with a mastopexy, you could achieve a satisfactory result and further augmentation of the upper pole could be achieved with fat transfer. In any case I would recommend a consultation with a board-certified plastic surgeon who is experienced didn't all types of breast surgery. I hope this helps and have a wonderful day. Dr. Kayser - Detroit

Melek Kayser, MD
Detroit Plastic Surgeon
4.9 out of 5 stars 33 reviews

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Do I need a lift? Or just repositioning of implant?

There are two correct answers here, but the one that is right for you depends on your goal look. If you want a high, round and more artificial look, that will take a lift. If you want to stay with a natural look you can get a beautiful result following your surgeon's suggestion. My patients lean towards the more natural look, as do I. 

Ronald V. DeMars, MD
Portland Plastic Surgeon
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Breast Lift is needed

Personally, I disagree with your surgeon. You do need a lift to change the overall footprint of your breast to a higher (and more medial) position on your chest with implant reposition. This can be accomplished without the dreaded (and very visible) vertical incision. A Mini Ultimate Breast Lift using the Horndeski Method can successfully reshape and reposition your breasts using a circumareolar incision. You are welcome to view my gallery to find examples of this technique. Hoping this helps. 

Best wishes and kind regards, 

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 215 reviews

A lift or re-positioning of implants?

To answer your question I would want to know whether or not you are overall happy with your size. If you are happy with your size then I might agree with your surgeon that a very slightly larger silicone implant positioned slightly lower (by releasing the scar capsule) would work well. This would result in less upper breast fullness, but still result in a very natural look. If you would like to have more upper breast fullness and larger breasts then a lift may be necessary to achieve the upper breast fullness you desire. A larger implant without a lift might create a bottoming-out appearance over time due to the weight of the implant. Please discuss your concerns again with your Plastic Surgeon. Your surgeon wants to get your surgery done right, and communicating your desires will be important to deciding the best plan of action!

Douglas Leppink, MD
Grand Rapids Plastic Surgeon
4.8 out of 5 stars 26 reviews

Breast implant exchange

Hello and thank you for the question and the photos. Based on the photos, an exchange to silicone is an excellent option for you. I do not believe that you need a lift. The breast still has good shape and forward projecting nipples. 

In the photo with you holding the phone, that breast shows a slight nipple position asymmetry. If you wanted you can have just the implant exchange to silicone and a modified nipple lift just for better nipple position symmetry. 

The procedure typically takes 1 hour to complete under anesthesia and you should factor a week off of work. Exchanges are typically not that painful, and based on the type of work you do, you might be able to return to work sooner. 

As always, best to be healthy, no smoking, and make sure any health conditions you have are managed by your primary care md.

Best to you.

Bennett Yang, MD
Rockville Plastic Surgeon
4.8 out of 5 stars 18 reviews

A Breast Lift May be Beneficial with Your Implants

The most common #breastprocedures include #mastopexy or #breastlift, #breastaugmentation, or #breastreduction.A #mastopexy or breast lift operation is designed to improve the shape and position of the breasts without reducing their size. It is the most suitable for #breasts which sag or droop (ptosis) as a result of development, aging, pregnancy, breast-feeding and weight loss . Some patients will experience better results to restore superior fullness if an #implant is used at the time of mastopexy; better known as #AugmentationMastopexy. Also, a breast lift may also be achieved with current implants if a patient is satisfied with their current size, type and volume.

Altogether, the surgery will create an elevated, more youthful breast contour. Also, the nipple and areolae of the desired size and correct height may also be addressed. I prefer to use a #shortscar technique, #LollipopScar or #DonutLift” rather than the majority of surgeons in the United States that use an anchor pattern lift which involve more significant scarring.The best method and #technique for your #procedures will be discussed in greater length during your one-on-one consultation with a board-certified plastic surgeon.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 99 reviews

Maybe a lift is better

From your photographs, what I can see is the look of a breast that is fallen off of an implant that is in the correct position. In my opinion, a small vertical lift with replacement of the implant would give a very nice result. Should you just open the bottom of the pocket to allow the implant to fall downward, this will lead to more droopiness of your breast over time. Hope that's helpful. 

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 47 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.