Do I need a lift in my right boob? Due to bad skin elasticity, will boobs bottom out w/in 3 or so years if I go too big? (Photo)

I was told that due to the sagging in my right breast that I only need a lift in that one and just an augmentation in my left with a slightly smaller implant. I want full boobs that are the same size and symmetrical. I was also told that due to not having strong skin elasticity (I nursed my son for 6 mo) that I should not go bigger than a B or C because I would bottom out in 3+ years. Is this true? I really want to be a full D cup. I am 5'7'', 150 lbs and currently wear a 34C.

Doctor Answers 7

A "DIEP flap aug" will achieve your goal without implants!

Hello!

Deflation and drooping are common among women after breast feeding, and you certainly have both. And your unique situation is a bit more complex because of the asymmetry of nipple position and breast droop. Purely based on your photos, I strongly recommend breast lifts (using a lollipop shape scar) and augmentation of both breasts. This will restore beautiful shape, symmetry and volume with a small trade-off of the scar which, with diligent scar therapy, generally heals quite well. The question is how to perform the augmentation!

As you know, placing implants is the usual way to augment breasts. However, I agree that the larger the implant then the greater the risk of "bottoming out" because the weight of larger implants will stretch out further your already stretched breast skin. A breast size limited to no larger than a C cup is not unreasonable if implants are used. However there's one way you can achieve your goal of D cup size without implants and without the worry of bottoming out: a tissue augmentation. This is a technique called the "DIEP flap aug" and I perform it for women wanting not only breast augmentation and lift but also tummy tuck. Instead of discarding the abdominal skin and fat, I transplant it to the breasts using microsurgery techniques. Augmentation with your own healthy tissue provides a natural result in appearance, feel and aging. Best of all, only do your breasts feel the most natural, the tissue will never bottom out like implants and so you should not need to have surgery to fix it. 

Aside from myself, I know of only 1 other plastic surgeon in the US who offers this surgery because it is extremely challenging to do. It requires skill and experience in microsurgery (not to mention a good aesthetic sense) that very few surgeons have. The other downsides are that the recovery is a little more than a mommy makeover with implants (about 2 to 3 weeks), and it costs more (~$25K). But, a quick word about cost: if you were to need future surgeries to fix problems that arose (such as bottoming out) then costs would add up and potentially be more than doing right the first time around. Other big upsides of the DIEP flap sit are: having the most natural breast look and feel, achieving your goal breast size without implants, having a beautiful result that lasts a lifetime, and a flat tummy, are worth it! (My video on this topic is coming soon). 

All the best in your search!
- Dr. Rad


Washington DC Plastic Surgeon
5.0 out of 5 stars 48 reviews

Breast Lift


Yes, I recommend a breast lift, however based on your images, I MAY recommend a lift on both sides. Best wishes!  I also think that a D size cup may suite your body frame a little but better.  I recommend an in-office examination as well as a detailed discussion with a board-certified Plastic Surgeon certified by the American Board of Plastic Surgery.
Best wishes!
Dr. Desai
Harvard Educated, Beverly Hills & Miami Beach Trained, Double-Board Certified Plastic Surgeon

Breast lift with implants

Hello and thank you for your question. Based on your photograph, you are a great candidate for a breast lift with an implant.  You could safely achieve a D cup if you desire this size. The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 80 reviews

Augment/pexy

A mastopexy would establish near equivalent nipple heights but pure symmetry is unlikely to result.  Both breasts require lifting. I agree that you should keep the augment to a C cup based on poor skin elasticity.

Lift with implants

The two breasts will always be a bit different although better symmetry can be achieved. Both will likely need lifting.  Good luck.

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

Do I need a lift in my right boob? Due to bad skin elasticity, will boobs bottom out w/in 3 or so years if I go too big?

Hello dear, thanks for your question and provided information as well.. The breasts may lose their elasticity and firmness which can be caused by different factors such as pregnancy, massive weight loss, lactation and aging. To reaffirm the breasts and restore the natural look your surgeon can perform a mastopexy or breast lift. A breast lift restores a firmer, perkier, and more aesthetically pleasing shape to sagging breasts. This not only can improve a patient’s appearance by restoring her youthful, feminine proportions, but  also help bras and swimsuits fit more comfortably and attractively. By removing excess, stretched out skin, reshaping the breast tissue, and raising the nipple & areola into a more forward position, a cosmetic surgeon can create a more youthful breast contour. Stretched, large areolae can also be reduced during breast lift surgery, creating an overall better proportioned, natural looking breast, Actually the perkiness on a person or another, depends on patients skin and breast tissue..

Tania Medina de Garcia, MD
Dominican Republic Plastic Surgeon
4.6 out of 5 stars 361 reviews

Breast augmentation and lift candidate, some advices:

Thank you very much for enquire.
After having analyzed all the information and photos provided to us, I realize that you have very sagging and small breasts. In this regard, you need volume (implants) and projection (the lift): Breast Augmentation w/Breast Lift.
I recommend you to use microtexturized highly cohesive silicon implant ("gummy bear" implants), with high projection, and 550ml will be excelent on you, to fill the breasts properly.
Finally, to perform the breast lift I recommend a Periareolar Round Block Breast Lift ("Benelli mastopexy"), which has an unnoticed scar around the areola, and if we see (in the surgery) that we can't obtain adecuate projection just with the Benelli Lift, we have to perform a "Lollipop breast lift".
Respectfully,
Dr. Emmanuel Mallol Cotes.-

Emmanuel Mallol Cotes, MD
Dominican Republic Plastic Surgeon
4.7 out of 5 stars 179 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.