Realistic expectation of breast lift? (Photo)

Question

I want a breast lift so that the "fold" of the breast can be seen. If I do go with an implant I hear a lot of people and doctors talk about them falling... I wouldn't want mine to fall much, if at all. So would that be high profile? I would want them to be full on top and equally as full towards the bottom without lapping over. I also have fat under arms and sides to my back. Would that be a lipo issue? My question is, is this realistic?

Adam Tattelbaum, MD · Answer

Thanks for this terrific question. I think many patients have unrealistic expectations about what a breast lift can do. Natural breast tissue wants to go south. The larger the breast the more it responds to gravity. If a larger breast is lifted it will always regain some droop beneath the fold, which I actually think looks more natural.

Generally only teenage women or pre-partum women with little natural tissue will have no droop.

Lifted breasts will eventually take on a teardrop shape, only the addition of volume will give upper pole fullness.

To get what I call a "gravity defying breast" you would do a lift and reduction, taking away the lions share of the natural tissue which responds to gravity. Heal, and then come back and place an implant. Implants tend to defy gravity, while natural tissue does not. In practice, I think it makes little sense to do a reduction just to then have an augmentation, but I hope the concept makes sense.

In a situation such as your I think a lift makes sense, but you would have to expect some recurrent droop. If  you then go with implants you will gain more upper pole fullness, but a larger implant will still go south over time.With respect to lipo you would need to be examined. Lipo makes skin looser and you may do better with skin tightening.

I hope this has helped

Jaime S. Schwartz, MD, FACS · Answer

I appreciate your question!

I perform a liposuction breast lift that removes tissue from the areas you don't want such as near the armpit and the lower portion hanging near your stomach. Once I use this to shape the breast I then remove the skin to tighten the breast and create a better shape with nice cleavage. Since I perform this less invasively the recovery time is faster and drains are not necessary. The size would depend on the proportion with your body versus going for a cup size. It works very well if there are asymmetries. I can also use the removed fat as a natural breast augmentation by grafting the fat back into the breast to create more projection or into the top to create more cleavage. If you have shoulder grooves from your bras, I can also use the fat to fill these areas in and give you more cushioning as well as contour. This procedure can also be combined with an implant if needed or wanted.  It should not affect nipple sensation, mammograms, cancer risk or breast-feeding. If you gain or lose weight, the transferred fat can do the same.

The best way to assess and give true advice would be an in-person exam. Please see a board-certified plastic surgeon that specializes in aesthetic plastic surgery.

Best of luck!

Dr. Schwartz

Board Certified Plastic Surgeon

#RealSelf100Surgeon

#RealSelfCORESurgeon

Emmanuel Mallol Cotes, MD · Answer

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.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.-

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  With that
being said, based on your photographs, the best shape and contour could be
achieved with an implant and a breast lift. Your nipple sits
below the inframammary fold and without a lift in addition to the implant, this
will not have a natural shape.  A breast lift with an implant can
result in a very nice shape if good technique is used.  The size,
profile, and shape of the implant is based on your desired breast
size/shape, your chest wall measurements, and soft tissue quality. 
This decision should be based on a detailed discussion with
equal input from both you and your surgeon.   Make sure you
specifically look at before and after pictures of real patients who have
had this surgery performed by your surgeon and evaluate their
results.   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

Chester K. Cheng, MD · Answer

Hello, thank you for your questions. I can see from your photo that you do have a low nipple position, making you a great candidate for a breast lift procedure. I would recommend doing an augmentation with a conservative implant to give you the fullness that you have described. I understand that you have concerns about placing an implant due to possible drooping in the future. However, as you age, the degree of drooping will be the same with or without the implant, especially if you are going with a smaller implant. The degree of falling also depends on your own skin elasticity, which varies between patients. In addition, I find that when I pair sculpting of the torso, back and axilla with the breast augmentation/lift it produces the best overall result for those patients that may have stubborn fat in these areas.

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