I’m 32 and breastfed my baby. I want more volume. Do I need breast lift? (photo)

Question

I’m 32 and breastfed my baby. I want more volume in my breasts but don’t want a lift. Can I get augmentation only?

Ronald J. Edelson, MD · Answer

You would be a good candidate fir a vertical lollipop lift along with implants. Whatever you do, do not let someone talk you into a crescent lift or donut lift. You  would be better off with implants and no lift than one of those options.

Semih Yildiz, MD, FEBOPRAS · Answer

From the photo, there appears to be breast deflation after breastfeeding with some lower-pole skin laxity and a relatively low nipple position. Breast augmentation alone can add volume, especially in the upper breast, but it does not reliably lift the nipple or tighten stretched skin.

If the nipple is at or below the breast fold on exam, a lift is usually needed for a more centered, perky shape. If the nipple is still above the fold and the skin envelope is mild, an implant alone may be possible, but it may leave a lower or more bottom-heavy look. An in-person exam with measurements and implant sizers is the best way to decide whether augmentation alone is realistic for your goals.

Leila Kasrai, MD, FRCSC · Answer

If it has been at least 6 months since you stopped breastfeeding, then cosmetic breast surgery may be considered. A lift may help if your nipples are located below your breast fold. This may be the case for you based on your photo although a side photo would be better to determine this.

Gary M. Horndeski, MD · Answer

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 or small implants can be placed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Jordan Kaplan, MD · Answer

Hi, thank you for this question and for supplying a photograph. I believe you can have a breast augmentation without a lift. An augmentation will increase your breast size and provide more superior fullness without requiring the scars associated with a breast lift. I would point out that your left areola is slightly larger and lower than the right. So long as you are ok with this mild asymmetry I think a breast augmentation would be a great procedure to help you achieve your aesthetic breast goals! Placing a breast implant will correct some of the ptosis or drop of the left nipple and can be done in such a way that will help improve this asymmetry. 
If any nipple asymmetry is not ok than you likely would need an augmentation with a vertical lift of the left breast.

Ted Eisenberg, DO, FACOS, FAACS · Answer

I recommend an in person consultation with a plastic surgeon to discuss your goals and be measured. 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

Carmina Cardenas, MD · Answer

Based on your photo you have a 2-3rd degree Ptosis (saggy breast), asymmetric, left one bigger and saggier, deflated on top. Solo augmentation will left  you with big saggy breast if the subglandular pocket is used or waterfall deformity if under the muscle pocket is used. 
You are candidate for breast lift and augmentation, my recommendation is to use under the muscle pocket, breast lift, little reduction on the left and no larger than a Full C (300-325cc high profile implant aprox). 
Be encouraged. 
Dr. Cárdenas

Martin Jugenburg, MD · Answer

Hello thank you for your question. Yes you can but keep in mind natural breast tissue always falls and so implants will give you more volume but this will drop over time. I would suggest going about the muscle if you don't want a breast lift. If in the future you change your mind, then you can go under the muscle with a lift. Check out the before and afters and see what you like and dont like about the afters.

Aaron Gilson, DO · Answer

The choice is ultimately yours and is best done in conjunction with a trained plastic surgeon. Several factors can guide your choice regarding breast augmentation with or without a mastopexy or breast lift. These include your aesthetic goals, the current size and shape of your breasts, the quality of your skin, and your overall health. Mastopexy helps to raise and reshape sagging breasts. It can correct the position and shape of the breasts and can also reposition the nipple and areola for a more youthful appearance. Breast augmentation uses implants to increase the size, shape, or fullness of the breasts. It's a great option for women who are unhappy with their breast size or those who have lost volume due to weight loss or pregnancy. Many surgeons will stage an augmentation mastopexy and you could always elect to undergo the augmentation portion first. Your individual outcome depends on the profile and size of the implant. However, one of the consequences of implants without a breast lift can be "waterfall" deformity where the breast "falls" over the implant. Additionally, you could consider a lift to help improve any asymmetry. These can be done with scars that go around the nipple areolar complex. 
Best of luck on your surgical journey!

Wayne I. Yamahata, MD · Answer

Implants provide volume but provide very little lift. Your need for a lift would depend on your goals. Your single photo does not allow for a definitive answer, but it appears you would achieve an acceptable outcome with implants alone. To truly answer your question, seek a consultation with a board-certified plastic surgeon. He or she can help to define your goals and provide you with realistic expectations with and without a lift.

I’m 32 and breastfed my baby. I want more volume. Do I need breast lift? (photo)

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