Currently a 32 B/C but would like to be around DD. Lift and implants or just implants? (Photos)

Thanks for your question! It would be helpful to see what you're hoping to achieve for an "after" result. The one side would benefit from a lift and the other would be fine with just an implant. If you are okay with minor asymmetry, you can probably avoid a lift for now. If you want perfection, commit to the lift. Good luck!

Dear tor_parker,

determining whether you need simply a breast augmentation versus a breast lift can be somewhat complicated. It depends on a number of factors including skin laxity and current nipple position. Generally speaking, if the nipples are lower than the inframammary line the patient will most likely need a breast lift. If the nipples are at or above the inframammary line we can generally get by with just a breast augmentation depending on the size of the implant the patient wants. I often still using implant when I perform a breast lift because it provides more upper breast fullness after the lift. To be sure a consultation with a board-certified plastic surgeon will help determine what the patient actually needs.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Thank you for your photos. From your photos, it appears your right breast nipple position is excellent and you have essentially no ptosis of that breast. Therefore, a simple augmentation of your right side with an appropriate sized implant should give an excellent result. Your left breast nipples is slightly lower and your left breast appears to have a Grade 2 ptosis. I believe the simplest way forward is to do a augmentation only on your left side as well, with an appropriate sized implant so that it matches your right side for volume and allow the augmentation to settle and see if you are happy with your appearance. If you are pleased with your appearance, nothing further needs to be done. If you feel that your left breast is still slightly low it would be possible to do a lift of your left breast under local anesthesia only to help you minimize the cost and it would be a very short recovery.

A lift may be suitable for the left breast (right in the photo) as your nipple is located below your breast fold. This would improve symmetry. Your surgeon could suggest the size of implant needed to achieve your goals, based on your measurements. Ask your surgeon about trying on sizers. These are implants you can fit into your bra to see your predicted results.

Your breasts are asymmetrical in volume, shape and position. At size 32, each 100 cc of implant corresponds to 1 cup size change. To go from a C to a DD would require 200 cc implants so your range between 240cc-300cc implants is good. I recommend a circumareola approach to reposition the nipple-areola complex higher and more medial and allows placement of the implants. I recommend retro-pectoral implants.

Best Wishes,

Gary Horndeski, M.D.

Patient concerns regarding the appearance of their breasts can typically be divided in two pools: volume, ptosis (droop). The procedures to address these issues are as different as the issues themselves. However, these concerns are not mutually exclusive. Many patients, whether they are aware or not, will benefit from both.
There are two factors which can help to answer the question of which surgery will deliver the most satisfying result: mastopexy, augmentation or both. Patients must first consider the position of the NAC (nipple areolar complex i.e. the pigmented portion of the breast) as it relates to the inframammary crease. If the nipples are at or below the level of the crease the patient may benefit from a lift or mastopexy. The breast lift is designed to elevate sagging breasts to a more youthful position. It also helps to reshape and tighten the skin of the breasts. This is typically accomplished via a periareolar (around the nipple) incision with or without a vertical incision.
Mastopexy is an effective way to address sagging breast, however, the changes which accompany weight loss or pregnancy can also decrease volume of the breasts. When a woman wants the volume restored, or increased, a breast augmentation will also be needed in conjunction with mastopexy. Augmentation can help restore the volume loss which is well known to women following children. There are a number of options available to women considering augmentation ranging from size and implant type to access incision.
A breast augmentation alone may also be appropriate if ptosis is mild. If the patient is comfortable with the natural appearance of the breasts but desires them to be larger, a breast augmentation alone is the right procedure. Augmenting significantly ptotic or sagging breasts tends to magnify the problem. In these cases, a mastopexy performed in conjunction with an augmentation is preferred.
Based on your photos, your nipple position does not demonstrate an absolute need for lift. Nipple areolar complex position is preserved. The left side has some pseudoptosis. You would likely benefit from an augmentation. That being said, there is no substitute for an in person exam.
There is a procedure for every problem. To determine which technique is right for you, consult with a board certified plastic surgeon Patient should discuss their concerns with their physicians in order to make an educated decision

Hi, I’m Dr.Eskalen from Istanbul/Turkey. Augmentation only is enough for you. My suggestion for you is making a 3D simulation to understand your expectations.This 3D simulation can also be online via a specific App, which we use for all of our patients. I hope my message helps you.
Best regards,Dr.Eskalen.

A DD will be too large and heavy for your frame and tissue, but a D would look nice. I would suggest placing the implants behind the muscle. You do not need a lift. Your size selection should do well for you.

When you look at the nipple, the lifting procedure will give better results because there is asymmetry in the nipples. It may be more symmetrical if it is done this way, but if this appearance does not bother you and you think that just having your breasts look more voluminous will be enough, only implants can be considered.

From the posted photos it appears you have asymmetry in volume and nipple position. In order to correct that a lift would be needed. If you do not have a lift and use differently sized implants the volume asymmetry may be improved but the nipple position will remain.