Do I need a lift? I want an areola reduction w/ augmentation. Will that lift the breasts? Tummy tuck type?​ (photo)

Judging from the photos, do I need a breast lift? I want to get an augmentation, areola reduction, nipple reduction, and tummy tuck. Will the procedures I want lift the breasts at all? As for my tummy tuck, will it need to be regular or extensive? (I plan to lose 25 more lbs before surgery- yes I know that changes things, however, I've been through this once before with 1st pregnancy and lost the weight but the saggy skin was still there). What will be the cost for all this? I live in Fargo, ND. 

Doctor Answers 14

Do you need a lift?

Far more important than the technique is the skill and experience of your plastic surgeon. Choose your surgeon rather than the technique and let them explain why one technique may be better than another. 
See the below link on some suggestions on finding the most qualified Plastic Surgeon for a consult.

Breast Lift with Mommy Makeover

Judging from your pictures it appears that you have significant ptosis ( sagging) of your breast gland.  I would recommend that you have a breast lift with repositioning of your nipple/areolar complex combined with an implant in order to give you increased volume with good positioning on your chest wall.   Losing an additional 25 pounds will definitely improve your abdominalplasty results.   Good luck and always consult a board certified plastic surgeon  for a definite plan when you decide to proceed with your surgery.

Carlin Vickery, MD
New York Plastic Surgeon
5.0 out of 5 stars 19 reviews

Modest breast ptosis can be camouflaged by breast augmentation is part of mommy makeover.

Depending on your final expectations you are a candidate for sub glandular breast augmentation without mastopexy. Areola reduction would require some form of a mastopexy. The diameter of your areola is not especially great. For liposuction, breast augmentation and abdominoplasty expect to pay $12-$15,000.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 32 reviews

Mommy Makeover

Thank you for your question.  You would be a good candidate for a breast lift with implants which would increase you size and also lift your breasts and reduce your areola.  Also, a full tummy tuck would be good here.  Getting closer to your ideal weight would improve your aesthetic results.  Good luck!

Zachary Farris, MD, FACS
Dallas Plastic Surgeon
5.0 out of 5 stars 15 reviews

Full tummy tuck with muscle reconstruction, implants without lift

Based on these photographs you appear to be an excellent candidate for a full tummy tuck with muscle reconstruction.  This will flatten the muscles, reconstruct your core muscular corset, revise the belly button, eliminate the stretch marks from the belly button to the pubic hairline, and remove the loose skin and fat of the anterior abdomen. You can have an excellent outcome without a lift.A lift with an implant is controversial for two reasons.  First, when you perform a lift you are making everything tight and closing the wounds under tension.  It you add the expansive forces of the implant at the same time, you are fighting against yourself.  There are forces on the wound which try to make them separate, which results in wider, thicker, more irregular scars.  In the worst case, the wounds will open.  So compromises are usually made in the operating room by the surgeon because they cannot close the lift wounds over the appropriate sized implant.  Either less of a lift is performed so that the skin is not as tight and therefore there is less tension on the closure.  Or a smaller implant than would be appropriate is used so as to decrease the expansive forces.  Either way, you are compromising the aesthetic outcome.  Often the outcome is so compromised that a second revision surgery is required.  If however, you plan to have the lift first and then the augmentation after everything has healed, then you have two operation that are planned, both with much lower risk than the combined mastopexy/augmenation.  The outcomes of the two meticulously planned operations are much better and a more aesthetically pleasing, and a safer outcome is achieved. The second reason the combination of mastopexy and augmentation is controversial is because of the risk of nipple necrosis (death of the nipple).  By making the skin tight for the lift, you are putting external pressure on the veins that supply the nipple.  By putting an expansive force on the undersurface of the breast with an implant, you are putting pressure on the thin walled veins that supply the nipple.  If the pressure by squeezing the veins between the implant and the skin is greater than the venous pressure in the veins, the flow will stop.  If the venous outflow stops, the arterial inflow is stopped.  If the arterial inflow is stopped, there is no oxygen for the healing wounds and the tissue dies. Placing the implant on top of the muscle in combination with a lift puts the blood supply to the nipple at a much higher risk because in addition to the issue of pressure on the veins, you have to divide the blood vessels that are traveling from the pectoralis muscle directly into the breast (and to the nipple) in order to place the implant between the breast tissue and the muscle. This adds a third element of risk to an already risky operation.  Mastopexy/augmenation with sub glandular implant placement is by far the riskiest way to address your anatomic question.

Mommy makeover

hello and thank you for the question and the photos. Based on the photos, you are an excellent candidate for the mommy makeover: breast augmentation and full tummy tuck. Losing the weight first will be very helpful to create and flattter tummy and better shape. The need for the lift is a little less obvious. There are always tradeoffs with surgery. An implant will fill your breasts more and since your nipples point forward, there is likely to be better nipple lift after the implants. If you have implants alone, you might get enough fill / lift that the breast lift scars would not be necessary. You can always go back to have the lift done in the future if you are not satisfied with that result. Costs will vary from state to state, and doctor to doctor. You should have several in person consultations with board certified plastic surgeons before making any decisions. As always, best to be healthy, no smoking, and make sure any health concerns you have are managed by your primary care md. 
Best to you. 

Bennett Yang, MD
Rockville Plastic Surgeon
4.9 out of 5 stars 10 reviews

Breast Lift Combined in Mommy Makeover

The mommy makeover is a combination of procedures to bring a woman’s body back to the way she looked prior to pregnancy. Most commonly some variation of a #TummyTuck and #BreastSurgery are performed. Additional procedures can include liposuction, umbilical hernia repair.  The most common #breastprocedures include #mastopexy or #breastlift, #breastaugmentation, #breastreduction.If there is too much loose skin and sagging, following pregnancy, then a breast lift is required. This procedure essentially removes excess skin to tighten and lift the remaining skin and breast tissues. The incisions vary depending upon the amount of skin to be removed. Some women benefit from a combination of these two procedures called an “augmentation-mastopexy.” In a few women, breasts actually enlarge, especially if there is a post pregnancy weight gain, and a reduction and Mastopexy combination may be most appropriate. You should be able to combine this lift with any and all of the breast procedures you are looking to have done together.Abdominoplasty will address loose skin, excess fat and muscle weakness “diastasis recti”. This weakness tends to enlarge the waist in many women. After pregnancy if your belly button has a bulge or sticks out, it may be due to an umbilical hernia. Both of these conditions are corrected during a Tummy Tuck, which will bring in your waist line. On the other hand if only a small amount of skin is redundant in the lower tummy you may only need a fairly simple “mini-tuck” rather than the more extensive standard Abdominoplasty – which corrects all the conditions noted above. 

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 94 reviews

Options for recontouring breasts and abdomen

Hi and thanks for posting your questions and photos!
Judging from the photos you posted you would benefit from a full abdominoplasty procedure as well as vertical breast lift with implants. This would allow for resizing the areola and positioning it in the optimal place over the implant. Weight loss to your goal weight prior to proceeding is the best plan for the best outcome.Seek a  consultation with a board certified, reputable plastic surgeon to have all of your questions and concerns addressed.
Best luck on your journey to achieve your goals.

Rachel Streu, MD
Portland Plastic Surgeon
5.0 out of 5 stars 14 reviews

Mommy makeover

Thank you for your photos.  It appears you are a candidate for the full tummy tuck, breast augmentation and areola reduction.  Depending on your surgical goals, you may not need to have a lift.  This is best determined after a discussion with your plastic surgeon on your desired final look.  The 25 pounds that you intend to lose will enhance your results and I encourage you to do that.  Cost will vary based on final surgical plan.

Camille Cash, MD
Houston Plastic Surgeon
5.0 out of 5 stars 28 reviews

Mommy makeover

You appear to be a good candidate for a tummy tuck, especially after your lose another 25 lbs. You may not require a breast lift but can definitely have an areolar/nipple reduction at the time of your breast augmentation. The cost can vary depending on saline/silicone implants but likely is in the range of 12-15,000 total.Best wishes,Dr.Bruno

William Bruno, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 330 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.