Grade 1 sagging? Do I need a lift? (Photo)

Question

So, my consultation with my PS is in early May and I am doing lots of research. My question for now is would you consider this Grade 1 or 2 sagging? As of now, I want 500-600cc. Would that help with volume? I don't want a double bubble. And don't really want the scars associated with a lift if I don't have to. Any help is appreciated!

Itzhak Nir, MD, FACS · Answer

Unfortunately, you will need a lift to get the best result. Your nipples are too low on your breast. I would categorize you as Grade 2. An implant and lift would be the procedure of choice. Probably a lollipop or vertical lift. I hope this has helped.

Jon Paul Trevisani, MD, FACS · Answer

Hello and thank you for your question!  Based on the photographs you have submitted, placing an implant alone will NOT lift your breasts. Your nipple position will still be low and the breasts will still have some ptosis (drooping). A breast lift will certainly lift your breasts to a desirable position. However, as you may know, a breast lift will require more incisions and thus resulting in more scarring. It is often times challenging inserting a larger implant during a breast lift surgery because of the risks associated with this. Such risks include: a lot of pressure on the incisions with a larger implant can cause poor wound healing, premature sagging. Often times when the procedures are separated into two step procedures, a patient is able to have larger implants. Step one would be to have the Mastopexy (Breast Lift) surgery alone. Step two would be to have the Breast Implant surgery.I would suggest seeing a board certified plastic surgeon in your area for a thorough examination and evaluation. Best of luck to you!

Donovan Rosas, MD · Answer

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 upon your photos alone, you demonstrate more than mild ptosis with a slightly downward cant to the NAC. Depending upon the nipple to IMF distance, the augmentation plane and the chosen augmentation volume some patients may be able to forego a formal lift as the breast mound rotates on the implant (large implant with a small NIMF distance placed subglandular can have a "pseudolift" effect). However, I would suggest for an optimal outcome that you consider both mastopexy and augmentation (either in concert or staged). 
There is a procedure for every problem. To determine which technique is right for you, consult with a board certified plastic surgeon (ABPS).

Steven J. Rottman, MD, FACS · Answer

Thank you for your question and photos. It looks like a lift will be required in addition to placement of breast implants. I do not think you will achieve a satisfactory result with either augmentation or a lift alone. It is best to have an in-person consultation with a board certified plastic surgeon who specializes in cosmetic breast surgery. Ask to see a lot of before and after photos of their work. Hope this helps and good luck!

Darryl J. Blinski, MD · Answer

Try 2 staged surgeries. 1st: larger implant in dual plane with or without donut lift. If not happy than second operation convert to full anchor lift.

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Grade 1 sagging? Do I need a lift? (Photo)

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Answer: Grade 1 sagging? Do I need a lift? (Photo)

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