I would like more breast volume but do I need a lift as well? Very confused. (photos)

I have been getting conflicted information and would like to know if I need a lift or not. One dr would like to do the mastopexy. The other one said a crecent lift will be enough for me. Personally I thought I did t need a lift but want something that will look good. Any opinion will help me....

Doctor Answers 17

On the breast lift fence

Your side view doesn't look like you need a lift because the nipple is above the crease at the bottom of the breast. From the front though, it looks like a periareolar lift might be better. I don't do crescent lifts anymore because the scar around half of the areola is more visible than one around the whole areola and the crescent can elongate and distort the areolar shape. 

IF you are going with a very full high profile type implant that will take up all the loose skin maximally, I'd probably wait on the lift. If you are going for a more natural conservative look, maybe the PA lift would be best at the same time.

Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

I would like more breast volume but do I need a lift as well? Very confused. (photos)

Women with breast sag are all alone a vast continuum from very slight sag to severe sag.  It's not surprising that you had several different opinions about whether you should have a lift.  Due to this broad continuum,  you are in the in between middle group with some degree of sag and you could go either way with implants.  In this large group of women with sag, if they choose no implants, well over half are happy and never have a lift.  Another way to make the decision is to answer the question...what bothers you the most?  If the thing that bothers you the most is a hollow above and loss of volume, then get implants alone.  Keeping in mind the possibility that you may want a lift later, but better than 50/50 chance you won't.  If sag is what bothers you the most, then I would recommend a lift in that case since you are more likely to be happy and I think the scars will be well worth the trade.  I hope you find this information helpful.  

Thomas Hubbard, MD, FACS
Virginia Beach Plastic Surgeon
4.8 out of 5 stars 37 reviews

Do I needs lift?

Thank you for your recent photos and questions! From the side profile your nipples seem to be in an okay position, however from the front view I would recommend a lift with implants to give you a fantastic look! Best of luck!

Brian K. Reedy, MD
Reading Plastic Surgeon
4.9 out of 5 stars 145 reviews

I would like more breast volume but do I need a lift as well? Very confused.

Thank you for your question.  On the front few it appears that she will benefit from a lift in addition to implants.  Your nipple position on the front view is low and there is medial deficiency of the breast.  A combination lifting implant should give you a rounder fuller breast with appropriate nipple position.  To understand more please read the link below:

Breast lift?

Thanks for your inquiry, and excellent pictures.  I think you would look better with a lift but could go either way.  Sorry you re getting "conflicting information" but it is only because you are a case right on the fence and best of luck.  

Vishnu Rumalla, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 201 reviews

Borderline lift

You could go either way. Particularly from the lateral view, you do not appear to need the lift. This is why there is no substitute for an in person consultation.  My sense is that you have options and will ultimately have to make a personal cost-benefit analysis. Best wishes.

Robert L. Kraft, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 42 reviews

To lift or not to lift?

Thank you for your question and photos.  From what I can see, you are a borderline lift patient.  On the side view, you nipple is above the fold, but on the front view, your breasts sit a little low and this very little non-pigmented skin below the areolas.  An in-person exam would be very helpful, but if you were in my office I would probably offer you a submuscular implant with a peri-areolar lift.  The per-areolar lift can be useful when only a small amount of lifting is needed.  I have not found the crescent lift to be very helpful in most patients. Another possible option, may be subglandular implants without a lift.  An exam would be necessary to be definitive.  Good luck.  

Matthew H. Steele, MD
Sioux City Plastic Surgeon
5.0 out of 5 stars 86 reviews

I would like more breast volume but do I need a lift as well? Very confused.

Based on your photos, you are an excellent candidate for a lift.  The breast are low. If you are happy with your breast size, then a lift is all you need.  Breast implants add volume and do not change the shape of the breast.  Both procedures can be done at the same setting.

Robert E. Zaworski, MD
Atlanta Plastic Surgeon
4.8 out of 5 stars 62 reviews

Breast enhancement surgery options

When enhancing the appearance of the breasts we need to take in account breast shape and size, symmetry, patient desires and the skill and expertise of the surgeon.  Based on the photographs submitted you have 4 options that are all acceptable:

  1. Mastopexy (breast lift) alone
  2. Mastopexy combined with an implant (one operation)
  3. Mastopexy first followed by breast implants (two operations)
  4. Breast implants alone

Of course, there different types of lifts and different types and sizes of implants to consider.  If you ask 10 different plastic surgeons, you will probably get 10 different answers.  So, what do you do?  Find a board certified plastic surgeon that will spend the time with you and review the options.  Look at the scars, down time, cost and what you really what to accomplish with this procedure.  You will come to a conclusion that will satisfy all your needs and wants and then go for it!!

Good Luck!

David Finkle, MD
Omaha Plastic Surgeon
4.9 out of 5 stars 75 reviews

Lift or Not?

Breast Lift with Implants or Implants Alone

One of the more common scenarios that we as aesthetic plastic surgeons deal with in cosmetic breast surgery is the patient from either weight loss, or post pregnancy has a little bit of drop of the breast off of the chest wall that we call ptosis. The question then becomes in the patient's mind, can we just fill the space with an implant and create a youthful looking breast. It all depends on what the patient's perception of youthful is. My patients, more than likely, would like to have upper pole fullness of the breast without the necessity for wearing a push-up bra. In these situations, a breast lift plus an implant both centers the nipple and areola complex on the breast while replacing the lost volume with an implant. Most patients’ hesitation in doing the breast lift as well as implants, are the potential for bad scars. In my experience, we talk a lot about the scars of a breast lift preoperatively, but hardly ever in the postoperative phase. It seems to me, that when the breast is up high on the chest wall, youthful and perky, that one does not even see the scars. Most of the time, these incision lines heal uneventfully anyway. In the small chance that the scars are more red or thicker than one would like, we have many options in lasers, light sources, and laser assisted drug delivery techniques to mitigate against unsightly scars. Sometimes, patients who I've seen have seen other physicians who have recommended simply placing a large implant to "fill the space". This seems to be a very temporary fix for the situation in that the stretched out soft tissue that the implant is placed into, usually will allow very rapid descent of the breast, such that in just a few months, it looks like a bigger version of the breast that they first started with. They will then sometimes have a secondary mastopexy, and at that time, I would often recommend that they replace the very large implant with a smaller one. In my opinion, a large lift, meaning taking out as much of the stretched out skin as possible, and placing a more modest size implant will make a breast that will remain perky and up on the chest wall for a long period of time. In my opinion, perky breasts, not necessarily large breasts, look youthful. Patients will then ask, "why then does Dr. so-and-so tell me that I can just have implants?" My answer to this is very simple. It is far easier in most plastic surgeons’ skill sets to place a large implant then do a breast lift with an implant. The simultaneous lift and implant procedure is a little more challenging in that you're trying to do opposite things at the same time. One, you're trying to make the skin envelopes smaller and at the same time make the breast larger. One easy way to decide whether a lift is good for you, is to see your image in 3-D on a Vectra camera system. In our office, we can then compare two images: one with mastopexy with implants and the other with implants alone. In that way, both the patient and plastic surgeon can see what the difference in the look of both procedures are. Usually when implant is placed only, and a breast lift was really needed, what the patient will see is a breast that is falling off of a properly placed mound that's higher in the chest wall than the breast is. The breast seems to be falling off the implant. They will commonly squeeze the end part of their breast and ask,  “why hasn't the implant filled this space out?” For me, the in between operation is to use a tall shaped implant. These anatomically shaped implants can create the illusion, that although the nipple has not really been raised, that the nipple is now more centered on the breast. While these implants do cost more than round implants, it still less expensive than adding a breast lift. All things considered, it's best to consult with a few talented and busy cosmetic breast surgeons to get different opinions. Good luck with your decision.

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 54 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.