Lift or Implants or Both
Based on your picture, it appears that implants alone will be ok. A lift will reposition the breast tissue higher and center the nipple/areola on the implant. If you just do the implants, it is always possible to do the lift at a later date if you change your mind.
Breast Implants with Lifting
GreetingsThank you for your question, I would recommend that you get Implants plus lift for best results. Breast sagging is an indicator of aging in women. Women always seek for a firmer, perpendicular and well-shaped breasts. Breast lifting operations are mainly designed to give a younger and better look to breasts.
Can I get away with no lift?
Thanks for your question. Based on your limited photo, you do appear to be a good candidate for breast augmentation without a lift. Like you, many women would do better with a lift but refuse. This is ok assuming that you and your surgeon have a long discussion discussing expectations and limits of the surgery. He or she should discuss what your upper poles will be like, how your tissue will feel, your asymmetry and your likelihood of needing another surgery. I hope this was helpful and I wish you all the best.
Breast implants without a lift
Thank you for the question and photo. You appear from the limited exposure of the photo to be okay with the implants only without the lift. A moderate plus style implant will most likely give you natural looking breasts. Good luck with your surgery!Dr. Khuthaila
Implants or lift with implants
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.
I agree with your goals and surgeon's recommendations that a lift is not a must. Implants alone don't lift but they often give a satisfactory illusion of a lift. After 9 months when the breasts have settled, if you feel they aren't perky enough, you could always get a lift at that time. Hope this is reassuring. For more information on this and similar topics, I recommend a plastic surgery Q&A book like "The Scoop On Breasts: A Plastic Surgeon Busts the Myths."
Lift or not
It looks like you might benefit from a lift. If you do not want one at this time, then you can go ahead with implants and have a lift at a later time.
No lift needed
O agree, there is no need for a lift.I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with and who is a board-certified Plastic Surgeon certified by the American Board of Plastic Surgery.
Harvard Educated, Beverly Hills & Miami Beach Trained, Double-Board Certified Plastic Surgeon
I don't think I would ever suggest a lift for your breasts, your nipples appear to be above your inframammary line - thus a lift would be useless.
Starting with implants alone is a reasonable decision. The pocket must be made precisely and postop compression is necessary. Always wear a brasiere afterwards. A lift can be performed later if you are not content.