Can I just get implants for fullness or do I require a lift? (Photos)

Question

My breast are lacking in volume due to weight loss, I just want them to look full like how they do when I’m on my period cycle. First photo are my breast when I’m on my cycle, and the last few are off my cycle. Am I able to get away with just implants? Or do I require a lift? I like my breast, I just want them to be fuller! Thank you!

Chet Mays, MD · Answer

Thank you for your inquiry!  We, at Mays Plastic Surgery, would love to meet with you to discuss your concerns.  there are options to getting fuller breast.  Implants, fat transfer and / or a lift. Schedule a consultation with Dr. Mays, a Board Certified Plastic Surgeon, to help you reach your goals.

Gianfranco Frojo, MD · Answer

You most definitely would benefit from a lift at the time of implant insertion/placement. There is no way to achieve a proper result with an implant alone. There has to be proper harmony between the implant and the amount of laxity/skin.

Gulcin Nujen Cardak, MD, FEBOPRAS · Answer

If your goal is only getting fuller breasts it won’t be necessary for you to have breast lift surgery. Actually with implants you’ll have a mild lifting too. But if you want your nipples higher position then breast lift and augmentation will be excellent solution for you.

Leila Kasrai, MD, FRCSC · Answer

Implants are centred behind the nipples. Your nipples are located below your breast fold so without a lift, the implants would sit low on your chest and you wouldn’t have any upper pole fullness. The weight of the implants would also accelerate the rate of sagging. For this reason, a lift is recommended.

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.
With regards to your specific question, you appear to have some droop/ptosis that may be amenable to a lift. Typically, this is recommended when the nipple falls below the level of the crease/fold below the breast. That being said, if you are only seeking volume and the small degree of sagging is not a concern an implant alone may be adequate.
There is a procedure for every problem. To determine which technique is right for you, consult with a board certified plastic surgeon (ABPS). Patient should discuss their concerns with their physicians in order to make an educated decision.

Luis Suarez, MD · Answer

With the level of ptosis that you have the best type of technique to give you the best prolonged result would be an anchor lift. Otherwise, if you do limited incision like a lollipop or only around the areola, you may still present sagginess after the procedure, especially with implants, they will eventually weigh it down, so in this case a full lift would give you a great result!

Joel Patrick Maier, MD · Answer

Since you are happy with your breast shape and desire more volume, fat transfer would be a good option. My concern with implants would be development of  Snoopy Deformity (also known as the waterfall deformity). This is where the breast tissue can slide off the breast implant (anchored at your inframammary fold) causing a contour problem. Fat can be injected into the tissues and naturally enhance your size much like the gland engorgement during your cycle. I hope this helps. Thank you.

Ted Eisenberg, DO, FACOS, FAACS · Answer

I recommend an in person consultation with a plastic surgeon to discuss your goals and be measured. After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what size and style breast implant is right for them. Mildly Sagging Breasts: If your breasts are mildly droopy, a saline or silicone gel implant placed behind the pectoral muscle might help create the illusion of perkiness. That’s because as the implant fills out the top of the breast, it also fills out the bottom, making it look as if the nipple has moved higher. It hasn’t. You can always get a lift later if you feel you are not perky enough when fully settled and healed. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Daniel Barrett, MD · Answer

Dear Butterfly8923,

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

Harry T. Haramis, MD, FACS · Answer

You don’t have to get a lift - if you just want more volume and are ok with the low, natural look on your cycle, then implants alone should give results you seek.