Do I need a lift with B/A surgery? (photo)

Currently have 14 y/o saline smooth sub muscular implants. No rippling but loss of upper pole fullness and would like to have cleavage without wearing a push up bra! Considering switching to a larger silicone gel implant., do I need a lift as well to get the fullness I want or will a high profile implant give me the look I want? Thank u

Doctor Answers 9

Breast Augmentation Revision

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I would consider a breast lift to give you the upper pole fullness and cleavage you desire.  Also, since you will be in the operating room, I would consider exchanging your implants for a new, higher profile, latest generation implant.  I believe that exchanging your implants for a larger implant without a lift will not achieve your goals.

LIft with change of implants

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You will never be able to get the cleavage it sounds like you want without a push up bra.  A larger implant will make you a little rounder but not necessarily higher. From the photo you posted I do not think you would need a lift. 

Robert Kearney, MD, FACS
La Jolla Plastic Surgeon
5.0 out of 5 stars 32 reviews

Breast lift and augmentation

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Hi.  I think changing your implants to larger silicone ones will help in the upper pole to give you better shape and fullness.  Since this won't necessarily elevate your nipples, a breast lift could help that part.  You can have a minimal scar lift, with an incision around your areola, and this would provide better shape.  A full breast lift with the anchor scar may be a bit overkill, since your nipples may not be low enough to justify all of the scars.  It would be best to check with your plastic surgeon to have him/her give you a face-to-face evaluation and then present the options.  I would be happy to discuss it with you further if you have other questions.  Best of luck!

Jonathan Heistein, MD
Fort Worth Plastic Surgeon
4.7 out of 5 stars 29 reviews

Saine switch to gel

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Thank you for the question.

Saline implants can undergo bottoming out with time.  It is the very slow elongation of the distance between the nipple and the inframammary fold.  An assessment of this distance may influence what is needed.  It does not appear that you need a "lift".

If this distance is long, there are many ways to shorten it.  It can be as simple as deflating the implants in the PS office.  It takes about 5 minutes under local.  Following this you would need to wear a tight bra for a couple months followed by replacement with a high profile implant such as an Inspira SRX.  This results in tightening of the breast implant pocket without any additional incisions. 

If you are not able to have your implants deflated for a couple months (because of the obvious change it will make in your appearance) your surgeon can reduce the bottoming out at the time of your BA replacement surgery.

It is best to discuss these options in person with your brad certified PS.

All the best,

Scott K. M. Barr, MD, FRCSC 

Scott Barr, MD
Sudbury Plastic Surgeon

Larger breast implants alone or larger implants plus a breast lift?

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From your photo I would suggest that you consider a modestly larger implant without an uplift.  Your nipple areolar position is quite satisfactory and a larger implant will give you more fullness in the upper pole and some improvement in your cleavage.  Keep in mind however that there is a risk that the heavier weight of the implant will cause more relaxation and stretching of your tissue resulting in the same problem in the future.  If you would like to be larger and go with the bigger implant however if you are happy with your size the alternative would be a skin reduction procedure (the equivalent of an uplift) with surgical incision lines.  I would vote for the bigger implants however.  Best wishes,

Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery
Member, American Society for Aesthetic Plastic Surgery (ASAPS)
ABC-TV Extreme Makeover Surgeon
Beverly Hills, California

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 32 reviews

Do I need a lift with B/A surgery?

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As far as the type of fill in the implants, most saline patients do switch to silicone because of the more natural feel. Your nipples appear to be above the fold so no lift is necessary and it would be unrealistic to expect better cleavage without the assistance of a bra. Bigger implants will go lower (gravity) so be careful in that regard. But you are very asymmetric in volume so either different sized implants or a skin reduction on the larger side would help that. 

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 29 reviews

Do I need a lift with revisionary breast augmentation surgery?

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Thank you for the question and picture. You may wish to post additional photographs, frontal and side views, with your arms by your side for better evaluation.  Understanding that nothing replaces in person evaluation when it comes to providing you with good advice, it does not appear that breast lifting surgery will be necessary. 

My best advice: select your plastic surgeon carefully. Then, communicate your goals carefully as well. In our practice, this is best done with the help of goal photographs and computer imaging. In other words, carefully show your plastic surgeon the "look you want".

 You may find the attached link helpful to you as you learn more about this type of revisionary breast surgery. Best wishes for an outcome that you will be very pleased with.

Breast augmentation exchange and or lift

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Hello and thank you for the question and the photos. Based on this and your photos, I would recommend having the exchange to silicone alone. You do have some sagging but it is very mild. There is some sagging of the breast skin but the nipple position is normal and "points" forward.

The photo shows your nipple position is slightly uneven. As a general rule, breast implants IMPROVE size differences, but WORSEN shape / nipple position differences. The implants tend to magnify such discrepancies. You should know this moving forward. 

I would agree with the decision to chose a larger HIGH profile silicone implant. You can do the rice test to see how much bigger an implant you are considering. Add dry rice to a nylon stocking and add that to a non padded bra. Keep adjusting the additional amount of rice until you get to the size you are wanting. 1 ounce of rice = approximately 30  cc of added volume. 

I would consider also a textured implant if you are athletic or a runner. The textured type implant has less movement and downward migration that some runners / athletes experience. 

You should seek several consultations with board certified plastic surgeons before making any final decisions. 

As always, best to be healthy, no smoking and make sure any health conditions you have are managed by your primary care md. 

Best to you. 

Bennett Yang, MD
Rockville Plastic Surgeon
4.8 out of 5 stars 21 reviews

No lift needed

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It is very common to switch from saline to silicone implants.  The current silicone implants were not available until 2006, only saline implants were FDA approved from 1992-2006.  Many women are now swapping their older saline implants for silicone.  Saline implants wrinkle and ripple more than silicone and they feel more unnatural (like a water balloon) than the newer silicone implants.

When switching the type of implant, you can also change the size and style of the implant.  In this situation, the breast shape is nice and natural and the chest circumference is narrow.  I would suggest swapping for a larger silicone implant that is a high profile shape, a lift is not needed.  Please consult with a Board Certified Plastic Surgeon who performs breast implant surgery frequently for the best possible result.

Good Luck!

David Finkle, MD
Omaha Plastic Surgeon
4.9 out of 5 stars 82 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.