Do I need a lift and implants or just a boob job? (Photo)

Thanks for your question, which is a good one. Based on your photo, breast implants alone would provide a fuller and more lifted appearance. Your nipples are in a good position relative to your breast volume, so you would not necessarily require a lift as well. However, you do have an element of asymmetry and a small uplift procedure, in addition to implants, could be performed to correct this. You could consider 3D simulation to give you an idea of post-op appearances with different sized implants with and without a lift.

During the aging process, the breast tissue sags and deflates resulting in loss of volume in the upper part of the breast, descent of tissue into the lower part of the breast with concomitant lowering of the nipples. A breast lift (mastopexy) re-distributes the sagged breast tissue and is used to reposition the nipple back into a higher (more youthful) position. It does not provide much volume restoration to the upper part of the breast. Breast implants are used to make breasts bigger and/or restore volume to the upper part of the breast. It does not significantly affect the position of the nipples. From a plastic surgeon's point, the most important information to ascertain from the patient is what bothers them most: the size and/or shape of the breast (here, an implant alone may suffice), the position of the nipple ( here, a breast lift alone may suffice) or both size of the breast and position of the nipple (here an implant and breast lift, so called augmentation-mastopexy, would be needed).In the photos provided there is deflation of the upper parts of the breasts. The left nipple is slightly lower than the high, however a comprehensive clinical examination with breast measurements would be needed to confirm this and aid in discussion regarding best treatment for what you want to achieve.

It is difficult to say without a side photo. If your nipples are located below your breast fold, then a lift would be recommended. The lift could also improve symmetry, reshaping the saggier breast to better match the perkiness of the less saggy one. Breast implants would only be necessary if you’d like to increase their size.

Hello,Firstly, if you want a fuller appearance in your breast area and your own breast tissue is insufficient, implants and breast lift are necessary. Asymmetry in your breasts can also be corrected during the lift.If you are satisfied with the size of your breasts but want them to appear more lifted, a breast lift alone will suffice. During the lift, we need to remove tissue from your left breast to correct asymmetry. Therefore, if you only want a lift, your breasts will be the same volume as your right breast. I hope this has been helpful.

Aside from wishing to have a fuller chest, you have mentioned two issues that are bothersome to you. The first is a lack of symmetry, and the second is the sagging of the breasts. Both of these concerns are best addressed with a breast lift, and here is why. Volume asymmetry can be addressed by different size implants, but the position of the areola can only be changed with a lift. Without a breast lift, the areolas will not be positioned at the same level, even if the breast volume is the same. Moreover, the breast sagging will not be eliminated without a lift. In fact, if you go so large with an implant as to not need a lift, the now much heavier breasts would sag faster. A breast lift, with implants, is most likely to achieve your goals of symmetry, firmer breasts, and additional volume.

Dr. B.

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

Your breasts are asymmetrical and low on the chest wall. The technique I recommend is The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. Later, fat transfers or small implants can be placed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Hi, thanks for your question, I think this is a question of weighing up the pro's and cons. You have slight asymmetry seemingly with one breast a bit more elongated than the other and I wouldn't say that the right breast needs an uplift and the left breast is on the margins of needing this in my view. Remember also that breast uplift commits you scar around nipple pad and sometimes below it. Doing implant and uplift at the same time has some other potential downsides because the implant puts strain on the scars so wound healing and scar stretch is much more likely and this makes results less easy to predict. My approach would be to go with implants only and see how everything settles and then 6-12 months consider whether you want to have an uplift on one side or other or both.

On your smaller side, and augmentation would work well. On the sagging side, you will need a lift. I would suggest placing the implants behind the muscle for better support, more upper breast fullness, and hiding the implant edge.