Some plastic surgeons said I need a lift, while others think i can get away with just implants. What is your opinion? (Photos)

I am a 37 year old, 5'5" 100 pounds, mother of two. After breastfeeding, i had loss of volume and sagging. I want to return from my now deflated A/B cup, to my original C cup with minimal scars. I have visited 5 different plastic surgeons. One said i need a full anchor lift, another that he can lift it just from the areola, another that i will need a very large implant to avoid the lift, and the last one that i don't need a lift but a subfascial with a inframammary incision. What do you think?

Doctor Answers 24

Breast lift or implants only

Your dilemma is a very common one. And as you can see almost every plastic surgeon you see has a different opinion  I have been doing breast augmentation and lift surgery for 30 years and will give you the best opinion that I can based on photos only. . It appears that you do have breast ptosis or sagging. An easy way that you can test this yourself is to place a pencil at the bottom of your  breast on the fold. If you can hold the pencil in place without touching it just with the weight of your breast, you need a breast lift.  If you were to have large implants, in a year or less you would have large saggy breasts instead of small saggy breasts.  Your ideal combination is to have a breast augmentation with a lift.  To determine the type of lift you would need to have a consultation with a board-certified plastic surgeon experienced an augmentation and lift. Judging from your photos you would be a candidate in my practice for either Periareolar or lollipop lift 

Sacramento Plastic Surgeon
4.9 out of 5 stars 106 reviews

To lift or not to lift??

I'm afraid that if you go forward with just implants, your breasts will be larger, but still at the same level they are now. Most women do not like this look. And without structural support, the weight of the implants will eventually stretch your breast mound down further. You may have enough breast tissue there that once lifted high, they will actually be a C cup. Take a look at my gallery and see what can now be done without the extra cost, risks/complications and maintenance associated with breast implants. I'm sure you will find a woman with similar dimensions as yours. Attached is an example of a woman who desired a lift without implants and without a vertical scar. I hope this helps.

Best wishes and kind regards, 

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.7 out of 5 stars 208 reviews

5 different opinions and all of them are right!

Hello Joy,

The answer is that they are all right. 

Your breasts are sitting a bit low and you would benefit from a lift to improve the shape and this could be combined with implants if you wanted to be bigger.  However a lift with implants does create more scarring and carries extra complications.  

To avoid this, you could have implants alone, but the shape would not be as good.  You need to find a plastic surgeon who can show you photographs of the options so that you can make an informed decision as to what might be best for you.  Good luck.

Lift vs Lift with Implant

Hello and thank you for reaching out. From the photos you have provided my best guess without a physical exam would be that a mastopexy or lift would be needed for you to achieve the best results possible & to relocate the nipple to it's original placement. When breasts are lifted, you will lose one cup size, but can easily be replaced using a small implant. While augmentation could be an option, it may lower the breasts even more in the long run. Make a consultation with a board certified plastic surgeon so they can take a look and recommend what's best for your body type. Best Wishes. 

Breast Lift with Implants

Thank you for your question and for sharing appropriate pictures. You seem to be a good candidate for a breast lift with implants. This procedure will address any asymmetry and will reshape and add volume to your breasts. Many women who opt for only an implant hoping it will give them a lift are disappointed with the results. I recommend undergoing Vectra 3D Imaging to get an idea of your post procedural results and to "try on" different implants. Make sure you're working with a  board certified plastic surgeon with expertise in these areas. Breast of luck! 

Kevin Tehrani, MD, FACS
New York Plastic Surgeon
4.9 out of 5 stars 84 reviews

Lift or implant or both

A lift will leave a visible scar that of course improves with time. You have a significant difference between the right and left breast. Have your plastic surgeon show you photos of their patients with a lift and with implants alone. That should help u to make a decision. You can always have a lift if you augmentation does not improve you look enough for you.

Ralph M. Rosato, MD
Vero Beach Plastic Surgeon
5.0 out of 5 stars 7 reviews

Breast Implant Results Helped with Lift

Candidates for Breast Lift (#Mastopexy) surgery are women who have #saggingbreasts due to past pregnancies, genetics, or aging. Often times the sagging is too great to be treated by implants alone. Women with asymmetric or enlarged nipples or areolae (pigmented areas around nipples) also may be candidates for a breast lift or a modification of a lift. #Asymmetric breast can be adjusted by adding or removing volume.  One side can be tightened more or less than another.

Implants with no lift can usually be a mistake. Most breasts will look larger and droopier.  They will sag more and sooner because of the excess weight.  The shape will usually not be satisfactory. There will sometimes be a “Snoopy” breast or double bubble. If the nipple is in a fairly high position on the breast or “glandular” ptosis or drooping, an implant may be useful. The best thing would be to continue seeking out consultations with board certified plastic surgeons to see if you can get agreement with the results you are looking for and the procedure recommended by the surgeon. Good luck to you!

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 94 reviews

Breast Implants Alone or Breast Lift With Implants

Many woman have breasts that are a little droopy and have lost volume.  Most women I see in my practice want breasts with fullness at the top, nice cleavage, and nipples that are positioned well on their breasts.  Sometimes all that's needed is an implant.  However, when there is a lot of breast tissue that hangs down over the breast fold, some type of lift may be required.  There are three major types of lifts, each having its advantages and disadvantages.  Sometimes a periareolar lift ("donut" lift) will provide a nice result.  This type lift works well when just a little lift is needed.  I personally rarely use this lift because it really only provides a minimal lift, and I've seen a number of women who had that operation done somewhere else come to me because they were unhappy with their scars and overall result.  The "circumvertical" ("lollipop") lift can provide very nice results.  Of course the downside is primarily that now, compared to the periareolar lift, there is also a scar that extends down the lower central part of the breast.  The inverted-T ("anchor") lift also may provide terrific results.  I use both the circumvertical and inverted-T pattern lifts quite a bit in my practice.  When a woman has heaviness in the lower part of her breasts, that can often be removed using either of these two types of lifts, but I prefer the inverted-T pattern to do that.  Removing the lower heavy part of the breast can help create a very nice shape to the breast, and then the implant is placed to help add fullness toward the top of the breast.  

These are very difficult decisions for women to make.  No one walks into my office and says, "Kelly, go ahead and cut on my breasts, I don't care about the scars".  Of course scars matter.  But in the end, women want breast that look great and they want the results to last a long time.  It is my opinion that minimal incisions and minimal scars may not provide the best long-lasting results.  

No one on the internet can really answer the question you pose.  Looking at your pictures, I suspect you might achieve the best result with either a "lollipop" lift or an "anchor" lift with implants.  Your best bet really is to make sure that the surgeon you choose understands what you really want.  If you have done your homework and chosen a surgeon who does a lot of breast surgery, and the surgeon is highly recommended by friends and physicians, you are likely to achieve the look you want.  

Kelly R. Kunkel, MD
Fort Worth Plastic Surgeon
4.8 out of 5 stars 22 reviews

Breast Enhancement Options

In your case, you don't need an anchor inverted T incision. It's either only around your areola or in a lollipop formation. The lollipop will give the most control of the reshaping but if you're completely against it then a circumareolar (around the Nipple and areola) approach with a proper implant will be very satisfying. In your case, you need a lift to achieve nipple/areolar symmetry. 

Justin Yovino, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 80 reviews

Some plastic surgeons said I need a lift, while others think i can get away with just implants. What is your opinion?

Thank you for your question. As you can tell there many different answers to the question of whether to add a lift and which type of lift to use. In my office careful measurements and examination are used to decide whether to add a lift.

Find a plastic surgeon that you trust and takes the time to explain your anatomy and their thought process. If you are on the border, regarding whether you need a lift, you can make the decision process simple by separating the procedures. Step one, have a breast augmentation with a conservatively sized implant that fits your natural breast measurements and is not too large for your body. Wait six months and see what you think of your breasts. After six months, if you feel that you need a lift, then you can have a lift performed as a second stage. What's the downside of separating these procedures? Cost. It's more expensive to have two operations. What's the upside of two stages? If you are happy with your breast augmentation, you can possibly avoid a second procedure altogether.

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.