Lift with breast augmentation? (Photo)

I'm considering breast implants to fill upper poles of breasts after weight loss. I'd really prefer not to have all the scarring involved with a lift. Would I be able to get a good result with implants only or would a lift be needed?

Doctor Answers 15

Trying to avoid lift scars

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When there is breast ptosis (sagging) present there are 4 basic surgical options:

  1. Breast lift alone
  2. Breast lift with small implant
  3. Breast lift first followed by large implant (2 separate procedures)
  4. Breast implants alone

In the photographs submitted, the breasts are equal in size and shape and mammary ptosis is present (the nipples are positioned above the inframammary crease).  Of the 4 options presented, 3 of the 4 require a lift scar.  To avoid the lift scar, breast implants alone can be used and a reasonable result can be obtained.  I would recommend silicone implants ON TOP of the muscle with an incision in the crease under the breast.  This will avoid the lift scar and because of the droopiness, the scar in the crease under the breast will be hidden.  The silicone implant will fill up the loose skin and elevated the nipple about one inch, not as much as a formal lift, but no lift scar either.  If you are unhappy with the result, you can always return for a lift procedure later on.

Good Luck!

Omaha Plastic Surgeon
4.9 out of 5 stars 82 reviews

Breast Implants

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Based on your photos, you could get away with just implants.  Implants add volume and do not change the shape of the breast.  You can always have a lift at a later date, if needed.

Robert E. Zaworski, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 61 reviews

Lift with breast augmentation?

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Thank you for the question.  Based on your photographs, I think that you are starting at a good place and should have a very nice outcome with breast augmentation surgery. Ultimately, careful communication of your goals (in my practice I prefer the use of goal pictures, direct examination/communication in front of a full-length mirror, in bra sizers, and computer imaging) as well as careful measurements (dimensional planning) will be critical.

Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery ( regarding breast implant size/profile selection) is:

1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work.

2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals. 

In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. For example, I have found that the use of words such as “very natural” etc means different things to different people and therefore prove unhelpful.

Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice.

3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery, after the use of temporary intraoperative sizers.

I hope this (and the attached link, dedicated to breast augmentation surgery concerns) helps. Best wishes for an outcome that you will be very pleased with.

Breast implants

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From the pictures you posted, it appears you would get a good result from breast implants alone. The surgery should also help give you upper pole fullness. To see pictures of women similar to you who only had breast implants alone, click on the link below. 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."

Ted Eisenberg, DO, FACOS
Philadelphia Plastic Surgeon
4.9 out of 5 stars 85 reviews

Implants alone for now

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You have mild sagging and using high profile implants can give you better shape and larger breast. I would recommend implants first and consider lift after few years. 

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.7 out of 5 stars 152 reviews

Lift with breast augmentation

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An implant alone with no breast lift will make you fuller, but in time, if placed on top of the muscle, may accelerate the further sagging of your breast. I do think you would have a natural appearance to the breast with an implant alone, but it will not be round nor higher on your rib cage without a lift.

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.8 out of 5 stars 27 reviews

Lift with breast augmentation?

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Based on your photo you may not need a lift and a dual pane breast augmentation with implants under the muscle may be all that you need. An in person exam is necessary for proper recommendation. Please read below:

Breast lift with implant

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Hello and thank you for your question.  The best advice you can receive is from an in-person consultation.  With that being said, based on your photographs, the best shape and contour could be achieved with an implant and a breast lift. Without a lift in addition to the implant, this will not have a natural shape.  A breast lift with an implant can result in a very nice shape if good technique is used.  The size, profile, and shape of the implant is based on your desired breast size/shape, your chest wall measurements, and soft tissue quality.  This decision should be based on a detailed discussion with equal input from both you and your surgeon.   Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.   The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 173 reviews

Lift with breast augmentation

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The "by the book" answer is that you would need a lift to give an ideal result.  However, every woman has her own idea of an ideal result and it is our job as surgeons to help you understand what needs to be done in order to get you your ideal look. Some women in my practice choose to have a more ptotic (naturally droopy) look by doing augmentation only and not the lift.  You can look at my before and after photos here on realself and see some examples of that.  I would recommend you find a board certified plastic surgeon you feel comfortable with.  Then she can help you decide whether or not a lift is best for you.  I often have my patients bring photographs of what they would like their breasts to look like.  If the photos you bring are all perky breasts with no ptosis then I'll tell you you need a lift to achieve your goal.  If you bring photos with ptosis in the after results then perhaps an augmentation with no lift is an option.  In most cases the trade off of a scar is worth it to achieve the look you desire.  Best wishes! 

Maida Parkins, MD
Milwaukee Plastic Surgeon
5.0 out of 5 stars 40 reviews

Lift with augmentation?

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Thank you for your question, and the pictures.

If you only wanted a smaller implant to fill out the upper poles, you would likely need an implant to help get the areaolas into the proper position (otherwise they would be pointing downward and that wouldn't look right).  If you were to go with a larger, shaped implant, you may be able to only have an augmentation without a lift.  Of course, this is all based on the photos alone.  An in-person consultation would be necessary to make actual recommendations.  I recommend you consult with several local/regional plastic surgeons to discuss your options.


Dr. Michael Epstein

MAE Plastic Surgery

Northbrook, IL

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.