Do I need a lift? (Photo)

Question

I'm 5'5 & 107lbs size 34b. I had an online consultation for a Breast Augmentation and I was told I need a lift. I'm looking to get high profile silicone implants under the muscle. Do I really need a lift?

Keshav Magge, MD · Answer

Hi- thank you for your question.  Based on your photos you definitely need a lift.  Your breast tissue is drooping and nipples are at about the crease level.  If you do implants only, it may create a ball in a sock look (implants up high, with the tissue hanging low).  Best to speak to a board certified plastic surgeon.  All the best,

Moises Salama, MD · Answer

Thanks for your question. From your pictures, you seem to be a good candidate for a breast lift with implants. I recommend scheduling a consult with a board certified plastic surgeon that has extensive experience with breast procedures and clean credentials. Hope this helps. Take care, Moises Salama MD, Board Certified Plastic Surgeon

Daniel Barrett, MD · Answer

Dear Thoughtful534297,
based on your photos, it looks like you would need a lift. My preferred lift is a lollipop lift when a periareolar won't do (ie greater than 2cm lift required). The lollipop technique was created by a Canadian plastic surgeon named Elizabeth Hall-Findley and treats the breast as a three dimensional structure instead of two dimensions (anchor - lift). Most importantly it does not require the horizontal component scars that the anchor-lift requires and breasts appear much more natural, lifted, and less boxy. Lastly, the lift lasts longer because the lollipop doesn't rely on the skin to hold the breast up, its actually breast tissue thats being brought together to support the breast and hence improves longevity. 
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Gianfranco Frojo, MD · Answer

From the images shown, it does appear that a bilateral breast lift would be beneficial to restore appropriate breast aesthetics.

Gary M. Horndeski, MD · Answer

Your breasts are too low on the chest wall for augmentation alone. You will need a breast lift using 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.

Best Wishes,

Gary Horndeski, M.D.

Ted Eisenberg, DO, FACOS, FAACS · Answer

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

Janet Woodyard, MD · Answer

Yes, you definitely need a lift, particularly with implants under the muscle which is the preferred position for the implants. Otherwise your breast tissue and nipples will sag off the implants if they are in the proper position. The trade off is the scars but it is well worth it. Best wishes.

Gerald Minniti, MD, FACS · Answer

Size, profile, and placement of a breast implant will not help women avoid a lift with the degree of ptosis your breasts exhibit.

Jeremy Bosworth, MD · Answer

It a little bit depends on your goals and what you are looking for but in my opinion a lift with implant is what would be best for you.An implant only, best case scenario the implant settles into your current breast shape and location and you have a more full version of the breasts you currently have, with nipples sitting on lower part of breast. That being said, the implant adds weight and can exacerbate the effects of gravity over time. Not as good of situation is that the implant is placed and does not settle into the breast shape and you get a waterfall deformity where it looks like the breast is falling off of the implant.Lift and implant will allow for the volume you desire as well as putting the nipple over the most projecting part of the breast, remove the extra/stretched skin, and give a much more youthful look. Although it is a trade off for scars, the end result will be a much nicer look and the scars are completely concealed by any bathing suit/ bra/ garment!

Maryam Zamani (Saheb-Al-Zamani), MD · Answer

Hi @Thoughtful534297,
I understand the hesitation in considering a breast lift and the additional scars in comparison to breast augmentation with implants alone. Having said that, I think it is important to consider the end-goal you have in mind-- if you desire higher, lifted, and more youthful breasts then I would recommend a vertical lift with the implants. You appear to have a long lean torso and your breasts have a low footprint (meaning the take off of your breast tissue is lower on the chest wall). When implants are placed under the muscle, they tend to remain quite high on the chest wall. What can happen is that there can be a disconnect between the implants sitting high and the breast tissue naturally sitting lower called "waterfall deformity"). The lift will elevate your breast tissue so that it can be centered on the implant and achieve a cohesive full and lifted appearance. With great surgical technique and judicious use of post-surgical care, scars can fade well over time and become inconspicuous. 
Dr. Zamani

Do I need a lift? (Photo)

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