Do I Need Lift with my Breast Augmentation? And with Saline or Silicone? (photo)

I've gone on four consultations and keep getting mixed reviews. 2 said no lift, one said Skin only lift and the other seemed unsure. Also I would prefer saline but because I am so thin, am I more likely to get rippling even with my amount of breast tissue? I want under muscle. Measurements chest to nipple =~22 centimeters Breast width 13-14 inches( I believe) I am 5"4 109lbs Age: 25 My nipple is above breast fold but I have droppiness due to breast feeding. I am a b/c Wanting a 32 DD

Doctor Answers 14

Sagging breasts need to be corrected before they are enlarged with implants

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You definitely need breast lift.  Implants can be saline or silicone behind your muscles or silicone in front of your muscles.  

Size is your option and your surgeon's judgement.

Good luck

Dallas Plastic Surgeon
5.0 out of 5 stars 24 reviews

Do I Need Lift with my Breast Augmentation? And with Saline or Silicone?

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     Rippling is generally considered better with silicone than saline, but rippling can occur with silicone as well.  You could also consider form stable implants, which would have less rippling.  You have low set breasts, which makes the droop appear worse that what it is.  Due to the large size of implant you want, I would place the implant first and reassess your anatomy in 6 months to determine if a lift is necessary.  Find a plastic surgeon with ELITE credentials who performs hundreds of breast augmentations and breast lifts each year.  Look at the before and after photo galleries to determine who has the results you expect.  Sometimes breasts that do not appear correctable by implants alone can be corrected by implants alone.  Kenneth Hughes, MD Los Angeles, CA

Breast Lift with Augmentation- Saline and Silicone breast implants

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Severe breast sagging or ptosis requires an Inverted-T mastopxy or breast lift. Submuscular placement of the implants enables plastic surgeons to use Saline implants with nice result.

Sean Younai, MD, FACS
Beverly Hills Plastic Surgeon
4.4 out of 5 stars 51 reviews

Lift with Breast Augmentation? #breastimplants

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It really depends on the look you are going for. I would really need to see on physical exam what is going on. Even if the nipple position is at the breast crease you can have what is called pseudoptosis when the breast gland itself dips below the fold. Those patients generally need a lift to give the high tight rejuvenated breast that you most likely desire. I tend to do the lift if it is even in question because most patients are much happier. I feel silicone is a better implant for the patient with thin tissue such as what would be seen after breast feeding. It clearly gives a more natural feeling breast.

Richard J. Brown, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 54 reviews

Do I Need Lift with my Breast Augmentation? And with Saline or Silicone?

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Best to two stage your operation. Large implants first than secondary lifting at 4 to 6 months. But IN PERSON opinions are always best. 

Breast Augmentation

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }} you have lots of decisions to make.  First, Lift or no Lift?  I definitely think you need a lift.  You have too much laxity to your breast.  Some doctors will tell you to pick a large implant and that will fill the space but that will be a big mistake.  While your breasts may look good for 6 months the swelling will settle and your breast will sag even more than they do now.  So yes to the lift.  You look like you need a Vertical lift if not a mini Anchor.  Next issue is Sal vs Sil.  No right answer.  You are thin skinned so it will make a big difference.  You can consider an overfilled saline implant or even a "gummy bear" implant to reduce your rippling.  Finally, Above or Below the muscle.  I would go below as you are thin skinned and you want to at least avoid visibility of the implant on the top and in the cleavage area.  You will always have rippling along the armpit and side.  Finally the larger size you pick the worse all your problems will be as the weight of the implant will put pressure on your tissue over time.  I think a DD is TOO big for your tissue to handle over time.  Hope that helps

Rady Rahban, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 141 reviews

To Lift or not to Lift...that is the question.

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A small lift is not abad thing. The scars can heal surprisingly well and the end result fantastic. You can always get the implants first and see how you like it but I would not recommend that approach. Saline would be fine for you but would put them under the muscle and do a lift as well. Good luck. I think you will have excellent results if get the correct procedure.

Joshua B. Hyman, MD
New York Plastic Surgeon

You may need a lift

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I agree that a submuscular augmentation with a saline implant would be a good option for you. Large implants will fill out you skin however, the weight of the implant may cause the implant to drop out the bottem of the breast. "Botteming out" can be treated with a internal support system of allograft if it occurs.  I would also wait to see how you heal after the augmentation to decide of a lift is necessary. Scarring from mastopexy is unpredictable.

Ralph M. Rosato, MD
Vero Beach Plastic Surgeon

Lift with augmentation

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It looks like you have very loose skin and  more than likely would benefit from a lift and augmentation.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Do you need a breast lift

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The answer to your question has everything to do with your expectations.  If you want to correct the "droopiness" then a lift is a must.  If you want to end up with a more youthful breast shape, not just larger, then you must strongly consider the lift.  If you do not, then you will always be dissatisfied to a degree.  On the other hand, I do not believe the "no lift" surgeon was wrong.  Your nipples are above the fold, and the sternal notch to nipple is 22cm (borderline measurement).  The question is more about art than surgery.  Do not be afraid of the scars required for a lift.  After all my years, I know that if the breast shape is good, patients are happy.   A larger droopier breast without scars will not satisfy your aesthetic goals.  Also, have your surgeon remove some of your low and saggng breast tissue at the time of the lift to reduce the risk of ongoing sagging, and replace the volume with a slightly larger implant which will hold its position better than lower pole sagging breast tissue will over time.   Also, saline is a poor choice in a thin  woman such as you. 

David Marcus, MD
Santa Rosa Plastic Surgeon
4.9 out of 5 stars 34 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.