Ptosis of my breasts- Can I correct with a BA w/out a lift to achieve a natural shape and profile? (Photo)

I'm 24 years old, wear a 34C bra and have never experienced significant weight gain/loss or breastfed- I've had this sagginess of my breasts since they developed. I'm currently scheduled for a BA procedure to receive silicone gel implants, however, I'm concerned even with a sub-muscular placement the sagginess will not be corrected to a degree that I will be pleased with.

Doctor Answers 17

Ptosis and an Implant

I think you probably have an answer from the other surgeons who have responded.  If you add the weight of an implant to your breasts, the breast will hang lower, although it may also appear fuller and rounder.  You have a slightly long breast fold, and a low nipple position. If these are the concerns you wish to correct, you should consider a lift.  

Take a look at any one of the great breast augmentation results you will see on this web site and find a patient with a little mole or freckle on their chest or upper tummy.  After the implants, you will see that the overall breast moves lower in most every case.

Houston Plastic Surgeon
5.0 out of 5 stars 270 reviews

Ptosis of my breasts- Can I correct with a BA w/out a lift to achieve a natural shape and profile?

Thank you for your question 

Breast sagging that occurs with age, weight gaining or loss and pregnancy. This situation may cause aesthetic problems and lack of confidence. Breast lifting surgery is intended to correct sagging and providing a better position and firmness. Sagging can be fixed also by incisionless way of skin tightening, The Spider Web Aesthetics.  In the Spider Web Aesthetics, absorbable medical sutures are placed via very fine needles under the skin triggering the body itself to produce collagen and cell regeneration. The cell regeneration and collagen production results with tightening and regeneration of skin. The Spider Web Technique can also be combined with implants and autologous stem cell enriched fat transfer.


Bulent Cihantimur, MD
Turkey Plastic Surgeon
4.9 out of 5 stars 90 reviews

Ptosis of breasts

Hi, DDee17.  Thanks for your question and sharing your photos.  Based on your photos, you have grade II ptosis.  From your "desired photo," you want to have perkier, rounded breasts.  You will most likely need a small implants with mastopexy (lift) and liposuction of the subaxillary tissue.  Please visit with a board-certified plastic surgeon to be evaluated in person.  As you know, implants will give your volume/fullness; mastopexy will give you a perkier shape.  Best wishes.  - Dr. Kim

Sugene Kim, MD, FACS
Houston Plastic Surgeon
4.7 out of 5 stars 76 reviews

BA or lift alone?

You will likely benefit from a lift for the best overall shape; that being said if the scars are too much of a trade off for you than an augmentation may achieve your goal, at the cost of a somewhat less ideal shape. Definitely discuss your concerns with your plastic surgeon. 

I hope this helps!

Bryan Correa, MD
Houston Plastic Surgeon
5.0 out of 5 stars 15 reviews

Is a lift needed?

Dear DDee17:

Thank you for your photos.  Based on your photos alone, it appears, as you have correctly described, you have significant ptosis (sagging).   A breast lift will be needed with your augmentation to achieve a better result.  If you opt for a breast augmentation alone, you will have larger saggier breasts.  Please visit with a board certified plastic surgeon to learn more about your options.  Best wishes,

Dr. Basu
Houston, TX

C. Bob Basu, MD, FACS
Houston Plastic Surgeon
4.7 out of 5 stars 209 reviews

Ptosis of breasts

Hi DDee,
You do need a lift along with a BA to achieve normal youthful looking breasts. Implant s alone would only make you look larger and would increase the droop that you already have. Although you will have more scars with the  lift , it is always important to understand that the creation of the proper form is most important  to achieve at the initial  operation. There are many wasy to reduce scarring , but if the proper form is not achieved you will never have natural looking breasts.
Hope this helps,
Dr. Rodgers

Christine Rodgers, MD
Denver Plastic Surgeon
4.9 out of 5 stars 89 reviews

Ptosis of my breasts- Can I correct with a BA w/out a lift to achieve a natural shape and profile?

Thank you for the question and pictures. As you state, your pictures demonstrate breast ptosis. You will benefit from breast augmentation/lifting surgery;  Breast augmentation law will not suffice when it comes to achieving an  aesthetically pleasing outcome. Some variety of vertical mastopexy and/or full mastopexy surgery will likely be necessary. 

Breast lifting surgery is more complicated than either one of the procedures done separately. On the one hand, breast augmentation surgery is expanding the breast skin “envelope” while breast lifting is (by definition) tightening up the breast skin envelope. These 2 forces are counteracting each other. Therefore, it becomes important to remove the appropriate amount of breast skin and to use the appropriate size/profile of breast implants to balance these 2 forces appropriately and to allow for achievement of the patient's goals while minimizing risks of complications.

Again, despite these efforts, breast implant and/or tissue/skin complications may arise causing minor or significant complications.
Generally speaking, it is difficult to achieve the “perfect” result with breast augmentation/lifting surgery, despite best efforts. Patients should be aware of the complexity of this combination procedure, achieve REALISTIC EXPECTATIONS prior to proceeding, and understand that additional surgery ( along with the additional recovery time, stress, expenses etc) may be necessary in the short or long-term. Patients should understand that the results of the procedure will not necessarily match aesthetically the results of patients who have undergone breast augmentation surgery only.

For example, some patients who wish to maintain long-term superior pole volume/"roundness" may find that this result is not achieved after the initial breast augmentation/lifting operation. An additional operation, possibly involving capsulorrhaphy, may be necessary to achieve the patient's longer-term goals ( with superior pole volume/roundness). It is helpful if patients understand that this breast implant capsule used to provide the support for the breast implant is not present during the initial breast augmentation/lifting operation. The capsule (layer of scar tissue) forms around the breast implant and may be a good source of supportive tissue during revisionary breast surgery, Including correction of breast implant displacement/malposition problems ( such as bottoming out, symmastia, lateral displacement etc).

Potential risks associated with breast augmentation/lifting surgery include infection, bleeding, incision line healing problems, loss/change of nipple/areola complex sensation, and blood flow related issues to causing skin or tissue necrosis. Poor scarring, pigment changes, areola/nipple asymmetry etc. are also potential problems. Again, patients may experience implant related problems such as encapsulation, leakage, displacement problems ( too high, bottoming out, lateral displacement, asymmetric positioning etc.), rippling/palpability of breast implants etc. Patients may also be dissatisfied with breast size, shape, and/or how the breast implants and overlying breast tissues “interface” with one another. Occasionally, a breast implant may even have to be removed and the patient will generally be “implant free” for several months at least. Obviously, this situation can be quite physically, emotionally, and psychosocially stressful to the patient involved.

Given the complexity of the combination breast augmentation/lifting operation and the greater risk of revisionary breast surgery needed, there are good plastic surgeons who will insist on doing the procedures separately.

For me, if I see a patient who needs a great degree of lifting, who has lost a lot of skin elasticity, or whose goal is a very large augmentation then I think it is best to do the procedures in 2 stages (in order to avoid serious complications). However, doing the procedure in one stage does increase the risks of complications in general and the potential need for further surgery. This increased risk must be weighed against the practical benefits of a single stage procedure (which most patients would prefer).
Conversely, if I see a patient who requires minimal to moderate lifting along with a small to moderate size augmentation (and has good skin quality), then doing the procedure one stage is much safer. Nevertheless, the potential risks are greater with a 1 stage procedure and the patient does have a higher likelihood of needing revisionary surgery.

Having discussed some of the downsides and potential risks/complications associated with breast augmentation/lifting surgery, most patients (If properly selected and who are doing the operations at the right time of their lives psychosocially) accept the scars associated with breast augmentation/breast lifting surgery as long as they are happy with the improvement in contour, size, and symmetry.

I hope that this summary of SOME of the issues surrounding breast augmentation/lifting surgery is helpful to you and other women considering this procedure in the future. Also, given her young age, I would suggest that you TIME the procedures carefully in relation to your life circumstances ( such as relationships, pregnancies…).
Obviously, much to consider… The attached link may also be helpful.
Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,488 reviews

Is a #BreastLift Needed?

There is no question that you need a lift. You breasts are already lower than ideal with some "sag" to your appearance. With the goal photo you posted, you need to have tissue removed, skin tightened and an implant to restore the upper pole volume. Even without that photo, you need a lift with an implant. Get a second opinion as you are headed for a second operation with this plan.

Best of luck,
Dr. Marin

Vincent P. Marin, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 46 reviews

Ptosis of my breasts- Can I correct with a BA w/out a lift to achieve a natural shape and profile?

Your wish photo is a model with very little breast tissue who never had droop and most of her volume is from implants. That is not your situation. You can get a nice result with implants and a better one with a lift and implants that is closer to your goal.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 27 reviews


An augmentation alone will not lift your breasts and nipples, but will give you fuller breasts. If you are OK with the location of your nipples, just have an augmentation. For fuller and perkier breasts, you will also need a lift.

Connie Hiers, MD
San Antonio Plastic Surgeon
4.6 out of 5 stars 13 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.