Just implants or do I need a Breast Lift? (photos)

Your nipples are at or slightly above your breast fold. I think you have more deflation than true sagging. I think a dual plane augmentation would give you a very nice result. Your breasts would not be super perky but you would not have the scars or cost of a lift. You could always have a lift in the future if you wanted a perkier look. Good luck.

Based on your photos, I would suggest a breast augmentation with a lift. I have included a video in hopes that it helps to answer some of your questions. Best of luck to you.

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 then get to choose what looks right for them. 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

Based on these photos, your nipples are bellow inframammary crease what means that you need a breast lift; vertical type (lollypop) breast lift and implant augmentation would be my suggestion. Good luck.

Good morning,
You are an excellent candidate for a submuscular augmentation with saline or silicone implants, depending on your preference. We would determine the exact size and profile when I measure your chest, we review photos together, and you have an opportunity to try on the implant sizers here in the office! I would also recommend a donut mastopexy because your nipples are a little low on your breasts, and they do not sit at quite the same level. A donut mastopexy would improve your symmetry and give you a better result!

The technique I recommend is 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 can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Dear Jovie35,
determining whether you need simply a breast augmentation versus a breast lift can be somewhat complicated. It depends on a number of factors including skin laxity and current nipple position. Generally speaking, if the nipples are lower than the inframammary line the patient will most likely need a breast lift. If the nipples are at or above the inframammary line we can generally get by with just a breast augmentation depending on the size of the implant the patient wants. I often still using implant when I perform a breast lift because it provides more upper breast fullness after the lift. To be sure a consultation with a board-certified plastic surgeon will help determine what the patient actually needs.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Measurements are needed to be sure, but just based on your photo, you still may need a lift. I would suggest placing the implants behind the muscle for better upper breast fullness and more coverage.

There are numerous options: implants alone, implants and a variation of a lift, implants and a crescent elevation of the nipple-areola, implants and a donut mastopexy without the incisions of a full lift, implants and a full lift. They each produce different degrees of cosmetic improvement.

Implants alone do not adequately lift the breast when there is significant sagging, no matter the size or the type, and will not produce a good cosmetic result in a patient who also needs some variation of a lift.

Keep in mind that following the advice from a surgeon on this or any other website who proposes to tell you exactly what to do without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of each operative procedure would not be in your best interest. I would suggest your plastic surgeon be certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with. If you live outside of the United States, the surgeon should ideally be a member of the International Society of Aesthetic Plastic Surgery (ISAPS). You should discuss your concerns with that surgeon in person and be very realistic about your potential cosmetic result.

Robert Singer, MD FACS

La Jolla, California

Greetings,
Without a consultation and an examination to determine crease levels, breast volumes, and degree of asymmetries, it is difficult to suggest the best of many options to improve your appearance. Your size objectives and tolerance for persistent unevenness must be assessed at your plastic surgeon's appointment. No option is perfect with more scarring with lift surgery and possibly less positional asymmetry with dual-plane submuscular enlargements
Best Regards,