Can Implants with a Nipple Lift Work? (photo)

I have been researching for about 4 months now and I have been on two consultations. I am 29 with three children and my breast have lost any firmness they had previously. They also "sag". Currently they are at a small C, and I would like them to be the size during my breast feeding days (A nice D). The first consultation the doctor recommended a lift "for now" with possible implants later. The second doctor I went to recommended 600cc silicone implant with a small nipple lift.

Doctor Answers 17

No question that you need a vertical mastopexy and breast augmentation

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You will need more than just a "nipple lift".  For you to get the proper result you will need at a minimum a vertical mastopexy with a implant size wide enough to cover your breast base diameter.  You appear to have a relatively wide breast and will need an implant with a base diameter in teh 14.5 to 15 cm range irreguardless of volume.  Women with a broad chest will literally eat an implant alive so a 600 cc implant while large on some women may be appropriate for your size and anatomic features. 

Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

Implants and "nipple lift" will NOT work with your anatomy!

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I must respectfully disagree with both of my colleagues; I think both approaches are not optimal for you (and your anatomy), but one approach is totally wrong. Though most plastic surgeons on RealSelf seem to disagree on how many cc equals one bra cup size, I believe that it takes about 250cc to equal about one cup size; therefore 600cc would add just under 2 1/2 cups to your present size. However, your "present size" is not the bra size you are wearing, since you have mostly loose skin and deflated breasts with only a moderate amount of your own breast tissue. You will also lose about an ounce or ounce and a half of skin from each breast in performing the (proper) full Wise-pattern (anchor) breast lift, so you probably have closer to B-cup actual breast volume. 600cc would make you a DD in many manufacturer's brassieres. I think this is too large for you, but probably by not too much.

Your degree of ptosis (breast sag or droop) appears to be severe enough that a periareolar (donut or Benelli) lift will be both inadequate and yield unsatisfactory scarring. Trying to achieve the degree of lift necessary with your anatomy by suturing a small-circumference circle (your areola size) to a much larger-circumference ellipse (to get the lift and skin-tightening required) will--by mathematical necessity--create puckering and pleating, as well as a scalloped irregular scar! Plus, it will not lift enough to solve your ptosis. Re-operation will be required.

Doing a full breast lift is an appropriate option for your degree of ptosis, but I believe a full Wise (anchor-pattern) mastopexy will be optimal as this design tightens skin in both horizontal and vertical dimensions, yielding the best aesthetic result. A vertical or lollipop lift only tightens in one dimension, and the scars are often poor as well!

Performing only a lift--as long as it is a proper "full" breast lift--is the best way to achieve a youthful perky breast shape. Nothing wrong with this approach . . . except that you want to be bigger than you are, and implants will be necessary to achieve this. Some surgeons have not mastered the technique of simultaneous breast lift plus augmentation, have had poor(er) results with this approach, or simply feel that two operations yield better overall results than a single combined procedure, and therefore recommend two procedures, as your second consultant has done.

Again, nothing wrong with this approach, but in my opinion it is unnecessary. A good many ABPS-certified plastic surgeons with extensive experience in breast surgery will safely and expertly combine both full breast lift with simultaneous placement of implants (probably about 400-500cc or so, but examination would be necessary), yielding wonderful results with one operation, recovery, time off, and (truly minimal) set of risks. This would be my personal recommendation, and it would be the least costly as well.

Though no surgeon can promise or guarantee "no re-operations necessary," I have found re-dos or touch-up surgery to be unnecessary in the vast majority of my patients undergoing this procedure. For several examples of my patients undergoing this exact procedure (full lift plus augmentation) click on the web reference link below.

I think you need a few more opinions. Best wishes! Dr. Tholen

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews

Breast implant and full lift

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When women have significant breast ptosis (droop), the best plan involves both a breast implant and a full breast lift.  The two procedures can be performed at the same time, or can be split up into two procedures (ie. a lift, followed by an implant later, or vice versa).

Dennis Dass, MD
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 183 reviews

Are implants and a nipple lift the right choice?

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From your photos, it appears that you will benefit from a full lift with an implant.  A donut lift only moves the nipple/areola up about 2 cm so it won't address your drooping breast tissue.  There is no reason to stage your procedure unless you are not sure about getting implants because a lift alone will address the tissue, but most patients want fullness up top and that can only be achieved with an implant.  It sounds like you are doing great with research, but make sure you see another board certified plastic surgeon before you make your decision.  ac

Angela Champion, MD
Newport Beach Plastic Surgeon

Nipple lift with implants

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Your   breast  presents  the condition   of  breast  ptosis   III  grade ,    wich is  when  the  nipple   is  around 26 ;28   cm   of   distance ,     it  is   mandatory to    correct  the    position   of   this  nipple  to elevate  it  to  20 cm   with a  complete   breast  lift ,and  augmentation ,   there  are different  patterns  of    scars   for the  lifting   depending on the   doctor    you choose .   Iwould recomend a   j  incision  combined   with a submuscle   implant   of   300   cc  or  325  cc of    volume of   implant


Cynthia Disla, MD
Dominican Republic Plastic Surgeon

Implants with a nipple lift is unlikely to work for you

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Your photos suggest that there is too much stretched out skin and the nipple sits too low for an around the nipple lift.  A formal breast lift with an implant is more likely to produce a good cosmetic result and achieve your goals. Best of luck.

Michael S. Hopkins, MD (retired)
Albuquerque Plastic Surgeon

Breast augmentation and lift

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You should seek out more consultations as you need not only a breast implant, but also a full lift. There is no way that you will achieve a reasonable result with anything else. Ensure you are seeing a board certified plastic surgeon as there are many physicians practicing cosmetic surgery without much training. 

Best of luck!

Vincent P. Marin, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 52 reviews

Can Implants with a Nipple Lift Work?

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Thanks for the good quality photos. I do a lot of combined augmentation and periareolar lift procedures  and very nice results can be obtained in the carefully chosen patient. I do not think you will do well, however, with that lift. Based on your photos, I would give you the same advice one of your consultants did, that is do a full breast lift and then later if you feel you need more volume an augmentation can be done. I find at least half of the patients decide an augmentation is not necessary after seeing how good they look with a well done lift.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 29 reviews

Nipple lift and implants

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based on the photos you provided I think you would benefit from more of a lift, ie one that leaves a scar like a lollipop. I think a 600 cc implant is a big implant and prone to give you malposition issues. I would recommend a more proper lift to position the nipple complex better with an implant appropriately sized for the diameter of your breast. I would perform the procedure in one surgery not staged as I do not believe there is any benefit. I hope that helps.

Rick Rosen, MD
Norwalk Plastic Surgeon
4.8 out of 5 stars 28 reviews

How Much lift Does A "Nipple Lift " Provide?

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Dear Mrs. Williams, Thank you for your question and photographs.  A nipple lift, also referred to as a periareolar lift, Bennelli lift. or mini lift of the breast will raise your nipple about 2-3 cm.  A big implant will give a rise in nipple position 1- 2 cm.  I do not think a 600 cc implant with a small lift is likely to look good on you.  The nipple will still be too low, the size of the areola is likely to widden from the weight of the implant and your scar is likely to stretch from the implant.   Your first plastic surgeons advise is far more likely to give you a good long term result.   Good luck!

Mary Lee Peters, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 117 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.