Saggy Breasts: Can I Get Implants Without a Lift? (Photo)

Thank you for your question. Based on your photos it does appear that you would benefit from a lift. In general, if your nipple is located at or above the crease below your breast then a lift is typically not needed. In addition to nipple position, measurements are also used to determine when to add a lift. It's important to know the breast implants do not lift the nipple to any significant degree, so you can't escape the lift by using a breast implant. Breast sagging is a spectrum and women with mild/moderate sagging can sometimes go either way. In this situation, I typically recommend breast augmentation as an initial procedure, waiting six months, and then only performing a breast lift if it is truly needed. When considering breast augmentation make sure you find a board certified plastic surgeon who will take the time to answer all of your questions and explain all of your options, so that you can decide which procedures are right for you. 

Thank you for your question and photographs.  Based on your photos I would recommend against a breast augmentation alone, particularly with a trans-umbilical approach.  You have evidence of significant sagging (ptosis) and will definitely need a lift to get an optimal result.  A large implant will only add unnecessary weight that will cause further tissue stretch and worsen your ptosis.  Patients sometimes lose sight of the desired goal, which is a well shaped breast with fullness in the upper pole.  Some patients will need a lift and the subsequent scars to get the desired shape and contour.  In most patients the scars will fade with time.  I would recommend that you get a second opinion from a board certified plastic surgeon.  Good luck. 

A common misconception is that you can lift ptotic breast by going with a larger implant. No one want additional scars on their breasts, however if you need a lift, you need a lift. It just doen't make sense that if your breasts are already sagging placing a large heavy implant will cure that condition over time. Remember gravity is always working against us. As a surgeon who specializes in revisionary breast surgery, I will often see the same scenario over and over again. "My breasts were drooping, my Dr. told me that I don't need a lift, just get bigger implants" 6 months later, "my breasts are much larger than i wanted and they are even more droppy". Be careful of the surgeon who tells you that you should just put in larger implants and you don't need a lift. Many of the TUBA surgeons in this community are NOT plast surgeons, but are "facial" plastic surgeons that do breast surgery, and they have not been proprly trained in doing a skillful lift (mastopexy). Remember, it's your body, do your research.

If you love your body, and want it to be beautiful, then focus upon results rather than procedures.  The question is, how to best go from what you have to the breasts you want?  Proportionate in size, nicely shaped, natural texture, symmetry between right and left, no visible scars or signs of implant(s), normal sensation, accommodating to your lifestyle.

     I would save yourself a headache in the future and get breast augmentation and a vertical lift.Kenneth Hughes, MDLos Angeles, CA

Thank you for your question.  Going with large implants in a situation like your is not what I would advise.  They will only cause the breasts to sag even more. You need a lift along with medium size implants. Saline are fine.  Newer lift techniques result in excellent results and very favorable scarring.  I would perform the lollipop lift and place saline implants around 300 cc's under the muscle.  

It sounds like you are getting some bad advice in my opinion. You have significant breast ptosis that will require a breast lift to correct. Trying to correct this with an implant alone is wishful thinking, unless your physical exam and measurements are much different than what your photos would suggest. And it really irritates me when I hear that surgeons suggest placing oversized implants to try to induce more of a lift. This is really bad advice. The reason that your skin envelope is "droopy" is because it is thin and weak. It won't effectively hold up a conservative sized implant, but certainly will not do well with a large implant. You will have much better long term results if you use an appropriate sized implant along with a breast lift. There also is little good to be said about the TUBA technique for breast implant placement. I would rethink your options and have another consultation before jumping into a surgical procedure that you may regret.

Hello dear, thank you for your question and pictures.
As i can see you'll need a breast lift in combination with your implants, you already have ptosis and independent  on the size of the implants with time the skin will have more laxity and the bigger the implantes faster this will happen. You need to discuss the possibility of this happening with your surgeon and he will guide you to what's best for you. Good luck.

and I can't think having a big implant will create an aesthetically pleasing breast.  Throw in the TUBA technique and now it really gets challenging.  You really need a lift and the scars that come with it.  Some doctors claim they can do it with minimal scarring (no vertical scar) and if you choose that path, make sure you know what happens if it doesn't look like what you thought you would get.

You will regret getting implants with no lift. Your nipples/areolas are below the fold of your breasts. Putting implants in without a lift, even large ones, will just give you bigger saggy breasts. You really need to accept that you need a lift. Since it looks like the distance between your nipple and the fold under your breast is short, a vertical lift would most likely be best. This brings skin in from the sides and lengthens that distance so your nipples can be raised up to the center of your breast mound where they belong.