Considering Implants, but What if Skin on Bottom of Breast is Tight?

I'm considering breast implants with possible lift,I had my consultation the other day, during the physical exam my surgeon mentioned that skin at the bottom of my breast is too tight for a lift, how will this tight skin effect my implants if i dont get a lift? will my breast be mis-shapen? he also couldn't tell me how big i would be able to go, is that normal?

Doctor Answers 9

Good candidate for lift


You are a good candidate for a lift, if you are happy with the size of your breast, when filling a bra cup, then you only need a lift, if you want your breast to be bigger then adding an implant will give you the volume you want.

If you have a breast augmentation without a lift, most likely your breast will be too low, and they will get worse with time.

I recommend you to obtain a second opinion consultation, remember being board certified by the American Board of Plastic surgery ( the only board in plastic surgery recognized by the american Board of Medical Specialties) will assure you of the proper training of your surgeon.

Good Luck

Kansas City Plastic Surgeon
5.0 out of 5 stars 29 reviews

A Lift for Sure

Dear Siennamarie,

You are a prime candidate for a breast lift by any technique.  If you wanted larger breasts as well, then you could add implants.  An augmentation without a lift will not age well with your breast shape.  Good luck!

Kenneth R. Francis, MD, FACS
Manhattan Plastic Surgeon
4.6 out of 5 stars 48 reviews

LIft and/or implants

WIthout a good exam it is difficult to tell you whether your lower breast pole is tight,. It usually stretches out a bit with implants.  On the other hand, you may be better off just having a lift.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Breast lift or not

In some instances the skin below the nipple and above the crease may be short as well as a tight. In these instances, a traditional lift may not be indicated. However, in your instance, it does not appear to be so. Placing implants without a lift will likely result in the implants falling to the sides of your chest.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 82 reviews

Skin tightness will relax after breast augmentation

Tightness in the lower part of the breast is a common finding in breast augmentation candidates. If the implant and procedure are planned well, the implant will settle in or 'drop' in the weeks following breast augmentation.

Addressing your photo specifically, your breasts are lax with the nipple positioned below the breast fold. Unless you consider a breast lift, matters could be made worse with the implant pressing the nipple further below the fold. This 'mature' look can be avoided by the breast lift. There is nothing in your photo to suggest that your skin is tight, and should be able to have a very full augmentation if you wish. It is probably best to keep looking for a surgeon in your area.

Best of luck,


Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 43 reviews

Minimal scar breast lift and implants will work.


1)  There are women with tight skin on the undersurface of their breasts.  These are called tubular breasts.  But from your picture, I would say you don't have this problem.

2)  You look like a good candidate for a "doughnut" breast lift (circular scars around nipples), and moderate size implants.

3)  Make sure your plastic surgeon knows exactly the look you want (pictures).

4)  We use sterile, disposable implant SIZERS during surgery to see exactly the best size for you, before we open the real implants.  This takes all the guess work out.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
4.8 out of 5 stars 9 reviews

Breast Lift?

I agree that there must have been some miscommunication between you and the doctor.  You look like a perfect candidate for a lift, and would probably be unhappy with just an augmentation as time goes on.

Christopher V. Pelletiere, MD
Barrington Plastic Surgeon
4.8 out of 5 stars 75 reviews

Breast Lift +/- Augmentation

I agree that unless you have some sort of scarring on the undersurface of your breast the skin there should not be so tight as to preclude a lift being performed.  It certainly apperars that you need a lift and would probably be unhappy with an augmentation alone.

John Whitt, MD (retired)
Louisville Plastic Surgeon
5.0 out of 5 stars 2 reviews

Breast Lift VS Breast Lift with Augmentation (Implants)

I have never heard nor believe that skin on the bottom of breast being  "too tight for a lift" except in burn patients .In reviewing your question and your photo, I am convinced that there must have been a miscommunication between you and your surgeon and suggest you may want a second opinion.

I think a properly done Breast Lift (Mastopexy) especially a Short Scar Technique (Hall Findlay) would be your best option. It would reduce your large areolas and give you long-lasting perky breasts. I do not think you need breast implants and above all, if you want the worst results, then have someone put breast implants in already sagging breasts.

See at least one if not more Plastic surgeons before you make up your mind.

Dr. Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon
4.9 out of 5 stars 109 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.