I Was Informed I Was Borderline in Need of a Lift What Do You Think? (photo)

I am 28 years old and have breast fed 2 children. I've lost 20 lbs in the past 4 months as well. I am currently 5'4 and 135lbs My consult Dr. informed me I was borderline in need of a lift. I am getting saline implants soon. Dr. stated that I can proceed with the implants and if a lift is needed in the future I can plan that in my future. Dr. stated he is pretty certain that I will not need a lift after implants, but it is possible. Not sure how I should go about this.

Doctor Answers 14

I Was Informed That I in Need a Lift. What Do U Think?

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In my opinion you need both a lift and a new doctor! I would not waste your time and money, only to get a lift later on. Many doctors don't like to do them and many women would rather avoid them but it really looks like it is needed...Your nipples are the lowest part of your breast and they sit on your tummy...That spells lift....

Phoenix Plastic Surgeon
4.7 out of 5 stars 48 reviews

I Was Informed I Was Borderline in Need of a Lift What Do You Think?

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 Thank you for the question and pictures.   Unfortunately, you will not end up with an aesthetically pleasing result if you undergo breast augmentation surgery only.

 If you were to undergo breast augmentation surgery only  I think that 2 types of “results” would be predictable:

1. You will end up with “big and low” breasts and unhappy with the aesthetic outcome etc.

2. You will end up with the breast implants sitting high on your chest wall with the breast tissue lower down,  again creating an aesthetically unpleasant outcome. You will find that you will continue to have breast skin sitting on top of upper abdominal wall skin, unless you lift the breasts.

For some patients the necessity of additional scars is a “dealbreaker” ; for these patients it is better to avoid breast surgery altogether.
 On the other hand, many 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. This acceptance of the scars is the essential “trade-off” associated with many of the procedures we do in the field of plastic surgery.

 I hope this, and the attached link, helps.

Considerations For Breast Augmentation vs. Breast Augmentation And Breast Lift

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Your photos are very helpful to answer your question. You have lost breast volume, your breasts droop, the nipples are currently positioned at the bottom of your breast, and this nipple position is probably a small distance below the level of your inframammary fold. All of these indicate that you need a breast lift.

If you were not getting an augmentation and wanted to improve your breast shape and nipple position, a breast lift would accomplish that. If you are happy with your current breast size then this is certainly an option. If you desire a larger breast then you will require an implant.

Given your current breast shape and skin envelope, an augmentation (without concurrent breast lift) will result in a ‘snoopy” deformity. The lax breast will hang off the front of the implant. Even a rather large implant will not alleviate the need for a lift; and personally, I disagree with the approach of trying to use large implants to avoid a breast lift. Inevitably there are problems related to skin stretching and thinning, a low hanging breast, implant rippling, etc that are sources of dissatisfaction for the patient causing them to seek additional surgery.

Using a two step (staged) approach to augmentation mastopexy is certainly acceptable. In that scenario, the lift is usually performed first, and the augmentation is done 6 – 12 months later. Since the pre-operative evaluation is not an exact science, we have all told borderline patients, at one time or another, that depending upon how the implant settles a small lift may be required. I do not think you are one of those patients, and believe that if you do not have a lift with your augmentation, you will be back later to have it done.

The consensus here is rather unanimous. Do you have a clear understanding of what size implant your surgeon plans to use? Do you have some understanding of what the expected breast shape is going to be without a concurrent lift? If you have concerns or questions, you should speak with your surgeon again.

Best wishes, Ken Dembny

Kenneth Dembny, II, MD
Milwaukee Plastic Surgeon
4.9 out of 5 stars 36 reviews

Breast lift question

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From looking at your picture I would say a lift is needed. Your nipples will be in a proper location with a lift and the areola will be made smaller which is a more youthful look. I agree with the otjer doctor that you could have just a lift and see how you like the results and then add an implant 4 months later if you decide you want larger fuller breasts. Good luck and please see a board certified plastic surgeon.

Gregory T. Lynam, MD
Richmond Plastic Surgeon
4.9 out of 5 stars 62 reviews

Need a Lift?

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Thank you for your question.

For women with moderate to severe #breast #sag, a breast #lift (mastopexy) may be recommended to ensure the best result and longest lasting result. Failing to have a breast lift when necessary will only lead to a less than ideal result leaving the patient unhappy and needing a revision surgery. A larger breast #implant can help lift the breast, but the low hanging breast tissue will still be present causing a disconnect between the implant and breast tissue located at the bottom of the breast.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Breast Lift Recommendation

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Congratulations on your weight loss. With your nipple position, my recommendation is to generally perform a lift. However, a lift must be consistent with your objectives, lifestyle, and lifestage. Without knowing the details of your case, it would be unwise to vehemently state a position. Consult with 2 - 3 additional experienced and expert board certified plastic surgeons to review your options.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 56 reviews

Do i need a lift?

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I agree with the other surgeons, your nipple position points down and even with large implants you will need a lift to position your nipples above your breast fold. One way to go about it is to perform the augmentation first and if unhappy with the appearance opt for a lift. Good luck.

Jonathan Weiler, MD
Baton Rouge Plastic Surgeon
4.9 out of 5 stars 93 reviews

Breast lift needed for breast contouring

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Your nipples point in a downward direction and your entire nipple and areola are below the level of the fold behind the breast.  With this breast shape you more likely to need  a breast lift as well as a breast lift.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

I Was Informed I Was Borderline in Need of a Lift What Do You Think?

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I'm afraid I would have to disagree with your doctor. With nipples at or below the lower breast fold, you definitely need a lift. Many of us feel it is wiser and safer to do the lift first, then the augment after the lift has healed. 

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

To lift or not

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I do think that you will need a lift. The nipples are low in relationship with the infra mammary fold. Although you can have implants only, you will most likely get a deformity that will require a breast lift. You can do it in two stages and see if you really need the lift.

John P. Stratis, MD
Harrisburg Plastic Surgeon
4.5 out of 5 stars 37 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.