Is it possible to insert a saline implant high enough in the existing "pancake" tissue? (photo)

And, under the muscle wall and still achieve an acceptable (by industry standards) result? I am 42 and had my first child at 41. In addition to nursing, I also lost an additional 30 lbs. from my pre-baby body. I am hoping to avoid a "lift" as I understand that this requires nipple removal/replacement.

Doctor Answers 11

Breast Implant position and need for a breastlift

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Your question and concerns come up frequently. Yes, there are additional scars involved with a breastlift, but it involves repositioning and resizing of the nipple areolar complex, rather than removing and reattaching the nipples. The attachments are NOT disrrupted during the operation. If you did not have a lift, it would be necessary to use larger implants that would be positioned under the breast tissue, rather than under the muscle. It would make it such that you may need a breastlift a few years down the line due to the drooping of the larger, heavier breasts.

It would be best to consider a breastlift (there are different types of breastlift- some with less scar) and augmentation for longer lasting and better looking results. An in-person consultation would be the next step for you so that you may get precise answers to your questions based on your physical examination and your goals. I hope this helps. RB

San Francisco Plastic Surgeon
4.8 out of 5 stars 44 reviews

Silicone better than saline

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Implants alone would be a disaster and will not raise your breasts. Women have been afraid of lifts because of the ugly vertical scars associated with the lollipop or anchor shaped incisions. For this reason, a new technique was developed, which uses only a circumareola incision to reshape your breast tissue creating upper pole fullness, elevate them higher on the chest wall and more medial to increase your cleavage. Through the same incision, implants can be placed. Aligning the areola, breast tissue and implant over the bony prominence of the chest wall maximizes anterior projection with a minimal size implant. Small round textured silicone gel implants placed retro-pectoral look and feel more natural, are more stable, less likely to ripple or have complications needing revision. I recommend Breast Augmentation with Mini Ultimate Breast LiftTM.

Best Wishes,

Gary Horndeski, M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

Implant without a Lift?

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An implant alone will not give you a good cosmetic result. In a lifting, the nipple is elevated to a higher and better position. It is left attached to the underlying breast tissue, not removed and replaced.

Following the advice from a surgeon on this or any other website who proposes to tell you what to do based on two dimensional photos 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 may not be in your best interest. I would suggest that you find a plastic surgeon 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. You should discuss your concerns with that surgeon in person.

Robert Singer, MD FACS

La Jolla, California

Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 22 reviews

Avoiding Lift

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No. No implant, saline or silicone, low or high profile, big or small, can lift tissue and nipple above the inframammary fold, if it is below. You are incorrect about the removal and replacement of the nipple; it is never detached during a lift, and it remains attached to breast tissue as it is repositioned into a more aesthetic location.

Augmentation mastopexy is a difficult operation to perform, and on average has higher rates of complications leading to reoperation then either augmentation or mastopexy alone. Be sure to visit only surgeons that specialize in all aspects of cosmetic breast surgery. Certification with the ABPS and membership with the ASAPS are just baseline requirements. A large portfolio of before and after results documenting the regularity of this type of operation should be available. Those that specialize in this surgery have much lower rates of complications.

If you are unwilling to accept incisions, however inconspicuous, it is my strong recommendation to do no surgery at all.

Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 100 reviews

Is it possible to insert a saline implant high enough in the existing "pancake" tissue?

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A small implant for increased superior pole fullness is reasonable, but a lift will also be necessary.

For the lift, I typically start with the smallest incision and custom tailor each breast lift to the shortest scar possible.

Find a plastic surgeon with ELITE credentials who performs hundreds of breast augmentations and breast lifts each year. Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.

Kenneth Hughes, MD Los Angeles, CA

Is it possible to insert a saline implant high enough in the existing "pancake" tissue?

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Thank you for the question and picture. It is difficult to give you specific or meaningful advice with the limited view photograph with your arms elevated. You may wish to consider sending additional photographs, taken by a second party (frontal and side views) for better advice.

Based on the limited photograph, I share your concerns that breast lifting is the primary operation indicated. Of course, breast augmentation will also be necessary to increase size/fullness of the breasts.

Breast implant size/profile selection will be best done during in person consultation. Dimentional planning and careful measurements will be part of this process. A careful communication of your goals, in my practice using goal pictures and computer imaging, will also be very important.

I hope this, and the attached link, helps.

To lift or not

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You are a borderline case as far as whether or not to lift your breasts. Your right breast is considerably lower than your left and the lift will help correct the asymmetry better.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 31 reviews

Is it possible to insert a saline implant high enough in the existing "pancake" tissue? (photo)

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Your type of post postpartum breasts could benefit from a lifting operation. Best to seek IN PERSON consultations...

Breast augmentation vs Augmentation and Breast lift

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From your photo, I am concerned that a breast augmentation alone may not achieve the results you are hoping for. Although, an implant can be placed higher on the chest - in the "pancake" tissue - without a breast lift, the breasts and nipples will tend to hang below the implant. This would be most noticeable on your right breast, which is slightly more pendulous that the left. For the best result, I would suggest that you consider some form of a breast lift - donut, lollipop, or anchor mastopexy. Seek out a board ceertified plastic surgeon with extensive experience in breast augmentation and mastopexy. Best wishes.

Vincent D. Lepore, MD
San Jose Plastic Surgeon
4.7 out of 5 stars 63 reviews

Is it possible to insert a saline implant high enough

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You will not get a good result with implants alone, a lift of some type is necessary. BTW, nipples are neither removed nor replaced with a lift. The areolas are repositioned and resized. They never leave the breast attachment. Sounds like you need to get a consultation to get your questions answered.

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