Do I need Implants with a Breast Lift or not? (photo)
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Doctor Answers 12
Question the Need of Implants along with Breast Lift - Intended Results
A #mastopexy or breast lift operation is designed to improve the shape and position of the breast swithout reducing their size. It is used for #breasts which sag or droop (ptosis). Sagging of the breasts may occur with normal development for some women, or as part of the aging process. Pregnancy, breast-feeding and weight loss are other conditions which increase breast ptosis. Some patients will have a better shape to their breast such as increased superior fullness if an #implant is used at the time of mastopexy. This is called an #Augmentation/Mastopexy. The procedure can also be combined with a minor breast reduction to reduce the breast width if desired. The surgery will create an elevated, more youthful breast contour. Also, the procedure will create nipple and areolae of the desired size and at the correct height.
#FatGrafting is another option to using #breastimplants and requires a small amount of liposuction to obtain the fat which is the prepared and transferred to the breast.
A hybrid operation may use both an implant and fat to provide the best contours of the lifted breast.
I prefer to use a #shortscar technique, #LollipopScar or #DonutLift” rather than the majority of surgeons in the United States that use an anchor pattern lift which involve more significant scarring.
Implants with no lift is usually a mistake. Most breasts will look larger and droopier. They will sag more and sooner because of the excess weight. The shape will usually not be satisfactory. There will sometimes be a “Snoopy” breast or double bubble.
If the nipples are in a fairly high position on the breast or “glandular” ptosis or drooping, an implant may be useful.
Breast lift candidate, some advices:
Thank you very much for enquire.
To perform the breast lift I recommend a Periareolar Round Block Breast Lift ("Benelli mastopexy"), which has an unnoticed scar around the areola, and if we see (in the surgery) that we can't obtain adecuate projection just with the Benelli Lift, we have to perform a "Lollipop breast lift".
Dr. Emmanuel Mallol Cotes.-
I think you would do well with a lift alone as you already have a large volume of breast tissue. Repositioning the tissues would involve reducing the areolae, lifting the nipples, and tightening the skin envelope. I think this make your breasts appear more youthful without sacrificing much in volume. Good luck!
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Are implants needed with a breast lift?
Hello, a breast lift alone will significantly improve overall breast shape, but I find that implants more successfully fill the upper part of the breasts. If you look at before and after pics of both procedures, I think you will see the difference I am describing. You can then decide which look you are seeking.
Thank you for your question and photo. The answer will depend on your goals. You have nice volume, so a lift alone can give you a nice result. The lift will reshape the breast and move the gland and nipple higher on the chest. A breast lift, however, does not provide long lasting fullness in the upper breast. If you desire fullness in the upper breast, you should consider an implant with a breast reduction. The implant will provide upper fullness and the reduction will remove exces tissue from the lower breast while reshaping and repositioning the breast tissue up over the implant. Good luck.
Lift with or without an implant
Based on the image you provided and the apparent fullness you have, I believe you would do best with a breast lift which will reshape your breasts to a more youthful appearance. If you decided after 6 months you wanted more volume you could than more appropriately choose a breast implant.
Best of luck to you
Breast lift with or without an implant
Thank you for asking about your breast lift and possible implants.
- Your breasts are quite large.
- If you have an implant, they will be larger and adding weight to the breast that makes them more likely to sag.
- An implant is a good choice only if you want to larger than you are now and can accept the risk of future sagging.
- A breast lift should not change your breast size - just reposition the breasts.
Always see a Board Certified Plastic Surgeon. Best wishes - Elizabeth Morgan MD PHD FACS
Hello and thank you for your question. Based on your photograph, you are a
great candidate for a breast lift. This can be designed to result in an
improved shape and contour of your breasts while minimizing scar
appearance. If you desire to add volume to your breasts, then add a small implant with the lift. Make sure you specifically look at before and after
pictures of real patients who have had this surgery performed by your surgeon
and evaluate their results. The most important aspect is to find a
surgeon you are comfortable with. I recommend that you seek consultation with a
qualified board-certified plastic surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon
Do I need Implants with a Breast Lift or not?
Thank you for the question and pictures. Your pictures clearly demonstrate significant breast ptosis. As you state, you will benefit from breast lifting surgery. It is likely that you will benefit from breast augmentation surgery also if you wish your breasts to be larger/fuller also.
You will do best by seeking consultation with well experienced board certified plastic surgeons. Ask to see lots of examples of their work and communicate your goals clearly.
Patients who are considering breast augmentation/lifting surgery should understand that this combination surgery is significantly more complex than either one of the procedures done separately. In other words, the combination breast augmentation / mastopexy surgery differs from breast augmentation surgery alone in that it carries increased risk compared to either breast augmentation or mastopexy surgery performed separately.
Furthermore, the potential need for revisionary surgery is increased with breast augmentation / mastopexy surgery done at the same time. This revisionary rate may be as high (or higher) than 20%. Patients should be aware of this higher revisionary rate; obviously, the need for additional surgery, time off work/life considerations, and additional expenses our “factors” that should be considered before undergoing the initial operation.
Personally, I find that the breast augmentation/lifting procedure to be one of the most challenging of the breast operations I perform, even compared to somewhat complex revisionary breast surgery. On the one hand, when performing breast augmentation/lifting surgery we are increasing the breast size with breast implants; on the other hand, we are reducing the breast “envelope” in order to achieve the breast lift. These two “forces” must be balanced as perfectly as possible in order to achieve the desired results. Removing too much skin/ breast tissue is problematic; removing too little breast skin/tissue can also be problematic. Remember also that patients presenting for breast lifting surgery and general have lost some skin elasticity/thickness making potential incision line healing problems and/or recurrent drooping/sagging important concerns to communicate.
The analogy I use in my practice is that of a thinned out balloon, being expanded with additional air, while at the same time removing some of the balloons rubber surface. I hope that this analogy helps patients understand some of the issues at hand when performing the combination breast augmentation/lifing operation.
To achieve a surgical result where the breast implant and breast tissue “come together” and behave like a single breast is one of my goals but can be difficult to achieve. Essentially, we are trying to create a breast implant/breast tissue interface that feels and behaves as naturally ( as a single unit) as possible. Generally speaking, making sure that the breast implant has some sub muscular and some sub glandular component ( dual plane) and tailoring the overlying skin/subcutaneous tissue/breast tissue as precisely as possible over the underlying breast implant is key.
Despite these efforts, breast implants are after all a foreign body that don't necessarily stay where we wish they would; therefore, breast implant related problems such as positioning ( too high, too low, lateral displacement etc.) can occur and may be a reason for returning to the operating room for revisionary breast surgery. I use a “tailor tacking” technique that allows a determination of what breast implant should be used to SAFELY produce the results the patient is looking for. This technique involves use of a temporary sizer and temporary “closure” of the overlying breast skin over the sizer. The use of the tailor tacking technique is very helpful. Breast lifting involves removal of skin ( and tightening of the breast skin envelope) while breast augmentation involves expansion of the breast skin envelope. These 2 forces are counteracting each other. Again, despite these efforts, breast implant and/or tissue/skin complications may arise causing minor or significant complications.
Generally speaking, it is difficult to achieve the “perfect” result with breast augmentation/lifting surgery, despite best efforts. Patients should be aware of the complexity of this combination procedure, achieve REALISTIC EXPECTATIONS prior to proceeding, and understand that additional surgery ( along with the additional recovery time, stress, expenses etc) may be necessary in the short or long-term. Patients should understand that the results of the procedure will not necessarily match aesthetically the results of patients who have undergone breast augmentation surgery only.
For example, some patients who wish to maintain long-term superior pole volume/"roundness" may find that this result is not achieved after the initial breast augmentation/lifting operation. An additional operation, possibly involving capsulorrhaphy, may be necessary to achieve the patient's longer-term goals ( with superior pole volume/roundness). It is helpful if patients understand that this breast implant capsule used to provide the support for the breast implant is not present during the initial breast augmentation/lifting operation. The capsule (layer of scar tissue) forms around the breast implant and may be a good source of supportive tissue during revisionary breast surgery, Including correction of breast implant displacement/malposition problems ( such as bottoming out, symmastia, lateral displacement etc).
Potential risks associated with breast augmentation/lifting surgery include infection, bleeding, incision line healing problems, loss/change of nipple/areola complex sensation, and blood flow related issues to causing skin or tissue necrosis. Poor scarring, pigment changes, areola/nipple asymmetry etc. are also potential problems. Again, patients may experience implant related problems such as encapsulation, leakage, displacement problems ( too high, bottoming out, lateral displacement, asymmetric positioning etc.), rippling/palpability of breast implants etc. Patients may also be dissatisfied with breast size, shape, and/or how the breast implants and overlying breast tissues “interface” with one another. Occasionally, a breast implant may even have to be removed and the patient will generally be “implant free” for several months at least. Obviously, this situation can be quite physically, emotionally, and psychosocially stressful to the patient involved.
I hope that this summary of SOME of the issues surrounding breast augmentation/lifting surgery is helpful to you and other women considering this procedure in the future. The attached link may also be helpful.
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.