Do I need a lift as well as implants? And what type of lift? (Photo)

Question

I’m 26, wanting implants but don’t want my breasts to sag further. Can I get a crescent lift or will I need an anchor lift in combination with implants?

Semih Yildiz, MD, FEPOBRAS · Answer

From the enlarged front photo and the second thumbnail I could review, there appears to be mild to moderate breast ptosis with the nipple-areola position low enough that an implant alone may not give a lifted result. A crescent lift only raises the areola a small amount and is usually best for very minimal asymmetry or very slight nipple elevation.

If your goal is implants without further sagging, you may need a formal lift with the augmentation. Whether that is a vertical/lollipop lift or an anchor lift depends on measurements such as nipple position relative to the breast fold, lower-pole skin excess, areola size, skin elasticity, and implant size. An anchor lift is not always required, but based on the photo, I would be cautious about expecting a crescent lift to control the breast shape well.

Daniel Barrett, MD · Answer

Dear Pioneering288172,
determining whether you need simply a breast augmentation versus a breast lift can be somewhat complicated. It depends on a number of factors including skin laxity and current nipple position. Generally speaking, if the nipples are lower than the inframammary line the patient will most likely need a breast lift. If the nipples are at or above the inframammary line we can generally get by with just a breast augmentation depending on the size of the implant the patient wants. I often still using implant when I perform a breast lift because it provides more upper breast fullness after the lift. To be sure a consultation with a board-certified plastic surgeon will help determine what the patient actually needs.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Gary M. Horndeski, MD · Answer

The technique I recommend is The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. Later, fat transfers or small implants can be placed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Ozge Ergun, MD · Answer

With a lollipop scar and right size implant a desired result can be achieved. Surgery under general anesthesia will take roughly 2 hours.

Ted Eisenberg, DO, FACOS, FAACS · Answer

I recommend an in person consultation with a plastic surgeon to discuss your goals and be measured. After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what size and style breast implant is right for them. Mildly Sagging Breasts: If your breasts are mildly droopy, a saline or silicone gel implant placed behind the pectoral muscle might help create the illusion of perkiness. That’s because as the implant fills out the top of the breast, it also fills out the bottom, making it look as if the nipple has moved higher. It hasn’t. You can always get a lift later if you feel you are not perky enough when fully settled and healed. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Steve Laverson, MD, FACS · Answer

The answer to your question depends on the final result you want and your chosen implant size.  Well placed breast implants will lift your nipple-areola complex and fill up loose breast skin sufficiently that you'll look quite nice without any breast lift at all.  If you want even tighter skin envelope with "perky" breasts, areola lift can be added.  The vertical or anchor scars, permanent features, can be added for even tighter skin envelope if your preference is for very low profile implants and you're accepting of the scars in exchange for a more youthful lifted robust breast shape, but are likely unnecessary based on submitted photos.

Connie Hiers, MD, FACS · Answer

You do not need an anchor ift, but may do well with the peri-areolar or vertical lift. The crescent lift is not a good option. Implants can be added for more volume at the same time if you want.

Hilton Becker, MD · Answer

You could get by with a circum-areolar lift 
Crescent lifts are not very effective I do not perform crescent lifts

Brooke R. Seckel, MD, FACS (retired) · Answer

Thank you for your question.  If your nipple lies above the level of your inframammary crease, or the fulled under your breast, and breast implants alone may be all that you need.

Of course and in person examination my board-certified plastic surgeon is necessary to properly advise you.

However based on the side view on the right side if the left side looks similar my guess is that breast implants alone may be all that you need.

If you do need a lift I would not do a crescent lift as this distorts the areola.  A periareolar lift would be all that you would need but again I think you may not need a lift at all.

Do I need a lift as well as implants? And what type of lift? (Photo)

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