Should I get implants with a lift? (Photos)

I used to have large breasts and 3 babies made me shrink. I like the way I look in a bra. I was so big before, I have never had upper pole fullness so I can't imagine it. I want a pretty, natural shape naked. 2 consults (best in city) said I should have an implant. I wear a 32dd. The last guy said with a lift I'd be a B or c? do I need an implant for shape? I've read differing things about how the implant impacts longevity. Which ages better (shape wise)? Also, I fluctuate a LOT with cycle

Doctor Answers 11

Breast lift with implants

Hello and thank you for your question. You are a great candidate for a breast lift with an implant.  The size of the implant is based on your desired breast size/shape, your chest wall measurements, and soft tissue quality.  This decision should be based on a detailed discussion with equal input from both you and your surgeon.   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

New York Plastic Surgeon
5.0 out of 5 stars 131 reviews

Should I get a mastopexy and or augmentation

I think your case brings up a couple of very good questions. The first question is whether you should get an implant or not.  If you like your current breast volume in your best supportive push-up bra then you don't need to have an implant but if you wish you had a little more volume than you definitely would want to add an implant to your plans.  The next question is should you get a mastopexy along with an implant.   That question is just a little bit more difficult to answer because it makes you consider a couple of different questions.   The first is how close do I want my nipple position to be to ideal.  If you're willing to accept a nipple position on the breast that's a little lower than the "ideal" nipple position then many people can get a nice improvement with just implants.  If you want to get the most aesthetically appealing outcome generally you would want to do a mastopexy as well.   However, if you do a mastopexy at the same time then you know that you're going to have some additional incisions and require a little bit longer in the healing process than just a simple augmentation.   Some patients will approach it with the plan of doing an augmentation first and then doing a mastopexy at some point in the future because that's the safest most predictable route.   However if you know that you want to do both surgeries at one time it is reasonable to combine the augmentation and mastopexy, you just have to be willing to accept that there's a slightly higher risk of complications or a less ideal outcome. 

Jonathan Amspacher, MD
Kansas City Plastic Surgeon
5.0 out of 5 stars 13 reviews

Implant and Lift

Based on your photos and your expressed desires, it appears that a breast augmentation with an implant in addition to a breast lift will be your best option.

The implant will give you the desired fullness and volume, while the lift will improve the shape and give the breasts the "perky" appearance.

It looks as though just doing an augmentation could possibly give you the desired result without a lift, but this would in part depend on how large of an implant you choose.  I think it is likely, though, that without a lift your breasts will still appear droopy as the breast tissue and implant will hang down below the breast fold, especially over time and especially if large implants are used.

It appears that you have some asymmetry as well, so be sure to address this with your plastic surgeon.  They may recommend different size implants and/or taking some tissue from the larger side in order to match them up.  The lift will help make the nipple position symmetrical, also.

Good luck and please be sure your plastic surgeon is a real plastic surgeon certified by the American Board of Plastic Surgery and is experienced in these types of procedures.

Christopher W. Chase, MD
Chattanooga Plastic Surgeon
5.0 out of 5 stars 33 reviews

Breast lift with implants

Thank your for your question, and the photos are very helpful to us to give you better advice. I would agree that you will be the most satisfied long-term with a breast lift to tighten the skin and elevate the nipple position. But, without a small implant, you will not have the improved cleavage and volume at the upper portions of the breast that looks pretty in and out of clothing. It should look very natural and not augmented once you are healed. Best wishes.

Paul J. Leahy, MD
Leawood Plastic Surgeon
5.0 out of 5 stars 8 reviews

Lift with or without implants

Hello dear, thanks for your question and provided information as well.. The breasts may lose their elasticity and firmness which can be caused by different factors such as pregnancy, massive weight loss, lactation and aging. To reaffirm the breasts and restore the natural look your surgeon can perform a mastopexy or breast lift with augmentation such as silicone implants, you will get very nice results.

Patients who goes to a consultation for drooping breasts (ptosis) or volume loss after pregnancy (pseudoptosis) almost always have one very important question. "Can my drooping be corrected with just implants or do I need a lift".

Implants alone will correct drooping when:

  1. Breast drooping is mild
  2. The nipple is still near the center breast and does not point downward
  3. There is some visible skin beneath the nipple/areola when looking at the breasts straight on.
  4. The patient is okay with being at least a cup size larger

A breast lift (with or without an implant) is better when:

  1. Breast drooping is moderate or severe
  2. The nipple is at the bottom of the breast or points downward
  3. There is no visible skin under the nipple/areola when looking at the breasts straight on.
  4. The patient is already a C or D cup breast size and doesn't want to be larger
  5. The areola is too large and the patient wants it reduced

I also show the patient photographs of a spectrum of breast scar present after a breast lift in order to check their tolerance for this scar. Most patients are surprised how little the scar shows and are okay with proceeding. If the patient really needs a breast lift, but is concerned about the scars, I will suggest they wait on surgery. In time the breast appearance problems will usually outweigh their concern about the scars.

I use implants in combination with a lift when:

  1. The patient wants to be larger in addition to being less droopy
  2. The patient desires to maintain projection and roundness of the breast mound
  3. The drooping is severe..... I recommend to see a board certified plastic surgeon for a personal evaluation and also to talk about your goals.

I recommend to make an appointment with a board certified surgeon for an evaluation and to talk abuot what kind of lift do you need and to talk about your goals.

Good luck :)

Tania Medina de Garcia, MD
Dominican Republic Plastic Surgeon
4.5 out of 5 stars 418 reviews

Breast lift candidate

Based on your photographs, you appear to be an ideal candidate for a breast lift with implants.  The lift will improve the size and shape of your breasts and the implant will restore lose volume.  A very natural shape can be attained.  The best size, shape and placement of the implant can really only be determined after an in person examination which includes measurements and a discussion of your lifestyle and goals.

Robert Drielsma, MBBS, BSc, FRACS
Sydney Plastic Surgeon
4.7 out of 5 stars 48 reviews

Breast Lift with Implants

Thank you for your question and for sharing appropriate pictures. You seem to be a good candidate for a breast lift with implants. This combination of procedures will reshape and lift your breasts long with providing you with some of the fullness that has been lost. I recommend undergoing Vectra 3D Imaging to get an idea of your post procedural results. You should make sure you're working with a board certified plastic surgeon with experience in these areas. 

Kevin Tehrani, MD, FACS
New York Plastic Surgeon
4.8 out of 5 stars 95 reviews

Breast lift

Thank you for your question.  Based on your submitted photos you appear to be an excellent candidate for a breast lift with implants to produce beautiful overall results.  Schedule a consultation with a board certified plastic surgeon to discuss your surgical options, address your goals and concerns, then work together to build a plan that best helps you achieve your overall desired look.

With kind regards,
Lane F. Smith, M.D., F.A.A.C.S., F.A.O.H.N.S., F.A.B.F.P.R.S.
Las Vegas Plastic Surgeon

Lane Smith, MD
Las Vegas Plastic Surgeon
4.5 out of 5 stars 93 reviews

Implants with a Lift

To answer your question, I need to know what kind of bra you wear. From what you have said about your consults and the size they predicted and your pictures, it seems as if you wear a padded bra to make you the DD you say you are in a bra. If this is so, you need an implant to get you to the size you desire. But, if you are quite happy with your size and fullness in a non padded bra, then all you need is a lift.

Robert T. Buchanan, MD
Highlands Plastic Surgeon
5.0 out of 5 stars 6 reviews

Breast lift with implants

Your options include having a lift alone, which will improve your shape but not volume, and your breast would still be empty in the upper chest. Probably the better option would be to do this and add an implant, which will fill out your loose tissues better. Hope this helps, Dr Steve Merten, Sydney, Australia

Steve Merten, FRACS
Sydney Plastic Surgeon
4.9 out of 5 stars 50 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.