I would like to restore volume after two babies. Implants only, or is a breast lift needed? (Photos)

Question

Hello! I'd like to get subfascial implants done to restore volume after two babies. I would really like to avoid vertical scars if at all possible, and I'm not even sure if I need a lift or not too? I don't mind more natural sitting breasts that are a little lower than high and tight, but I don't want a rock in a sock look. I'm thinking motiva preserve method with ergonomix implants?

Randal Haworth, MD, FACS · Answer

From your photos, you have post-pregnancy volume loss with some breast droop (ptosis). The decision between implants alone vs a lift comes down to where your nipples sit relative to the breast fold and how much loose skin you have, that can only be confirmed in person, but I can give you the practical rule of thumb:
When Implants Alone Can Work
Implants alone are often reasonable if:
The nipples are at or above the breast crease (inframammary fold)
You mainly need upper pole fullness
You accept a more natural, slightly lower breast position
In these cases, choosing an implant with an appropriate width and moderate volume can restore shape without that “rock in a sock” look.
When a Lift Is Usually Needed
A lift becomes more likely if:
The nipples sit below the crease, or point downward
There’s significant loose skin that an implant would simply “fill” without tightening
That’s when implants alone can create the “rock in a sock” look (implant sitting high with loose skin draping lower).
About Subfascial + Motiva/Ergonomix
Subfascial placement can work well in select patients, but the bigger issue here is skin envelope and nipple position, not just implant plane or brand. “Preserve” style approaches may reduce trauma, but they don’t replace a lift if you truly need one.
Best Next Step
Book a consult with a qualified, board-certified plastic surgeon and ask them to show you:
Implants-only simulations vs implant + lift on patients with similar anatomy
Whether a limited lift (peri-areolar or short-scar) is an option if you’re trying to avoid vertical scars (not everyone qualifies)
That consult will quickly tell you if you can get a beautiful, natural result with implants alone — or if a lift is the difference between “restored” and “rock in a sock.”
Good luck!

Franklin D. Richards, MD · Answer

From your photos you may or may not need an implant. A larger implant may lift the nipple adequately to avoid breast lift scaring. A smaller implant won't be effective in doing this. You can also ask your surgeon to do a dual plane technique that can lift the nipple further without additional scaring. If you do need a lift you may be a candidate for one of the more minimal lifts which will also dramatically reduce breast scaring.

Ira H. Rex III, MD · Answer

Many of the decisions that plastic surgeons make require a good physical exam.  From your photographs, it seems quite evident you would need a breast lift to get any kind of perky results.  Without a lift, your nipples are usually in the same position or even lower.  In this situation, you would probably have to wear a bra most the time.  With a lift, you have more freedom in that respect.

Gary M. Horndeski, MD · Answer

You are a poor candidate for breast augmentation alone. You would benefit from a breast lift using the Bellesoma. 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 can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Gerald Minniti, MD, FACS · Answer

The Preserve method would be excellent, but you will do poorly without a breast lift. You have excess skin with little elasticity. Done by an expert, your lift scars will be minimal and you will feel confident with your new breast's appearance.

Zoran Potparic, MD · Answer

There is no doubt that both breast lift and implant augmentation is the way to correct you current deformity. Good luck.

Kadir Berat Oyur, MD · Answer

Hi and thank you for your question.
Looking at your photos and goals, a combination of a breast lift and implants would likely give you the best result. The lift will address any sagging and improve breast shape, while the implants provide added volume. Motiva Ergonomix implants are a good option for a natural, well-proportioned appearance.
Hope this helps!

Donovan Rosas, MD · Answer

Patient concerns regarding the appearance of their breasts can typically be divided in two pools: volume, ptosis (droop). The procedures to address these issues are as different as the issues themselves. However, these concerns are not mutually exclusive. Many patients, whether they are aware or not, will benefit from both.
There are two factors which can help to answer the question of which surgery will deliver the most satisfying result: mastopexy, augmentation or both. Patients must first consider the position of the NAC (nipple areolar complex i.e. the pigmented portion of the breast) as it relates to the inframammary crease. If the nipples are at or below the level of the crease the patient may benefit from a lift or mastopexy. The breast lift is designed to elevate sagging breasts to a more youthful position. It also helps to reshape and tighten the skin of the breasts. This is typically accomplished via a periareolar (around the nipple) incision with or without a vertical incision. 
Mastopexy is an effective way to address sagging breast, however, the changes which accompany weight loss or pregnancy can also decrease volume of the breasts. When a woman wants the volume restored, or increased, a breast augmentation will also be needed in conjunction with mastopexy. Augmentation can help restore the volume loss which is well known to women following children. There are a number of options available to women considering augmentation ranging from size and implant type to access incision.   
A breast augmentation alone may also be appropriate if ptosis is mild. If the patient is comfortable with the natural appearance of the breasts but desires them to be larger, a breast augmentation alone is the right procedure.  Augmenting significantly ptotic or sagging breasts tends to magnify the problem. In these cases, a mastopexy performed in conjunction with an augmentation is preferred.
Based on your photos, you would likely benefit from a lift in concert with an augmentation. However, this is entirely dependent on nipple position which cannot be accurately determined without an in-person exam.
There is a procedure for every problem. To determine which technique is right for you, consult with a board certified plastic surgeon Patient should discuss their concerns with their physicians in order to make an educated decision.

Mehmet Ozdemir, MD · Answer

Hi and thank you for your question.
Based on your photos and goals, you would likely benefit from both breast augmentation with implants and a breast lift. The lift will help restore shape and position, especially if there’s any sagging, while the implants will add volume. The Motiva Ergonomix implants can help achieve a natural look with a more balanced shape.
Hope this helps!

Darryl J. Blinski, MD · Answer

I agree with you placement of implants with no lift . Expect fee to range from $5,000-$10,000 depends on type of implants . Best to virtual consult

I would like to restore volume after two babies. Implants only, or is a breast lift needed? (Photos)

Answers (11)

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