Should I get a breast lift or implants alone? 26 years old, 75C but want fuller, perkier breasts (Photos)

Hi, thank you for sharing your question. Based on the photos, implant alone will provide you with the desired outcome giving you more volume, projection and some lift.

Dear Exuberant9742,


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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

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 upon your photos, your degree of sagging/ptosis is mild. Your nipple position is maintained. You would benefit from an augmentation. While there is no replacement for an in person exam, a lift may be unnecessary.
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.

Ideally, to achieve the rounder, fuller, and more lifted appearance you're looking for, a breast lift would be necessary. A periareolar lift might help improve the appearance to some extent, but if you want a more complete lift, an anchor-style lift would likely be the most effective technique to achieve that outcome.

From the pictures, your nipples are in the right position but you are lacking fullness. An implant will give you more fullness and will give an illusion of a lift at the same time. Once you see a board certified plastic surgeon, then you can have your options for the size and shape of the implant based on your measurements.

I would really need to examine you closely to be able to give you excellent advice, but since he wants larger breasts, you at least need augmentation. It seems you are nipples are in good position and you probably do not need any kind of lift. Although some patients have a certain expectations of results, often the best final result dictated by your breast and body anatomic relationship

It's great that you're taking the time to evaluate your options for achieving your desired breast appearance. Here are some considerations to help you decide between a breast lift, implants, or a combination of both:
Assessing Your Goals: If your primary concern is volume and achieving a fuller, rounder look, breast implants alone may provide the enhancement you’re looking for. However, if you also want to address sagging or a loss of shape, a breast lift might be necessary to reposition the breasts and improve their overall contour.
Combination Approach: Many patients find that a combination of both implants and a lift provides the best results. The lift can help reshape and elevate your breasts, while the implants add volume and fullness. This approach often leads to a more youthful and aesthetically pleasing appearance.
Consultation with a Surgeon: It's essential to consult with a board-certified plastic surgeon who can evaluate your breast anatomy, discuss your goals, and recommend the best course of action. They can provide insight into whether a lift, implants, or both will help you achieve the desired results.
Consider Size and Projection: When discussing implants, consider what size and projection align with your vision for fullness. This will help the surgeon recommend the appropriate type and size of implants to use in conjunction with a lift, if needed.
Personal Comfort: Ultimately, the decision should reflect your comfort and aesthetic goals. Ensure you communicate openly with your surgeon about your desires and concerns, as they can guide you through the options available to achieve the look you want.
By working closely with a qualified surgeon, you can develop a tailored plan that meets your specific needs and helps you achieve your desired breast shape and volume.

The breast lift 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 can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

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

Dear Exuberant9742, thanks for sharing your concerns and picture, In order to achieve your desired goal you would need breast augmentation with small dual implants with lift, this would give you an amazing results. Make sure you go on consultation with a board-certified plastic surgeon. Hope this helps and best of lucks! Dr. Luis Mejia.