Can I Get Large Implants to Avoid Lift? (photo)

This is what I do to maximize lift with a breast implant alone:- use silicone cohesive gel implants. The more cohesive the better. I am not sure if these are available yet in the US, but the Allergan Inspira Truform 2 implants are ideal- use high profile implants. The more projection you have, the more lift you will get- have the implants placed in the submammary pocket (under the breast itself). You should have a pinch thickness at the top of your breast of at least 2 cmPlease see an experienced board certified plastic surgeon to find out whether you are a suitable candidate. Best of luck.

There are different classes of droopy breasts. Class I can be addressed with implants. Usually with other classes you will need a lift, no matter how large of an implant you are considering. The shape of an aesthetic breast relies on amount of skin, position of the nipple/ areola and volume. Depending on the amount of the droop, large implants can not address the position of the nipple/areola complex. Be weary of surgeons out there, many of whom are not plastic surgeons and do not have specific training or experience with breast lifts, who will attempt to place an overly large breast implant into your breast rather than perform a breast lift.  Not only can this give you larger breasts than you wished for, but it can cause long-term negative consequences on the breast tissue and breast-supporting ligaments.  It is in these situations that long-term complications such as implant mal position (the implant sliding down too far) are more likely to happen.

Large implants make the breasts large but do not lift the breast. It is very likely that if your skin and tissues are thinned and deflated, that you will not be able to support such a large implant without some type of additional procedure such as a lift or acellular hammock.  Large implants can cause thinning and problems down the road. Consider carefully before proceeding and discuss these issues in detail with your plastic surgeon. Best of luck.

Hello Kriswill,

If you are paranoid about your nipples ending up in some strange postition, then don't get big implants without a lift!  It is difficult to give you a truly fair assessment with only photosgraphs to look at, but you will not be happy with large implants overfilling the upper poles of your breast while the nipple and lower breast tissue remain low and sagging. It's a misunderstanding that big implants can some how rotate breast tissue into a higher position on the mound.  In fact, with ever larger implants, the nipples will more likely remain below the meridian that divides the top from bottom of the breast.

Please read my blog on breast lifts.

Best of luck!

Using a large implant to treat sagging breasts does not usually work.  One way to check for yourself is to see where the bottom of your breast attaches to the chest wall.  if the breast or if the nipple hang below this point then most likely you will need a lift.  This is mainly because the implant usually cannot be placed below the fold of the breast.  So, if you simply put an implant and do not do a lift then the drooping tissue will likely be hanging lower than where the implant is on the chest. 

One of the biggest mistakes I see in breast surgery is the placement of a large implant to try to fill out loose skin and avoid a lift.  It really doesn't work if your breasts are too saggy.  It will ultimately give you larger saggy breasts or breasts that literally fall off the implant when you stand.  If you have significant ptosis or sagging, you can only correct this with a lift.  The implant is only helpful to add volume, not lift.

Thank you for the photos. Based on the photos, it looks like you have grade 1 ptosis, meaning your nipple is at your inframammary fold or a very slight grade 2 ptosis. That puts you at the border between mastopexy or augmentation. It is a decision you should make with your plastic surgeon once you have all of the facts. A lift will cause more scars but the shape and the location of the nipple will be improved. An implant will improve your projection but with ptosis, you will need a larger implant and your nipples may lie slightly lower on the implant. I have performed both procedures in patients who have grade 1 or 2 ptosis and as long as the patients understood the outcome beforehand, they were happy. If you couldn't decide, I think augmentaiton alone is a great option for you.

Hi Kriswill,

Thank you for sending the photos, it is very helpful.  It appears that your nipple is a little low but not low enough that you absolutely need a lift.  There is some sagging of the breast tissue itself.  I advise my patients that we first determine what size implant is appropriate for your body, that you feel comfortable with.  Then, depending on the implant size, we decide whether or not you need a lift.  For example, if you prefer a 240cc size implant, you might need a lift.  If you prefer 400cc and it fits you, you might not need a lift. Another factor is your tissue thickness.  If your tissues are thick enough to put the implant on top of the muscle (and assuming a mid size implant), you might be able to avoid a lift.  I do not think you will need overly large implants to avoid a lift and I absolutely do no recommend using overly large implants to compensate for not performing a lift.   However, you must be examined in person to make this determination.  I have seen many patients who are unhappy with their implants because they had too large implants placed when they really needed a lift, so I am glad you are asking this question and appear to be open to a lift if you need one.  Also, if the implants are placed under the muscle, I do believe a lift will help you achieve a better result, particularly to reposition the breast tissue itself.  Keep in mind that I do not recommend saline implants for patients who have stretched or sagging tissues.   Lastly, even if you do not need a lift now, you might need one in the future. Please consult with a board certified plastic surgeon to discuss your options.  Hope this helps.

Tracy M. Pfeifer, MD, MS

Based on your photos it does not appear to me that you need a lift.

• A breast implant of any volume will not compensate for a breastlift. If you need a breastlift and your board certified plastic surgeon will be able to tell you this after examining you, a breast augmentation alone will not be satisfactory.  Placing a larger breast implant to compensate for not performing the breastlift will make you larger than you may want to be.  A larger implant will accelerate the stretching of the skin and put you in the situation where you are in greater need of a breastlift because the sagging will be increased.  I have seen many patients who have gone down this road to avoid the breastlift and they are unhappy for a number of reasons and they end up having the lift anyway.

• In my practice, most patients would rather have one operation than two.  I tend to perform the augmentation with the breastlift at the same time.  Having said that there are many plastic surgeons who, for a variety of reasons, separate the procedures and that is personal preference and comfort level of the surgeon with the procedure.  Having the result you are looking for, safely is the goal for the surgeon and it should be for the patient as well.

• You should ask to see before and after photographic results at the office where you are having a consultation.  This will give you a good idea about the personal results of your plastic surgeon.  Take into account size, shape, nipple position and scar quality.  Do not expect your breasts to be perfect after this or any operation.  Especially with the augmentation/breastlift a number of issues are being addressed; namely, size, shape and position and size of the nipple and areola.  With all those changes there will always be some differences.  It is a good idea to ask your surgeon how often a revision is performed to address these differences.  The breasts, remember, are naturally different from each other and they will most likely have some differences after surgery as well.

Thank you very much for this question.

From your pictures, you are border line on whether you should have a lift in conjunction with your Breast Augmentation in order to achieve a result of perkier and fuller breasts. An option to avoid the lift is to choose larger breast implants, but there are other techniques available to give you the desired look. A technique I often use is a minimal scar technique called a Circumferential Breast Lift. It's where I make an excision around the areola, then excise a donut-shaped piece of skin and then suture it close lifting and tightening your breast skin. The results are lifted breasts and after recovery should have a very minimal scar. You need to consider your lifestyle and if large breast implants will suit your life. Are you active such as running? Will large breasts interfere with anything? You should not base your decision on a possible scar. A good plastic surgeon will minimize that either way.