Do I absolutely need a lift? Is it possible to get a gummy bear implant to regain some volume? (Photos)

If you just put implants in you will get a very poor result. If you don’t want a lift I recommend doing nothing at all

Hello, thank you for your question. It really depends on your expectations. You can put in an implant for volume but you will still have a lot of your natural breast tissue hanging below. Speak to your plastic surgeon about your options. Be sure to bring in lots of wish pics. Feel free to check out our before and after gallery.

Hello and thank you for your question! Based on your photos, you have grade 2 ptosis, meaning the nipple/areola has descended to the lower part of the breast, beneath your breast folds but is not yet "pointing at the floor". This, along with your history of weight loss and the quality of your skin (stretch marks on photos) would lead most surgeons to recommend a breast lift for the best results. The implant will add not only volume but fullness to the upper and inner parts of the breasts, but will not change the position of the nipple/areola and it wont raise and reshape the breast tissue like a breast lift would. Placing an implant alone would likely lead to a "waterfall" appearance to the breasts (where the implant volume stays higher as the breast gland tissue continues to descend lower). As always, I recommend an in person consultation with a board certified plastic surgeon to fully address all of your questions and concerns!

Hi manders6978, an implant placed above the muscle may give you volume and fill your soft tissue envelope some, however you will look saggier and have a higher chance of the breast pocket capsules getting stiff. An implant below the muscle with high projection may counter some of your sagging and has a higher chance that the capsules will remain soft, however your breasts may not stay centered and then create a “waterfall deformity”. Doing a lift with an implant is a good way to center the nipple/areola and remove the extra skin/soft tissue that is creating the sagging look, and revolumize the breasts. Rarely, I have had a patient do an implant but 100% return within months to have the lift—two operations/anesthetics/recoveries can be avoided if you do it together. Best of luck with your decision-Dr. Doolabh

The short answer is....no, you cannot just get an implant to replace lost volume. An implant comes in a certain size, shape, dimensions, etc. but it is a rounded (or shaped) implant and is not customized for each person's need. So unless you choose a large enough implant to fill the available skin (which would be much too big in your case), then you are going to need a lift in addition to the implant. And given your history of weight loss and the stretching of the skin in the photos, I would suggest that you do those in two stages.
Good luck!
Dallas Buchanan, MD
VIVIFY plastic surgery
Tampa, FL

Yes it is. But implants will only fill out a portion of your breasts. Even if the implants are very large your breasts will drape over the implants and you will have excess skin on the sides as well. If this is not a problem for you, go for it! Plus, if you want, there is always the option of a lift afterwards.

Another option could be a breast lift without implants. Your breast would still look natural but a bit smaller. If you don’t want to go smaller, a breast lift with implants over the muscle might be a good idea. Over the muscle placement would make your breast look less stiff and the implants will eventually sag with the breast allowing for a more natural look.
Hope this helps!

Best of luck,
Dr. Miguel Mota

No matter what the filling (saline, silicone gel, or highly cohesive silicone gel, aka gummy bear), the shape (round versus shaped), projection, size, or position above or below the muscle, there is no implant that will look normal, nevermind natural. Your breasts are large, and hang well below the fold. A breast lift would give you a beautiful and natural result, and your skin type (pale, with freckles and striae) will make fine white scars invisible.

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 can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Without a lift, implants alone will improve upper fullness. However, your breasts will still be low and sag over the implants. In a bra, they will look better.

As long as you are ok with that result, you can restore lost volume with an implant, size to be determined during consultation with a plastic surgeon.

Best results would be implants for volume with a lift for shape.

Dear manders6978,
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