I want larger, fuller, natural looking breasts - will I need a lift? (Photos)

Thank you for your question. Since your nipples sit below the inframammary fold, augmentation alone will worsen ptosis. The most reliable plan is a combined augmentation and lift: an implant—typically a moderate or Moderate-Plus profile—will add fuller, natural upper-pole fullness that doesn’t sit “too high,” matched to your base width for a natural look. A lift is necessary to reposition the nipple–areola and tighten the skin envelope. The type of lift depends on how far the nipples need to move—usually vertical (“lollipop”) for moderate ptosis; Wise/anchor if there is more skin excess; a periareolar or donut lift won’t provide enough elevation and often widens the areola. To minimize scarring, use careful closure, taping, silicone, laser treatments, and consider internal support materials like P4HB or GalaFLEX to help with longevity without external scars. You should have an in-person exam with a board-certified surgeon to assess nipple position, skin quality, base width, and to determine the best implant size, profile, and lift pattern.

I would highly recommend implants with a lift. Proper scar care and good follow up will maximize how minimally visible the scars are over 12 months.

That’s such an important and well-considered question. You’re absolutely right to think carefully about achieving a natural, full look while being mindful of scarring, especially if your skin tends to mark or fade poorly.
Whether implants alone will give you the result you want really depends on where your nipples sit and how much your skin has stretched. If your nipples are still close to or slightly above the breast crease, a breast augmentation on its own may provide enough lift and fullness. The implant can gently fill and shape the breast from within, giving you that smooth, natural curve you’re hoping for, not the “high and round” look you dislike.
If your nipples sit lower than the crease, then a breast lift may be needed to bring them back to a youthful, centered position. However, there are modern lift techniques that focus on minimizing visible scars. For example, a short-scar (vertical or lollipop) lift reshapes the breast without the traditional anchor incision, and in select cases, we can perform internal tightening (auto-augmentation) to lift tissue from the inside with smaller incisions.
For patients who scar easily, I always take extra precautions, using delicate closure techniques, medical-grade scar treatments, and laser therapy post-op to help scars heal as discreetly as possible.
Dr. Sibel Atalay, MDBoard-Certified Plastic Surgeon & Destination Doctor

Hi, Thank you for your inquiry! We here at Mays Plastic surgery would love to sit down for a consult to discuss your concerns. With breast laxity you have options. A breast lift, and adding volume, whether its fat transfer to your breasts or implants. Schedule a consultation with a Board Certified Plastic Surgeon to help you reach your goals.

Thanks for your question! I believe you would be a great candidate for a breast lift. If scarring is a concern to you, proceeding with just a breast augmentation is possible. However, you would need to keep in mind that the location to where your breasts sits will not change, they will be just be fuller. We would love to help you, feel free to schedule a consultation at our office.

From your photographs, it seems almost certain you would need a breast lift. This would allow your plastic surgeon to improve your natural asymmetry, but this would require a vertical scar. A board certified plastic surgeon would be able to give you a few options and perhaps the best overall plan to me your expectations for fuller breasts.

Dear Forceful580804,

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

Thanks for your question! You will absolutely need a breast lift to get a good result. You may even need a small reduction on the larger side. If you are active in your scar care (ie: scar gel, silicone sheeting, microneedling, etc), you will fare much better! Good luck!

Dear Forceful580804, thanks for sharing your pictures and concerns, after analyze your case I can rather say that no that much large implants for augmentation and a lift can help to improve the look of your breast and give that natural look you are looking for. Make sure you go on consultation with a board-certified plastic surgeon. Hope this helps and best of lucks. Dr. Luis Mejia

Forceful580804,The best way to answer this question is to understand the difference between a lift and an augmentation. A breast lift, or mastopexy, will elevate the height of your nipple and tighten your skin envelope. A breast augmentation with an implant (or fat) will add volume to your breast. In some situations, an implant will add enough volume to fill in the lose skin and raise the nipple. In other situations, an implant will be combined with a breast lift for the desired result. Some patients want a breast lift alone because they want perkier breasts without any additional volume added. Best to have a consultation with a plastic surgeon to understand the results of these options and see what meets your goals the best! You may realize once you select your implant size that your nipples will still be too low and to get the look you want will require a lift as well. There are things that can be done to minimize scaring including avoiding sun and smoking, staying hydrated, minimizing tension on your skin, massage, and silicone. Ask to see before and afters from your surgeon to understand the range and location of scaring for surgery.Dr Stein