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

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, you would likely benefit from an augmentation in conjunction with a lift. This can address asymmetry as well as the moderate degree of ptosis/sagging. Without measurements, it is difficult to comment on technique. Mild ptosis can be addressed with limited scar approaches. However, this decision is best left to an in-person consultation.
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.

Hello,
Thank you for sharing your photos and your detailed question. Based on your pictures, you have moderate ptosis (sagging), with the nipple sitting below the inframammary fold. In your case, breast implants alone would not be enough to achieve a naturally lifted and full result. If we placed an implant without a lift, the breast tissue would still sit lower, creating a “bottomed-out” look rather than a youthful contour.
To achieve the fuller, rounder but still natural result you want, you would benefit most from a breast lift combined with augmentation. The lift repositions the nipple higher and tightens the lower pole, while the implant restores upper fullness and projection.
Considering your concern about scarring, I always aim to use short-scar or vertical mastopexy techniques whenever possible. With precise markings and fine closure, scars usually fade well over time — especially if post-op scar care is followed closely.
If your skin quality and elasticity are good, a vertical lift with an implant placed under the muscle can give a very natural shape and minimize visible scarring on the lower breast.
During a consultation, we would measure nipple position, breast base width, and skin elasticity to decide the best combination for your anatomy and healing characteristics. My goal is always to create the most beautiful, natural enhancement with the least visible scar possible.
Warm regards,Op. Dr. Yücel SarıaltınPlastic, Reconstructive & Aesthetic SurgeonIstanbul, Turkey

Hello, I’ve reviewed your photos and question carefully.There seems to be a mild asymmetry between your breasts, and even if a full lift is not required, a small correction on one side may help achieve better balance.
If the skin has good elasticity and the nipple is positioned above the fold, a dual plane augmentation can often restore fullness without a lift. The high look you mentioned is usually related to implant profile. High profile implants push the volume forward, while moderate profiles create a softer and more natural shape.
Scar formation is influenced by more than the incision itself. Careful wound care, avoiding smoking, and maintaining good overall health before and after surgery all help the tissue heal more smoothly.
A face to face evaluation will show whether implants alone can achieve your goals or if a small lift on one side would create a more symmetrical and harmonious result.
I hope this gives you a clearer sense of how careful planning and healthy recovery together shape a natural outcome.
Güray Yeşiladalı, MD