Do I need a lift or will just implants below the muscle suffice? (Photos)

Hello renpen12, this is a good question, and one of the most common questions we see routinely in cosmetic breast surgery. Really, augmentation mammaplasty and mastopexy are two separate procedures. They are very commonly done together as a combination procedure with good results (combination approach is generally accepted to have a slightly higher revision rate), although there are surgeons out there that prefer to do them staged. Based on your pictures, it appears that you have grade I breast ptosis, which means your nipple position is approximately at the level of the lower breast crease. Not infrequently, in borderline cases such as yours, I will discuss with patients the option placing the implants only and only do a lift (typically at 6 months post-op) if needed. There is a reasonable chance you will need a lift in addition to implant (if I had to guess a very rough number, maybe 40-60%), but I am often surprised by how often a patient does not end up needing a lift. Alternatively, if patients prefer only one surgical procedure, they can opt to go ahead with augmentation and lift, however I am careful to counsel them that there is a slightly higher revision rate with a combination procedure, so there is a chance they would have two surgeries anyway. Regardless, I would recommend submuscular positioning. Hope this helps. Thanks, Brian

Dear renpen12,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

It appears that your nipples are located below your breast fold, therefore a lift would be recommended.

Thank you for your question and for uploading the photographs. Your breasts present some minor degree of laxity and asymmetry (entirely normal).

Due to the width of your breasts, I believe the your implants should not be too small, otherwise they would not be able to allow you to achieve the desired cosmetic result.

Trust the judgement of the surgeon you have selected and make sure you have a long and thorough conversation so that he/she is aware of what you would like to achieve.

All the best

Andrea Marando
Consultant Plastic and Cosmetic Surgeon at Star Clinic
Manchester and London, UK

Hello, thank you for your question. Thats great to hear ! you maybe able to get away with just an implant depending on your end expectations. Speak to your plastic surgeon about what can be done. Bring in some wish pics. Feel free to check out our before and after gallery for something you may want to bring with you.

Thank you for your query! You have lost some volume and have what we call “pseudo ptosis”. The best option for you , with minimal scars is breast implants that can be inserted in the dual plane (upper part behind the muscle and lower part behind the breast tissue) or the sub-fascial plane. Please find an experienced Board certified Plastic surgeon who can examine you and help you with all your concerns. All the best!

In general, I would offer you a breast lift. You have some breast asymmetry and some excess lower pole skin, both of which are more appropriately addressed by a lift with implants rather than implants alone. However, larger implants could help to fill out the lower pole of your breast. Many women will be satisfied with larger implants even if the breast tissue is not centered perfectly around the implant. Performing the implants first can also give you the option of pursuing a breast lift later if you are unhappy with the result, and staging these procedures can decrease the need for revisions long term. I would make sure that you are consulting with a board certified plastic surgeon to ensure the best outcomes.

Based on the fact that your nipples are bellow breast crease, implant augmentation alone will not correct that condition. Vertical breas lift with lollipop scar and implants in the range of 300 ml. would be my suggestion. Hope this helpd. Good luck.

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

Hi, thank you for sharing your question. It’s difficult to say based on photos alone but you seem to be a good candidate for breast implants alone without a lift. Discuss your options with your board certified plastic surgeon