Lift or no lift? Advice greatly appreciated, I'm really confused and stuck (Photo)

Question

I've had 5 consults&have had varying advice. I'm trying not to get upset&stressed with making the right choice for the best result. Anwers: 1: no lift & round implants 2: Periaerola lift, mesh bra & implants. 3: No lift & implants 4: T lift & implants 5: No lift & teardrop implants I know I have a small space between my nipple and base/mild tubular & loss of volume on top. Will implants alone improve the shape or do I need a lift. I really don't want a vertical scar.

Jonathan Heistein, MD · Answer

I would recommend no lift.  As long as you don't use too large of an implant, your nipples will end in a very natural and normal position without the lift.  Also, without the lift, you can avoid unnecessary scars.  Best of luck!

Moises Salama, MD · Answer

Thanks for your question. From these pictures, it seems like you're a good candidate for a breast augmentation alone. I recommend scheduling a consult for a proper evaluation. Be sure to always consult with a board certified plastic surgeon. Take care, Dr. Salama, Board Certified Plastic Surgeon.

Gulcin Nujen Cardak, MD, FEBOPRAS · Answer

Hello, thank you for sharing your photos. I have evaluated them and I can confidently say that you don’t need any lifting surgery. You don’t have any sagging, and your skin looks good, so augmentation alone will work perfectly.Regarding implant shape, in my opinion, round implants would suit you better, since you already have a natural tear-drop–shaped breast. By adding equal volume to both the upper and lower parts, the final result will still be a tear-drop shape.I hope this helps you.

Daniel Barrett, MD · Answer

Dear neurospicy91,

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

Ira H. Rex III, MD · Answer

A straightforward and simple approach may be to have breast augmentation and consider a lift at some future point.  You may be quite satisfied with just the augmentation and avoiding further surgery.  From your photographs, I am not sure you are even a good candidate for a lift.  I usually recommend round implants.  Round implants will often settle into a teardrop shape depending on the surgeon's technique and choice of round implant.

Ted Eisenberg, DO, FACOS, FAACS · Answer

After 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

John Michael Thomassen, MD · Answer

I would recommend the implants alone with a muscle release that will cause the muscle to windowshade and lift the nipple areola without scars.  Your nipples are above your inframammary fold, which usually means a lift is not needed.  Also shaped implants have fallen out of favor due to risk, although infinitessimal, of a reaction with surrounding tissues due to texturing of these implants.

Guler Gamze Eren, MD · Answer

Hi from Istanbul, Thank you for your question.You have a low seated breasts on the chest wall and a contracted fold.You will probably be unhappy with an implant without lifting. The nipples will look down unless they are lifted up. You will have a scar periaroelar or vertical. Ergonomix implants will help to enlarge the contracted lower pole.Best luck!

George Marosan, MD · Answer

Thank you for your question and photos. Based on these photos, you do have low lying breasts, but they are not saggy. The nipple areolar complex is above the breast crease from the lateral view. You do not need a lift! A dual plane submuscular augmentation with a round smooth implant based on your breast and chest wall measurements, will give you a very nice result. You probably noted, that the older, more experienced surgeons are favoring smooth round implants (they have gone through the whole spectrum of possibilities) and the younger ones still promote textured shaped implants. The wheel was invented already. See a board certified plastic surgeon with extensive experience in breast surgery for an in person consultation/evaluation. Good luck.

Gerald Minniti, MD, FACS · Answer

Photos don't help, unfortunately. The size of any given implant will dictate the ideal N/FD. Once you've been sized in the office to determine volumetric needs and an implant is chosen, then your N/FD can be measured; for example, and 8 cm distance can accommodate an implant between 300 to 350 cc. If it is too short, a lollypop scar lift can displace your nipple and increase N/FD. If it is sufficient, then no lift is recommended; the implant will sit in a position to bolster the overlying nipple areolar complex, leaving you with a pleasing shape.

Lift or no lift? Advice greatly appreciated, I'm really confused and stuck (Photo)

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