Lift and Over? Asymmetry, Sagging.

I'm getting a bl and ba. The lift is due to VERY noticeable assymetry, and the the bigger one has a lot of sagging. (My left is about a B cup and the right an A cup) The ps told me that I have enough breast tissue to have implants over the muscle. Will having the lift now prevent me from having another later? I've heard that a disadvantage of having overs is that with time they produce sagging. I was leaning toward unders but now I'm confused. BTW, I am going for about 250-300cc.

Doctor Answers 5

Lift necessary

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A lift is sometimes necessary for patients undergoing breast augmentation.  As for needing a future revision it is dependent on multiple factors.

New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Breast Implants and Lift

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  In general, placing the implants under the muscle is usually the best option.  As tissue thinning occurs and rippling, the muscle provides another layer of coverage.  It also tends to create more camouflage for the implant.  Kenneth Hughes, MD Los Angeles, CA

Breast Augmentation/Lifting and Positioning of Breast Implants?

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Although it is not possible to provide you with specific advice online,  I generally offer patients breast augmentation/lifting with the breast implants placed in the sub muscular ( dual plane)  position.

This positioning allows for more complete coverage of the breast implants leading to generally more natural feel/look  of the implants in the long-term. This position will also decrease the potential for rippling and/or palpability  of the implants (which may increase with time, weight loss, and/or post-pregnancy changes).

The submuscular positioning  also tends to interfere with mammography less so than in the sub glandular position. The incidence of breast implant encapsulation (capsular  contraction)  is also decreased with implants placed in the sub muscular position.

I hope this helps.

Risky to place implants above the muscle at the time of breast lift.

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In my opinion it is preferential to put rest implants below the pectoralis muscle when augmentation is done with a breast lift concurrently. This has to do with blood supply to the healing tissues.

Lift and Over? Asymmetry, Sagging.

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It is difficult to give specific advice without at least photos. I find that for the overwhelming majority of patients the advantages of placing implants under the muscle outweighs the disadvantages. I don't necessarily agree that an A cup breast has enough volume to make over the muscle placement a reasonable alternative, but that is just one surgeon's opinion, based upon incomplete info. 

If you develop the need for another lift in the future, it can be done. On line opinions can be useful, but probably won't clear up any confusion as well as an in person second opinion might. 

All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.