Do I Need a Lift or Could I Get by with Augmentation Alone? (photo)

I am 36 years old, 5'11" tall, weigh 150 pounds. I have 3 children -- ages 11 and 7 year old twins. All three were breastfed until they were 18 months old. Yesterday I had a consultation with a board certified plastic surgeon. He says that he will do an augmentation alone, but that with my grade 1/2 ptosis my best cosmetic result will be with a combination lift/augmentation. If I really need a lift to get a good result, I think I will just skip surgery altogether. What is your opinion?

Doctor Answers 24

Breast lift vs.Augmentation alone.

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If you had not provided the specific information on your height and weight, I would hve recommended a lift and augmentation. But, you are tall and although you have drooping to your breasts, they have an overall nice look to them. If the implants are placed subglandularly and you choose a size that has sufficient volume, I think you would be happy with an augmentation alone. It will avoid the additional scars and if at some point you decide that you would like to have a lift, then you will do it then. 

San Francisco Plastic Surgeon
4.8 out of 5 stars 44 reviews

If your sagging is minimal, just have breast implants. A lift can wait.

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You do have a little sagging, but just a little.  Breast implants will fill your upper poles nicely.  Your nipples will still ride just a little low, but that's okay.  A little sagging is very natural. 


My advice would be to have implants alone, which is also a good idea if you are at all reluctant about having a lift, which you are.


You don't burn any bridges this way.  You can come back for a lift later.  If you do have a lift, a vertical lift is the best.


Have a look at photos of other women with just a little sagging.  I've attached a link to my website.


Good luck!

Eric Swanson, MD
Kansas City Plastic Surgeon
4.7 out of 5 stars 62 reviews

A breast lift with implants is likely your best option.

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Thank you for your question and the photos.
A breast lift with implants is likely your best option. Implants alone do not lift breasts. Breast implants restore lost volume but do not provide lift.
To be sure, see two or more board-certified plastic surgeons in your area for a full and complete evaluation to make sure you are a good candidate and that it is safe for you to have surgery. I hope this helps.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 221 reviews

A lot depends on how large you want to be

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Your nipple is just above the inframammary crease, from your lateral view. You don't appear to have much breast tissue in the upper portion of your breast, so most plastic surgeons would recommend a sub muscular implant. That will place the implants higher on your chest than when they are placed sub mammary. This will most likely cause you to have a "Snoopy dog" look or double bubble appearance, unless you have a breast lift performed. The lift could probably be done with an incision around the areola. Some plastic surgeons prefer to perform the augmentation and lift as two separate procedures. I prefer to do the procedures at the same time and if necessary, perform a minor touch up procedure under local anesthetic in the office.

Joseph M. Perlman, MD
Houston Plastic Surgeon
4.3 out of 5 stars 27 reviews

Mini Ultimate Breast Lift best choice for maximum lift with implants and no vertical scar

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Dear Kristen,

I understand your hesitance in not wanting the unsightly scars involved with outdated vertical lifts. The Mini UBL is a technique that repositions your breast tissue directly over the implant to successfully avoid the 'double bubble' look. This technique utilizes a circumareolar incision only - no vertical scar. It is NOT a Benelli lift. The Mini UBL achieves a round, perky natural appearance with minimal scars.

FYI, the problem with placing breast implants above the muscle is that they have no support other than the skin. As you know, skin is simply not enough to hold the weight of a breast for very long especially when you add an implant. So, with this method, the bigger the implant the sooner you will need a real lift. Correcting this type of ptosis is extremely difficult.

Breast implants do not lift breasts, so please do not be misled. I stopped doing this years ago because it simply did not work for your degree of ptosis.

Your breast tissue MUST be lifted and anchored securely from within to accomplish a true and long lasting lift.

Vertical scars only weaken the skin envelope by placing an incision at the point of maximum tension. This method works well without an implant, but its simply not aesthetically pleasing with the visible scar. If an implant is added with a vertical incision in place, the weight of the implant eventually stretches and weakens the scar allowing the implant to 'bottom out'. Not a pretty look.

I hope this clears things up for you.

Kind regards,

Dr. H

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

Is a Lift Needed?

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In order to get the best results I would recommend getting the Breast Lift because it does look like the breast are falling below the breast fold. 

Robert N. Young, MD, FACS
San Antonio Plastic Surgeon
4.6 out of 5 stars 73 reviews

Do I Need a Lift or Could I Get by with Augmentation Alone?

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I have read all the expert responses. To lift or not to lift with implants??? I might suggest try larger implant in dual plane position, like a 500 cc HP. If after 3 months you are not satisfied than a lift can be done. Regards 

Breast implants alone can give you a lift

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If you go with larger implants like around 400cc you may not need a lift.  However, if you want to go small than this you may need a periareolar breast lift.

Breast lift or augmentation alone depends on desired results

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Do you need a breast lift or implants alone? This all depends on what your expect your breasts to look like after surgery. If you want them higher and fuller, then you will need a breast lift with implants. If you only want them larger, the upper pole filled and a natural look, you could achieve this with implants alone. Good luck!

Donna Rich, MD
Webster Plastic Surgeon
4.5 out of 5 stars 33 reviews

Augmentation Alone vs. Augmentation/Lift

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I would agree with your surgeon that the best result would include some form of a lift, whether it be a periareolar or vertical technique.  That does not mean that a "good" result could not be obtained with augmentation alone, incorporating a dual plane dissection to offset some of the glandular sagging.  You would have to be comfortable with using a larger implant to more thoroughly lift the breasts.  Since you are tall, larger implants would not look overly artificial.  It really depends what you would be willing to accept in a larger cup size, and what you consider to be a good result.

Christopher J. Schaffer, MD
Birmingham 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.