Do I Need a Lift Before Breast Implants? (photo)

I am 45 with three kids and I am 112lbs and 5'3. I want to get implants but i didn't want a lift as I don't want scars and I think it might make my changes of feeling in my breasts go away. I would like some feed back on how it will look if I get round saline 425cc implants. thank you.

Doctor Answers 16

Simultaneous breast lift and implants considerations

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There is no reason to need to separate your lift and implant procedure per se. That's usually only really needed for more complex mastopexies where either more skin or more nipple elevation is required (at least in my hands). For the small amount of movement of the nipple you'd ideally need (<2 cm), I've found the peri-areolar "Benelli lift" with a gore-tex pursestring suture employed can be a very elegant solution.


Unlike some of the other responders, I do not think you would get a really good result with an implant alone as the center of the breast will be noticeably low on the chest. If you wanted to consider that however, do the breast implant first and a small mastopexy could be performed later under a local anesthetic fairly easily.

Breast lift

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Great question!  whether you will be happy with just implants without a lift is difficult to say.  However, I would advise that you have the lift and implants done at the same time.  Personally, I think the implant size should be a bit smaller, maybe about 350 cc's.  A vertical lift should work quite well in your case.   The scars typically heal quite nicely . If you do not have lift done and just have the implants placed, you can always have the lift done at a second procedure.  There is nothing wrong with 2 staging the procedures, but I think you are an ideal candidate to undergo both procedures at the same time.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 31 reviews

Risks associated with large breast implants

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I'm afraid that we as physicians have failed to properly educate our female patients regarding the many risks associated with large breast implants.

Let me start by saying that the larger the implant (425cc are large for your frame and may not even be possible to place without over dissection) the sooner you will need another lift.

Implants are heavy. They not only stretch out your tissues, they can also cause chronic pain and even cause rib notching in some cases (very rare).

As an experienced PS who has done countless of breast implant revisions, please be cautious. If all you are looking for is to achieve a natural long term result, then I have a suggestion. There is a new lifting technique called the Mini Ultimate Breast Lift which lifts and repositions your existing breast tissue directly over a small subpectoral implant (in your case a silicone implant) to create a fuller, perkier appearance. There is no vertical scar or an inframammary scar. The only scar is one that is hidden around the areola. Nipple sensitivity is not affected.

I hope this helps,

Dr. H

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

Some saggy breast need a lift before implants but not yours.

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No, you can squeek by without a prior lift if you have your implants sub-glandular (on top the muscle) and go big enough to fill out all your loose skin. I would choose round smooth high profile implants with a range of 400-500 cc and fill them to whatever it takes to fill up the loose skin. Let your surgeon be the judge of the exact amount of fill. It's like trying on shoes in a shoe don't know how well they'll fit until you try them on. Your surgeon is the expert at this. You should be willing to have a nipple lift later if the nipples wind up a little too low.   


   Dr Foster 

Lawrence Foster, MD (retired)
Sacramento Plastic Surgeon

Do I need a Lift before implants?

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It is hard to determine from your photos as to whether you need a lift, but the most important factor is where the nipple is located relative to the inframammary crease. If the nipple is at the level of the crease or below the crease some type of lifting procedure is probably indicated. A full consultation with a board certified plastic surgeon will go over all your options, especially your goals and expectations of the final appearance of your breasts. A general rule of thumb is the more the breast is lifted, the more scars are created. Scars are forever and never go away, and only you can decide what scars are acceptable to you.The breast lift procedure and the breast augmentation can be done at the same time or separately.

Do I Need a Lift Before Breast Implants?

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Great series of posted photos, but iin person examination is still much better than over internet responses. Based only on the posted photos and your limited description I would do a lifting first to achieve a more upright appearance than aadd an implant after 3 months for size, 450 cc HP would be my choice. You can also try to have all done in one operation but again in person evaluation is needed. Good luck. 

Do I need a lift before breast implants?

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It is difficult to see from your photos where your nipples are and where your breast overhang is in relation to your inframammary crease. Why is this important? Because the bottom of an implant rests at the level of the inframammary crease and it fills out the breast above this level.  An implant has a very limited ability to fill out tissue that hangs too low past the crease. And a nipple too low on the breast and below this crease will be so far below the implant "equator" that it may point downward and look even lower. If, after careful examination by a board-certified plastic surgeon, it is determined that you are borderline, you can always try implants and see what your results are...and do a lift later if needed.  But if you are definitely beyond borderline and you go for implants alone, you will not be happy with your results.  No one wants extra scars, but most people are not satisfied with a poor shape, and in the long run accept the scars in order to have a good contour and pleasing result.

You likely need a breast lift as well as breast implants

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If you simply had breast implants, based on the photos provided, and assuming that your consultation/examination was consistent with these photos, you would have some semblance of a "snoopy dog deformity," i.e., a nice perky set of breast implants and the breasts falling off them.  Possibly with smaller implants and a subglandular (over the muscle) implant placement you could "get away without a lift", but about 80% of my patients would accept a lift with this presenting appearance, 10% would later wish they had, and the other 10% would "live with it".  I'm totally guessing about the numbers, but you get the idea. 


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From your picture our practice would recommend a breast lift the minimal (periareolar), if you get no lift at all you will have the implant up high and your tissue sagging, giving you the double look. You need to make sure you address your concerns with your PS to make sure you get what your looking for.

Stuart B. Kincaid, MD, FACS (in memoriam)
Beverly Hills Plastic Surgeon

Lift and implants

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legitimate question. from the pictures it looks like you could go either way. if you were putting in a small implant probably no but with implants in the range you are asking for you may do just fine with an implant alone. it would have to be placed in a slightly lower position but know that after 6 months or year and the settling process takes place you might first consider a lift. at that point you will probably get away with 1 of the minimal scar procedures. as stated above find a couple of good board certified experienced plastic surgeons and see what they think.

Sherwood Baxt, MD
Paramus 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.