Do I Need a Lift with a Breast Augmentation

For several reasons I really do not want a lift and I just had my first consultation and the surgeon recommended a lift for me and really didn't give me any other options. I am small framed so I don't want to go extremely big. I would prefer to go under the muscle as well. Besides the sagging the skin is thinner as well. Thanks for any information.

Doctor Answers 30

Do I need a breast lift or just implants?

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Very few people interested in breast augmentation come in wanting to have a lift...the question is whether you need a lift in order to avoid a bad result. Although it is difficult to tell exactly where your inframammary fold is without measuring you, it looks like your nipple level is below the level of the inframammary fold, and that you have a significant amount of breast overhang below the level of the fold. Since the implant has its bottom at the level of the fold, and only fills out the tissues above this point, tissues hanging below the fold will not really be filled out.  They will hang off the implant, and the contour will not be pleasing to the eye.  There is no reason that you have to have the implant and the lift done at the same time.  If you need to see the results for yourself, you can certainly do the augmentation and see if the result is one with which you are happy.  If not, do the lift later.  But if you want to get it all done in one stage, then have your surgeon discuss your anatomy and measurements with you, and get a second opinion if you would like to hear it from more than one person.

Breast implant and breast lift

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Judging from your photographs, if you have implants under the muscle without a lift, you risk a 'double bubble' appearance where the implant sits higher under the muscle and the breast tissue droops lower.

The best appearance is likely to come from - 1) just a lift if you are happy with the volume of your breasts within a bra, or 2) a lift and a small-ish implant if you would like some more volume and projection.

Anindya Lahiri, FRCS (Plast)
Birmingham Plastic Surgeon

Do I need a lift with breast augmentation?

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I agree with your surgeon - you need a lift.  I can understand why you wouldn't necessarily want to take on the extra scars and potential complications associated with a lift, but there is no doubt that you need one to restore the shape of your breast.  If you are happy with the volume of your breast in a bra, a lift is all you need.  If you want to have a larger cup size, then you will need an augmentation as well, which can be done at the same time or separately.

In my view, it is negotiable whether you have the augmentation or not, but the lift is not negotiable.  Good luck.

Breast Lift with Augmentation

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Thank you for sharing your photos.   I do think you will need a breast lift with a lollipop or possibly an anchor shape incision.  This will depend on an in office exam and how large an implant you select.  Here are my criteria:

Candidates for a Breast Lift (Primary Breast Shape Concern):
1.  Patient is happy with breast size in a bra, but desires improvement in shape.
2.  Nipple position sits at or below the level of the breast crease (inframammary fold)
3.  Significant amount of loose skin and breast tissue, which hangs over the crease leading to a hollow appearance in the upper pole of the breast.

Candidates for Breast Augmentation (Primary Breast Size Concern):
1.  Patient is happy with nipple position and amount of skin in relation to crease.
2.  Desires increase in volume of breast to increase bra cup size and provide more cleavage and fullness to upper and lower pole of breast.

In many cases, patients have concerns of both size and shape, therefore requiring a breast augmentation with a breast lift to achieve desired results.  I hope this helps.
Dr. Gill

Paul S. Gill, MD
Houston Plastic Surgeon
4.8 out of 5 stars 94 reviews

Improved shape with a lift out-weighs the scars

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Thank you for your question and photographs. Based on your pictures, I would strongly recommend a full breast lift. I agree that your implants should be placed under the muscle for a wide variety of reasons. You appear to have lot of extra breast skin. I feel that the improved shape and contour that you get from a breast lift out-weigh the scars.

James McMahan, MD
Columbus Plastic Surgeon
4.8 out of 5 stars 40 reviews

To lift or not to lift.

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You certainly can have an augmentation without a lift. However, you are likely to be unhappy with the results. Without an overly large implant, the breast tissue will tend to "hang" off the implant which most women dislike. You can always stage the procedures and have the lift later to be sure that you want it, but that is likely to cost a bit more as an additional surgery.

David Bogue, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 26 reviews

Breast Lift Is Needed When the Nipples Are Low on Your Breasts

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Patients frequently wish to have only breast enlargement instead of breast enlargement with a lifting procedure because they want to avoid the additional scarring.  I spend 30 - 45 minutes reviewing a patients medical history and expectations for their result,  examining their breasts and discussing the possible options.  It is important for you to know why you need a breast lift, since it involves extra scarring. You should also know how those scars will usually look once healing is complete

Here are some of the most important features I use to decide if a patient needs a lifts along with breast enlargement:

1.  The breasts droop and the nipples point downward with the nipple sitting lower than the crease under the breast

2.  The nipples face forward but are low on the breast with little or no skin visible beneath the nipples

3.  When the measurement of the skin from the areola (edge of the nipple) to the crease beneath the breast is more than 7- 8 cm when the skin is stretched upward.

4.  When the nipple and areola are very large and relatively low on the breast

5.  When the breasts have lost most of their volume in the upper area of the breast

I notice in the photos that your arms are partially raised which helps lift the breasts slightly.  Judging from your photos your left  nipple and areola is lower and appears to meet  2, 4 and 5 above.  Your right breast nipple and areola is higher on the breast and just meets 4 and 5. 

If both breast were shaped like the right breast you might be a candidate for augmentation alone (depending on your measurements).  With the amount of drooping you have on the left it appears some form of breast lift is needed to give you the best result possible.

I find most women are happier with a very good result using a breast lift than an average result without a lift.  But you are not most women and everyone is an individual.  If you are very much against any additional scars on the breasts it may better to stay with what you have now.  If you proceed with breast implants alone you will most likely end up with a bigger version of what you have now.  I have learned from experience that women are not happy with this result.

I hope this helps in this important decision.  Also, if you are not totally happy with the first consultation experience, by all means seek out an additional opinion. 

Need for Mastopexy - Breast Lift

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Based on your pictures and especially since you say that you do not want large implants, you definitely need a breast lift in addition to a small implant to achieve the best results.


Good Luck.

Choose a minimal scar breast lift

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In your case, it appears you can get a good result with a minimal scar lift with the incision just around the areola.  The augmentation can be done through the same incision. These scars heal very well and are frequently nearly imperceptable.

John Squires, MD
Denver Plastic Surgeon
4.9 out of 5 stars 82 reviews

Breast Implant and lift

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Based on your photos, I agree with your surgeon. You will get the best result when you combine breast implant and Mastopexy (lift). Not all patients need a lift with breast implant. For most patient's, the main concern is scar and cost. The scar can be placed around the nipple for both the lift and augmentation. The scar fades over time. Cost of lift varies. Make sure your surgeon is a board certified Plastic surgeon.

Stanley Okoro, MD
Atlanta Plastic Surgeon
4.7 out of 5 stars 168 reviews

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.