Do I Need a Lift with my Implant? I Have Been Told Yes and No (photo)

I have been to 2 of the best dr's in my area. 1 said I need a full lift with my implant. The other was shocked that I was told that. He says a silicone 400 cc is all I need. w some lipo on the sides of my breast for better curve. I have very Bad stretch marks from puberty and my breast sit low. I have learned how to hid them with clothes. there is nothing to help the stretch marks but I don't want negative attention to them.I went with implant and lipo but am starting to doubt it. BA is in 2 wks

Doctor Answers 14

Breast Lift Good Idea But Can Be Done Second

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Thank you for your question. I understand your dilemma. However from looking at your photos and listening to your concerns it is likely that you will need a breast lift to reposition the breast to a better location on your chest.

A combination breast augmentation and breast lift can certainly be done as a single procedure. However many plastic surgeons prefer to do a breast augmentation and wait for the implant to settle to its final position before doing the breast lift as a second procedure.

Most important factor is that you have trust and confidence in your plastic surgeon and I would suggest that you follow the advice of the plastic surgeon who you are most comfortable with and whose recommendations make the most sense to you.

Breast Lift With Implants

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The pictures submitted are not adequate to define the base of the breast and where it is attached to the anterior chest wall. That is the point which determines whether you need a skin lift to your breasts or only more volume to fill your existing skin on the chest. The position of your breast on the chest determines if you need a skin lift or not. The most critical relationship is the position of the nipple compared to the base of the breast where it meets the anterior chest wall. Mild degrees of ptosis may benefit from a skin lift but it is not always required. A 400cc volume implant will allow elevation of the breast by filling the skin of the breast and will simulate a lift providing the nipple is in a good position at this stage. I would suggest you return to your surgeon to discuss this further and have him explain it to you in a satisfactory manner. Breast surgery is very private and personal and if you are not satisfied with the explanation of the recommended treatment, you should definitely seek another opinion until that is achieved.

Sherif M. Khattab, MD
Torrance Plastic Surgeon
4.5 out of 5 stars 9 reviews

Breast augmentation and lift

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You absolutely need a lift. You will be extremely unhappy without it. On the frontal view you can see the upper edge of the areola is at the level of the fold, the areola are stretched out vertically and there are lots of stretchmarks. The entire breast mound is below the lower edge of the pec major chest muscle. The skin has lost its elasticity and will not shrink wrap tighten around an implant. I would bet that if you pull one nipple straight forward with your ams down at your side it will move outward at least 3 or 4 cm and the breast skin will still be lax. That means you would need a very large implant to fill that skin envelope.

If you put an implant under the muscle most of the breast tissue will lie lower than the lower level of the implant. If you put the implant above the muscle it will make the drooping much worse since the skin does not have the elasticity to hold it up. You need to balance out the size of implant with the amount of lifting/skin scar you are willing to accept. It is clear that you understand that you cannot get rid of all of the stretchmarks. You could do the implant first and the lift at a later date. You also need to know that if you do the lift and implant at the same time there is a chance you will need some revision or fine tuning of the lift at a second operation.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Aaron Stone, MD
Los Angeles Plastic Surgeon

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Do I Need a Lift with my Implant? I Have Been Told Yes and No

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My vote is YES!. But you can try a larger implant allow 3 months healing than do a lifting operation. 

Yes you need a lift

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Your nipples look too low in the photos and there is too much lax tissue in the lower pole to get a great result without a lift and augmentation.  Liposuction has really no role in your case.

Is a lift needed with your augmentation?

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As you know, there are many opinions out there but the bottom line is what are your expections?  If you wish to be perky and firm, a lift is likely needed.  If you would be content with matronly but fuller breasts, you probably don't need a lift.  As for the circumareolar lift, I am not a fan of it due to the potential for stretching of the scar and flattening of projection and would advise against one unless you are willing to accept those shortcomings.  The bottom line is what do you expect of this.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Don't Do It!!!

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I hate to dispute what one of the "best doctors" in your area recommended but he/she is wrong given the photographs you have submitted here!!!  The best choice for you is placement of the breast implants under the muscle and a CIRCUMAREOLAR BREAST LIFT!!!  This approach will give you beautiful, natural breasts with minimal scarring.  If the circumareolar breast lift is not sufficient to center your own breast tissue over the implants you may need a vertical or "lollipop" lift, but I doubt it. 

Just putting in implants, either above or below the muscle, and liposuctioning the sides of your breasts will give you a terrible result and lead to much unhappiness...go see some more doctors and good luck with your decision!


Eric Sadeh, MD
Manhattan Plastic Surgeon

Breast lift question?

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You have elevated arms in your picture and it appears that your nipple is at the level of your breast fold, with arms down it will be lower of course. So with this limited information it appears you may need a lift. If your skin is loose and implants placed then you may end up with a "rock in a sock" look which is not very attractive! In your case given the volume of breast tissue you have in the photo and the stretch marks which tells me there is a loss of skin elasticity I am going to favor the opinion that a breast lift is needed. Good Luck!

Gregory T. Lynam, MD
Richmond Plastic Surgeon
4.9 out of 5 stars 62 reviews

Lift and implants

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Bases solely on your photos, it looks like you could benefit from a small lift with implants.  Best to discuss this with your surgeon.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews


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Hello. Judging by your pictures it looks like your nipples are lower than your inframammary fold. If this is the case I would definitely recommend a lift as your best option of correcting your ptosis. A consultation would definitely be helpful in determining your best option as it is hard to determine based on pictures alone.

Jaime Perez, MD
Breast Augmentation Specialist
Plastic Surgery Center of Tampa

Jaime Perez, MD
Tampa Plastic Surgeon
4.8 out of 5 stars 81 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.