Lift Needed or NOT? Gel Implants 400-450cc? (photo)

31y old, 3 pregnancies. I have had 1 consult so far and am scheduled with another PS to compare consults. I was told I was borderline needing a lift. BUT could go with a slightly larger implant and would get the fullness I'm looking for. I want a more natural appearance. We discussed the snoopy deformity issue and that in the future I may want to consider a lift if I was not satisfied with how the BA looks. Was also told that I may get the BA with out a lift and have no issues. WHICH will give best result under or above muscle?

Doctor Answers 18

Breast augmentation with or without lift after pregnancy

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So far it seems as though you have been told all appropriate things based upon what you have written and what your images show.  I agree that you are sort of borderline, and you could likely get a satisfactory result from breast augmentation with or without a lift.  The key question is what your specific goals are and what procedure is likely to best meet YOUR goals.  For instance, if you wish to be really full busted and somewhat disproportionately large on top, then the use of a large implant without a lift might serve you well.  However, if you wish a more modest increase in volume and dimension of the breasts but still want a fuller rounder shape, then you might need some form of lift.  Also bear in mind that there are different ways to lift a breast, and each will produce slightly different results.  Additionally, you should definitely consider a surgeon who is skilled in performing breast augmentation with a dual plane technique, because that is the one way that we can virtually eliminate the "Snoopy deformity" with breast augmentation alone in ladies such as yourself with mild ptosis and who may not want a lift.  It is also true that just because you don't get a lift right away it doesn't mean that you can't get one in the future.  It would be an additional procedure, but if you aren't committed to the idea of doing that right now, you can simply get a breast augmentation and see how you look, and if you determine in the end that you would like more fullness and projection, then a lift can usually be done fairly easily.  Although a personal consultation and exam are necessary to know exactly what type of lift is best for you, I will venture a guess and state that you would most likely only need a periareolar, or "donut," mastopexy to meet your goals if you did opt for a lift.  Continue to obtain consults and opinions until you find a surgeon who seems to really understand what you want and takes the time to thoughtfully plan a procedure to meet your individual needs the best.  Good luck.

San Diego Plastic Surgeon

Small implants and simultaneous lift

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You are an excellent candidate for a new technique called Breast Augmentation with Mini Ultimate Breast Lift.  Using only a circumareola incision it is possible to reshape your breast tissue creating upper pole fullness, elevate them higher on the chest wall and more medial to increase your cleavage.  Through the same incision, an implant can be placed.  Aligning the areola, breast tissue and implant over the bony prominence of the chest wall gives maximum anterior projection with a minimal size implant.  Smaller implants look and feel more natural, are less likely to ripple or less likely to have complications that need revision.  If you simply place an implant, the added weight will cause breast descent and you will need two operations instead of one.  Many women avoid lifts because of the ugly vertical scars of the traditional techniques.  However, this new technique eliminates ugly vertical scars.


Best Wishes,


Gary Horndeski, M.D.

Lift Needed or NOT? Gel Implants 400-450cc?

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Thank you for the question and pictures.  Understanding that accurate device would require in person consultation, I think that you  will be able to achieve a very nice outcome with breast augmentation surgery only. In my practice, I would offer you a sub muscular ( dual plane) breast  augmentation procedure.

Generally speaking, the best online advice I can give to ladies who are considering  breast augmentation surgery ( regarding breast implant size/profile selection) is:

1. Concentrate on choosing your plastic surgeon carefully.  Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you're looking for. Ask to see lots of examples of his/her work.

2. Have a full discussion and communication regarding your desired goals  with your plastic surgeon. This communication will be critical in determining  breast implant size/type/profile will most likely help achieve your goals. 
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as  “natural”  or “C or D cup” etc means different things to different people and therefore prove unhelpful.
 Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup  size may also be inaccurate.

3.  Once you feel you have communicated your goals clearly,  allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals.  Again, in my practice, this decision is usually made during surgery.

I hope this (and the attached link) help.

Breast Augmentation - Lift

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Based on your photos it would be tough to predict the necessity to do a small lift.  It's discussion best held during a consultation and with precise measurements.  From a initial photo evaluation, you are perhaps on the borderline for needing a lift and in my practice I would put in implants and allow them to settle before I make that decision.  Best wishes!!

Breast lift not needed with large breast augmentation.

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The amount of the parent droopiness is relatively modest. Breast augmentation of the volume you describe should be enough to camouflage the modest breast position problem.

Breast lift or not with augmentation

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It is difficult to tell from your photos if you need a lift for sure.  The use of shaped silicone gel implants may provide you a more natural look with or without a lift, since these implants tend to shape the breast, unlike round implants where the breast has more tendency to shape the implant.  You should discuss your concerns with an American Board of Plastic Surgery certified plastic surgeon.

Todd C. Case, MD
Tucson Plastic Surgeon

To Lift or not to Lift?

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Its really hard to assess the position of your nipples with respect to you chest wall and overall degree of sagging just from the photos you posted alone.  Your PS will assess your chest wall anatomy, your degree of sagging, and the quality and amount of excess skin.  Based on your photos alone, I'm making an educated guess that you would do well with a dual plane augmentation.   Please see a board certified PS to learn more about your options. Dr. Basu Houston, TX

Lift or Not?

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Without an exam it is impossible to make a recommendation.  Based on your photos, you may get away with just implants for now,but with a possible lift later on. The implants will not change the shape of your breast, but will add volume. Try on sizers as you consult with a Board Certified Plastic Surgeon to discuss your concerns and expectations.

Do I Need A Breast Lift or Just An Augmentation

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Dear Chichis2014,  You have asked one of the hardest questions to answer in breast augmentation, "Do I need a lift or not to achieve a "natural look"?"  The problem is that everyone has their own definition of what is a "natural look".  This is why it is important that you discuss with your plastic surgeon the appearance you want to achieve with your breast surgery and if possible, provide some photos of the desired result.  While you may not be able to obtain that exact result, the photos and your time with your plastic surgeon will help define if the issue is just a matter of adding more volume in which case an implant alone would be the solution or do you want a different position of the nipple on the breast mound in which case some form of lift will be also needed.  Please consult with a board-certified plastic surgeon who can help you learn what options are best for you and your desired goals.  Hope this helps.

Lift or not

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Without an in person examination of your individual anatomy and discussion of your goals, it is impossible to provide specific advice to you. In general, however, a lift moves the position of the nipple upward on the breast mound and moves the breast tissue upward as well. An implant provides volume but does not change the position of the nipple. From your picture it looks as if just replacement of the volume might give you a full, natural look. You should discuss your goals with your plastic surgeons and find one with whom you feel comfortable and who understands what you want. It sounds like you are already doing this, so good luck to you in achieving your goals.

Margaret Skiles, MD (retired)
Sacramento 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.