Lift Vs. No Lift? (photo)

Doctors have told me I can have just a lift. OR just implants because the "sag" isn't advanced and they think the implant will fill out the lost fullness on top. OR I can have the lift and the implants at the same time. I can't decide. I have had large breasts since a very young age but about 3 years ago I lost 80 lbs. and they are much smaller. What would your opinion be as to which procedure would work best for me? I am 46 years old, active, 5'2", 130 lb.

Doctor Answers 24

LIft or no breast lift

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Your question is a very common question in my practice. The question is relevant, logical, and important. The answer depends on several factors. 

First of all, there are two guidelines I follow to determine whether a patent needs a lift or not. If one stands upright in front of a mirror and were to place a small pencil or long Q tip in the breast fold oriented transversely, you must see where the nipple position falls in relation to this line. (the pencil) If the nipple is above the line then you have no droopiness clinically. if the nipple is at the line then it is called grade I ptosis(droopiness). The nipple is below the line then you have grade II and if the nipple is at the very bottom of the breast it is termed grade III. If you have grade II or II ptosis, then you need a lift. If you have no ptosis or grade I ptosis, then I measure the distance from the nipple to the breast fold, as measured on the skin as it curves under to reach the fold. If this distance is 7 cm or less, you may not need a lift. If it is 9cm or greater, you definitely need a lift. If you are 8 cm you must decide whether you can live with scars for a better perkier contour or you can accept some "maturity" to your breast over the scars that necessarily come with a lift. 

I usually show photos to the patient that are reasonable examples of both scars and enlarged breasts with maturity. One continuous mistake I see many women make in trying to avoid scars is going with larger and larger implants. they end up with larger even droopier breasts. As you think about it, if your skin can not keep your current breast volume perky, how can it hold up under additional weight long term?  A short term gain in upper breast fullness usually results in long term disappointment in this situation. 

I recommend getting multiple opinions from board certified plastic surgeons  before making such an important decision. 

Good luck. 

Dallas Plastic Surgeon
4.6 out of 5 stars 47 reviews

Mastopexy or lift for sagging after weight loss

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Implants and No Lift
This is usually a mistake. Most breasts will look larger and more droopy. They will sag more and sooner because of the excess weight. The shape will usually not be satisfactory. There will sometimes be a “Snoopy” breast or double bubble.
If the nipples is in a fairly high position on the breast or “glandular” ptosis or drooping , an implant may be useful.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Lift and Implant or Just a Lift

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    An implant should be placed only if you want larger breasts or more fullness in the superior pole.  The type of lift will depend to some degree upon the size of the implant placed and the exam.


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there is no lateral photograph of your right breast which actually sits lower than the left. I think you will need some sort of lift on this right side.

Norman Bakshandeh, MD, FACS
New York Plastic Surgeon

Lift or No Lift

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Thank you for sharing your photos.

Although you do not state your goal through the post, I believe that you have several options depending on what you want to accomplish.

Larger implants will allow you accomplish a limited lift but will be dealing with the effect of mother nature (gravity) and ptosis will happen sooner than if you consider going with smaller implants.

A lift alone will provide you with correction of the ptosis (drooping) exhibited in the photos (especially the profile one - 3rd) but you may feel that your breasts are smaller than what you would like them to be.

A combination of a small implants with a lift could be the best approach to consider. With this option, the larger the implants are the less successful the lift will be.

That being said, please remember that commendable results require an exceptionally skilled surgeon to perform the surgery and settling for anything less than that increases the chances of additional corrective surgeries dramatically.
I hope this helps and please feel free to check the website below.

Thank you for your inquiry.
The best of luck to you.

Dr. Sajjadian

Ali Sajjadian, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 205 reviews

Lift versus no lift with breast augmentation

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Great question. Answer depends on your goals. For patients in similar situations I discuss the following considerations:

  • Larger implants may fill out the breast skin enough to make you happy without a lift, but larger implants will stretch tissues more over time increasing revisions.
  • If you are happy with your nipple position and breast shape, consider implants alone. You can always have a lift later if you decide you want to be perkier. 
  • If you want the perkiest result possible, an augmentation plus lift may be required. These can often be done in one stage.
  • If you are still unsure, consider getting an aug alone. In my experience, most women with minimal sag are happy with breast implants alone.

A discussion with a plastic surgeon who can examine you is the best way to get feedback for your individual case.

Best wishes,

Michael Vennemeyer, MD

To lift or not to lift

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Thank you for your question and photos.  As you have seen, there are many different answers to your question. I think you are borderline with regards to needing a lift.  Depending on your goals, you may do well with an implant alone.  You may, however, need a staged breast lift if the bresat tissue sits too low compared to the implant.  A mastopexy alone may suffice for reshaping the breast and repositioning the nipple, but the lift will not give you a full upper pole in most cases.  Combining the operations together is safe, however, the complication rates go up. Without an exam, it is impossible to recommend one option with certainty. You should discuss your concerns with your board certified plastic surgeon and get several opinions until you feel comfortable.  Good luck!

Lift and/or implants

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It sounds like from your description that you would like larger breasts as you used to have before you lost weight.  Therefore, an augmentation will be needed.  If you only do the augmentation, there is a chance the breast will sit slightly lower than the implant.  So, mostly likely you will need a lift as well.  An in person exam and a thorough discussion with your surgeon will help you make your decision.  Good luck!

Naveen Setty, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 78 reviews

Lift versus lift with implants depends on your desires

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It looks like you need a lift at the least - if you want more volume as well, you will need an implant.

Lift only, or lift with implant

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The first question to be answered is "Do you want to be bigger?"

If you are happy with your current size, then a lift will make you perkier, but maintain your current size. If you want to be bigger, then do the implant only, knowing that if you go large enough, the implant will take up the extra skin, but if not, then a lift can be done later.

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.