Would I Need a Lift in Addition to Implants?

Hello Dr's My body is not quite the same after 3 children and a lot of weight gained and lost. Just wondering your opinion on whether I would require a breast lift as well as implants if I was to ever regain what once was! Thank you.

Doctor Answers 10

To breast lift or not to breast lift

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Hello, I think the answer really all depends on your goals.  Your breasts are deflated from multiple pregnancies and you have some sag.  Your nipples are still pointing straight out instead of down, which is a good thing.  If your goal is a very natural look without much fullness up on your chest - like by your axillary crease - then I also believe you can get away without a lift.  The larger the implant however, the quicker you will stretch your tissues even more and will be looking at a lift in the future.  Your result may look great at 6 months, but you may not be pleased with the larger breasts low on your chest in 1.5 years.  It is a common mistake to just put in a larger implant to fill out the loose tissue in an effort to avoid a lift.  BUT, your tissues will pay the price and you will be buying a lift in the future.  However, if your goal is fullness higher on your chest and you do not want to wear push up bras for the rest of your days, then a lift combined with an implant will provide better upper pole fullness.  In patients like you, I would show patients with similar breasts preop and show you their 1 or 2 year results with both approaches.  Then, you can make a more informed decision.  Best of luck!

Shreveport Plastic Surgeon
4.9 out of 5 stars 31 reviews

Breast lift with implants?

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Based on your pictures I think you're an excellent candidate for a breast augmentation alone. I understand your goal is to “regain what once was” and communicating these goals will be critical to the success of your surgery.

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 cup” or "fake looking" means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.
I use  intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the press implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison.
I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible.
By the way, the most common regret after this operation, is “I wish I was bigger”.
I hope this helps.

Augmentation (implants) and lifts

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I agree with Dr. Loutfy and Dr. Manchester that you don't appear to need a lift and implants are pillow volume and do not actually lift the breast. The need for a lift has to do with where the nipple-areola sits in relation to the inframammary crease behind it, upright, and with the arms down. I would also agree with Dr. Minniti's first point and not fall into the misconception that larger implants lift the breast more. The lift effect caused by filling out the breast properly with an implant is an illusion, not reality. Any kind of lift in your situation would currently give you some additional scars but give you little or no benefit. Be sure that the implant width is the same as your breast (minus about 3/4 cm across) and you choose the forward profile depending on the desired increase size of from one to two cup sizes from the lowest to the highest profile in round implants. 

Scott L. Replogle, MD
Boulder Plastic Surgeon

Shape of the breast

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It would be best to examine your breasts to determine how much sagging is present.  It appears from the photo an implant would be enough to restore volume. However from the side view the arm is raised which partially lifts the lower breast. So an areolar  or donut breast lift may be needed.

The shape of the breast is determined by skin envelope and breast volume. So we tighten the breast by removing excess skin and fill the empty breast with an implant. I recommend to schedule a consultation with a board certified plastic surgeon.

Andrew Turk, MD
Naples Plastic Surgeon
4.8 out of 5 stars 31 reviews

You do not need a lift

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Your nipples are above the inframammary fold.   This is the reason that you do not need a lift.  A mastopexy is designed to lift the nipple areola  complex to the inframammary fold.  You already have this.   

Gary H. Manchester, MD (retired)
San Diego Plastic Surgeon

Breast Lift and Breast Augmentation.

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Hello Caldo,

Don't ever choose an implant size to compansate or try to eliminate the need for a lift.  It never works and makes you bigger than you want, typically with as much or more sagging.  Based on the limited photos you posted however,  I think that you will need a either a circumareolar (donut) or a vertical (lollypop) lift.  My recommendation might change after a proper physical examination though.

Go see a breast specialist who is certified by the American Board of Plastic Surgery and a member of the American Society for Aesthetic Plastic Surgery.  He or she will deterimine the need for a lift in addition to breast augmentation.

Best of luck!


Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 100 reviews

Do I Need a Breast Lift in Addition to Breast Implants?

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Dear caldo,

An examination is necessary to determine whether you need a breast lift along with breast implants. Your photos suggest that breast implants alone *may* be sufficient to restore fullness and perkiness to your breasts. I would consult with an experienced Board Certified Plastic Surgeon.

Warmest wishes,

Larry Fan, MD

Larry Fan, MD
San Francisco Plastic Surgeon

Would I Need a Lift in Addition to Implants? (Photos)

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Based only on the posted photos I feel a larger (400 cc HP implant or more) could avoid a donut lift. Or you could have the donut lift after healing from the implantation surgery. 

Don't always need a lift with implants

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I agree with Dr. Loutfy, you might do well with just a breast augmentation and thus avoided added surgery and added scars.  Following your consultation and examination your surgeon will be able to make the best recommendation.  Best wishes.

Louise Ferland, MD
Richmond Plastic Surgeon

? Breast Lift with implants

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Your photos are helpful, but without an examination, no one should make an absolute or final recommendation. However it appears that an implant alone may be sufficient. Implants do not lift the breast, rather they fill the involuted or "empty" breast which may give the appearance of elevation or "lifting". This in contrast to actually surgically lifting a ptotic or saggy breast.

William Loutfy, MD
Albuquerque 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.