Do I need a breast lift as opposed to just getting implants and what kind of implants?

Thank you for your question and photos.  You do have some excess breast tissue falling below the bottom crease of the breast.  The lowest part of the implant is at that bottom crease.  The implant sits behind the breast and not in the breast.  Therefore if you have breast tissue falling below the bottom crease, it will fall over the top of the implant and give a less than desirable shape.  

Implants with no lift 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.A #mastopexy or breast lift operation is designed to improve the shape and position of the breasts without reducing their size. It is used for #breasts which sag or droop (ptosis). Sagging of the breasts may occur with normal development for some women, or as part of the aging process. Pregnancy, breast-feeding and weight loss are other conditions which increase breast ptosis. Some patients will have a better shape to their breast such as increased superior fullness if an #implant is used at the time of mastopexy.  This is called an #Augmentation/Mastopexy.  The procedure can also be combined with a minor breast reduction to reduce the breast width if desired. The surgery will create an elevated, more youthful breast contour. Also, the procedure will create nipple and areolae of the desired size and at the correct height. 





#FatGrafting is another option to using #breastimplants and requires a small amount of liposuction to obtain the fat which is the prepared and transferred to the breast. A hybrid operation may use both an implant and fat to provide the best contours of the lifted breast.





I prefer to  use a #shortscar technique, #LollipopScar or #DonutLift” rather than the majority of surgeons in the United States that use an anchor pattern lift which involve more significant scarring.

Hello, I think it's safe to say no on-line consultant can determine where your inframammary fold lies, so determining the need for a lift is more conjecture. However, my best guess is that it is at least at the level of your nipples, and with that much tissue hanging, you'd do better with a lift. Implant size is determined by analyzing your tissue capacity as well as determining aesthetic goals using sizers. 400 cc implants would be relatively large if combined with your current breast size. Both round and shaped implants are available, the difference being not in the result produced, but the longevity of the result being greater in the shaped implants due to their form stability.  More than 90% of plastic surgeons in the US have never used shaped devices, fearful that they might rotate. However, FDA date show that they have the lowest overall complication profile. Go visit a few ABPS certified/ASAPS member surgeons that specialize in all forms of cosmetic breast surgery, not just implants. Best of luck!

From your photos, I agree that you could get good results with implants alone, however the final determination would be if you would be happy with the location of your nipple areola and the breast mound location on your chest wall would not change.  A lift will simply elevate the location of your nipple areola which I don't think is necessary if you would be happy, as you say, with having the same look that you do now but just more youthful & perky.  An in office exam and evaluation would be helpful and to go over photos of other people similar to you so you could see some before & after photos to see likely results. As far as the implants are concerned, I typically choose which implant is going to be best for your body according to your breast width measurements and the volume that you want, so it is not an easy straightforward "high profile" or "moderate profile".  Good luck!

Although a proper exam is needed with measurements, judging by your photos I would vote for you needing a lift to get the best result.  In addition if you wanted additional volume then an implant can be added to the surgery.  So patients are happy with the volume they have and simply desire to have more upper pole fullness.  In those cases a small breast reduction can be performed and a smaller implant can be placed to help with the upper pole fullness in addition to the lift.I would recommend that you visit with another 1-2 board certified plastic surgeons who perform a tremendous amount of breast augmentation with mastopexy together.  The two procedures can be done together safely and effectively to get you the result you desire.Hope that helps.