Should I get a lift or augmentation with fat transfer? (Photo)

are my breasts sagging and are they tuberous I was told they were considering getting a breast lift

Doctor Answers 12

Should I get a lift or augmentation with fat transfer?

Thank you for your question.  For sagging breasts, a breast lift would be required.  Breast implants would contribute to increased size and rounder shape.  Be sure to consult with an experienced board certified plastic surgeon.  Good luck! 

Dallas Plastic Surgeon
5.0 out of 5 stars 20 reviews

Lift with or without implants

Hello dear, thanks for your question and provided information as well.. The breasts may lose their elasticity and firmness which can be caused by different factors such as pregnancy, massive weight loss, lactation and aging. To reaffirm the breasts and restore the natural look your surgeon can perform a mastopexy or breast lift with augmentation such as silicone implants, you will get very nice results.

Patients who goes to a consultation for drooping breasts (ptosis) or volume loss after pregnancy (pseudoptosis) almost always have one very important question. "Can my drooping be corrected with just implants or do I need a lift".

Implants alone will correct drooping when:

  1. Breast drooping is mild
  2. The nipple is still near the center breast and does not point downward
  3. There is some visible skin beneath the nipple/areola when looking at the breasts straight on.
  4. The patient is okay with being at least a cup size larger

A breast lift (with or without an implant) is better when:

  1. Breast drooping is moderate or severe
  2. The nipple is at the bottom of the breast or points downward
  3. There is no visible skin under the nipple/areola when looking at the breasts straight on.
  4. The patient is already a C or D cup breast size and doesn't want to be larger
  5. The areola is too large and the patient wants it reduced

I also show the patient photographs of a spectrum of breast scar present after a breast lift in order to check their tolerance for this scar. Most patients are surprised how little the scar shows and are okay with proceeding. If the patient really needs a breast lift, but is concerned about the scars, I will suggest they wait on surgery. In time the breast appearance problems will usually outweigh their concern about the scars.

I use implants in combination with a lift when:

  1. The patient wants to be larger in addition to being less droopy
  2. The patient desires to maintain projection and roundness of the breast mound
  3. The drooping is severe..... I recommend to see a board certified plastic surgeon for a personal evaluation and also to talk about your goals.

In my opinion I do not recommend fat transfer to the breast, because increase the risk of breast cancer.

I recommend to make an appointment with a board certified surgeon for an evaluation and to talk abuot what kind of lift do you need and to talk about your goals.

Good luck :)

Tania Medina de Garcia, MD
Dominican Republic Plastic Surgeon
4.5 out of 5 stars 418 reviews

Breast augmentation or lift

A breast lift and an augmentation address different aspects of the breast. Patients that have good volume but sag or droop too much need a lift. There are several types of lifts. They range from little lifts with minimal scars to big lifts with more scarring. Augmentation is when the patient desires to have more volume. Implants (silicone or saline) are used to get volume. Fat grafting has not been widely accepted because it can affect breast cancer screening. From your photos, a breast augmentation with a lift would give you both volume and improved nipple position. Please visit a qualified plastic surgeon in your area.

Chester K. Cheng, MD
Bay Area Plastic Surgeon
4.0 out of 5 stars 26 reviews

Breast Lift / Breast Augmentation/ Breast Implants/ Anatomic Gummy Bear Implants/ Silicone Implants/Tuberous Breasts

I appreciate your question.

From your photos, you appear to have characteristics of tuberous breasts.

Constricted or tubular breasts tend to be too narrow with a breast crease that is too high. Tight ring-like bands of tissue around the areolae and nipples may create the appearance of protruding or puffy areolae. A higher than normal breast crease may make your nipples appear to be too low or down pointing. Constricted breast features can be very mild or severe. In fact, mild variations are relatively common. To summarize, the features can include:

  •          Inframammary fold (breast crease) too high
  •          Inframammary fold misshapen
  •          Breasts too narrow (disproportionately narrow base width)
  •          Insufficient breast skin
  •          Constricted or tubular shape, resulting from tight bands of tissue within breasts
  •          Protruding or bulging appearance of areolae (pigmented area around nipples)

Improvement is possible and generally includes a breast augmentation, sometimes combined with a lift (mastopexy). The lift is usually limited to an incision around the areolae. During the procedure, I release the tight, constricting bands from the inside, allowing the skin to expand properly. I also lower the inframammary fold to a more ideal position and improve its shape. Breast implants help create the right amount of volume and improve breast contours, resulting in a more rounded or tear drop shape.

The best way to assess and give true advice would be an in-person exam.

Please see a board-certified plastic surgeon that specializes in aesthetic and restorative plastic surgery.

Best of luck!

Dr. Schwartz

Board Certified Plastic Surgeon



Jaime S. Schwartz, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 93 reviews

Breast augmentation and lift

Thank you for your photo. It is difficult to assess exactly what is needed from the angle and clarity of your photo. If you would like larger breasts, then at the minimum, you would benefit from an augmentation with an implant. An implant gives you both instant volume and shape whereas fat grafting has variable volume and poor shape definition. It is also likely  you may need a lift if your nipple positions are too low. If that is the case, you would not need a significant lift and may be able to keep your scarring to a minimum with either periareolar incision or a single vertical incision. It is best to have an in-office examination to determine what exactly is needed and what your options are. It can also be demonstrated to you the approximate size, shape, look, and incisions used to acheive your goals and final result. Hope this helps!

Johnson C. Lee, MD Plastic Surgery

Johnson C. Lee, MD
Beverly Hills Physician
5.0 out of 5 stars 14 reviews

Should I get a lift or augmentation with fat transfer?

Thank you for your question and pictures. Hard to tell from only one picture of one angle, but it does appear that you have some features of tuberous breast deformity. You would benefit from a lift +/- an implant. I would not recommend fat transfer as a primary means of volume increase for you. See a local board certified plastic surgeon to discuss the options available to you.

Best of luck!

Dallas Buchanan, MD
Spokane Plastic Surgeon
5.0 out of 5 stars 30 reviews

Breast lift

fat transfer to the breast does not work, period.  I have never seen any good picture on any web site or the literature.  That tells me all I need to know.  You are a good candidate for a lollipop lift and a modest soled implant, around 400 cc's.  Don't let anyone talk you into fat transfer.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 27 reviews

Should I get a lift or augmentation with fat transfer?

Thanks for your question.  You are a candidate for any of the procedures that you mentioned and would be best served by having a face to face consultation with one or two ABPS Bd Certified plastic surgeon to determine your priorities before making a decision.

Regards and best wishes,

Jon A Perlman MD FACS 

Certified, American Board of Plastic Surgery 

Extreme Makeover Surgeon ABC TV

Best of Los Angeles Award 2015, 2016 

Beverly Hills, Ca

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 31 reviews

Breast surgery

Thank you for the question and photos and YES you do appear to have tuberous breasts and would benefit from a lift with out without augmentation with an implant or fat.  So go on some complimentary consultations with experts in the area and be evaluated

Dr Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 62 reviews

Breast Augmentation With Fat Or Implants For Tuberous Breasts

Breast augmentation with fat transfer will just make your breasts look like a slightly larger version of what they are now. To truly get a more rounded breast shape, a breast augmentation with implants will provide a more stable breast form. During a breast augmentation with breast implants, you will also benefit from scoring of your breast tissue which, in plain words, means releasing the tissue that is causing your breast constriction. You may also need a breast lift/repositioning of the nipple-areola complex. Photos that are taken straight-on versus from a below-the-breast/underneath view will provide a better view of your breast issue. An inperson evaluation will give you an even better, more personalized answer.

Millicent Odunze-Geers, MD, MPH
Sacramento Physician
4.7 out of 5 stars 6 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.