Okay, which implants are better if I do not want a lift. I want implants that don't look like a ball in a sock? (Photos)

I am sure that is clear as muddy water in a wooden boot, but so are all the opinions on sub muscular VS Sub facial placement. I was all set to have my surgery but he will only do sub-fascial? I have seen some amazing under muscle implants I am big enough to have big big implants but I want to wear low cut or strapless with no Bra. I am getting a tummy tuck too so gut will be better.

Doctor Answers 7

Which implants

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Thank you for your question. Based on the picture breast lift with small implant will give optimal results. Implant alone will not give good results in your case.

You need a breast lift

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Thank you for your question and helpful photos. The problem is that your breasts are too low to have implants placed under the muscle. The muscle area where we typically place implants is much higher than your breasts. This approach will give you the double bubble look. The subfacial approach allows the surgeon to place the implant directly behind the breast where it lies. This is great for women who's breasts are high or relatively in a good position, but if your breasts are low, the implant will make your breasts larger but still saggy and even saggier with time as the weight of the implant pushes them down further. Going braless is not a good idea when considering large breast implants. You will need continuous support to help keep them in place. Now, what is it that you're really looking for? Most women I see just want increased cleavage, but with sagging breasts that's not possible. You have enough breast tissue to create upper pole fullness without implants or the dreaded vertical scar from standard breast lift techniques. I have attached a short video of a patient who just wanted her breasts back where they were without all the risks and complications associated with breast implants. You are also welcome to view my gallery to find a patient with your dimensions to see what can now be achieved with current breast lifting technology. I do hope this clears up the muddy water.

Best wishes and kind regards,

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews


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From your photos i would suggest a lift to reposition your nipple/areola complex. Putting in big implants is going to give you an appearance of big saggy breast. Make sure you see a board certified plastic surgeon.

Deborah Sillins, MD
Cincinnati Plastic Surgeon
4.5 out of 5 stars 16 reviews

Droopy breast

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Based on your photos you should consider a lift at the same time due to the stretchiness of your skin and the position of the nipple. Trying to fix your extra skin with a big implant will lead to more problems long term 

David R. Alfonso, MD, FACS
Grand Rapids Plastic Surgeon
5.0 out of 5 stars 66 reviews

Breast Augmentation - Need a lift?

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Thank you for your question and photos. It looks like a lift will be required in addition to placement of breast implants. I do not think you will achieve a satisfactory result with either augmentation or a lift alone. It is best to have an in-person consultation with a board certified plastic surgeon who specializes in cosmetic breast surgery. Ask to see a lot of before and after photos of their work. Hope this helps and good luck!

Lift or not?

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Thanks for your question and the photos. Yes, you are getting mixed messages because you your starting breasts are challenging. Fuller heavier breasts want to go south even with implants and even with a lift. With an implant alone, subfacial or not your larger natural breast will continue to droop. The natural tissue will respond to gravity.  Big implants will make you larger, but you will likely droop even more over time.

Subfacial, fills out the skin more directly, but from what you are saying I am not confident it will give you what you are looking for- it also burns some bridges if a lift is in your future.  I favor under the muscle.

Many patients that I see want what I call a " gravity defying breast". The only patients that truly get this are the patients who have no droop and very little natural tissue. They wind up " all implant" with nothing much more to droop.  In women with more natural breast tissue gravity will always affect the natural breast tissue.

To make you a gravity defying patient you would consider a reduction and lift, leaving less natural tissue to sag. Then come back and place an implant.  For most patients a reduction just do do an augmentation is unappealing, but I hope the concept makes sense.

A saline implant, or a round ( not tear drop) gummy bear would likely give you the most upper pole fullness and elevate the most skin, but I don't think that alone will achieve what you have written. I don't want to disappoint, but if you don't get what you are expecting you may be unhappy.

Hope this helps.


Adam Tattelbaum, MD
Washington DC Plastic Surgeon
5.0 out of 5 stars 115 reviews

Okay, which implants are better if I do not want a lift. I want implants that don't look like a ball in a sock?

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The implant type will not determine if you need a lift or not. A larger implant in a dual plane may be an option but without knowing more information (your desired size and breast measurements), it is hard to be specific.

Karol A. Gutowski, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 76 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.