Implants with uplift or just implants alone? (Photo)

Originally I was going to have an uplift but my surgeon thinks I can get away with just implants. The implant is 400cc teardrop shape long length over the muscle. I would ideally like to avoid the uplift scar but am worried that with the implant, even though it may fill out the deflated skin that the result will be breasts that look too low. I have lost weight in the past year (50kg) and when I lean fwd the skin is very empty/crinkly. My right breast is slightly larger and lower than the left.

Doctor Answers 16

Implants with uplift or just implants alone?

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Hi jbc2007,

Thank you for your question and photos.  Judging from your photos, I believe you would benefit from implants and a lift.  It is difficult to say, but I would probably recommend a peri-areolar (donut) or vertical (lollipop) lift depending on where your nipples fall in relation to your lower breast fold.  We also need to consider the elasticity of your skin.  Combining a lift with implants can provide support to saggy skin and result in a much more pleasing result.  Good luck, and please see a board-certified plastic surgeon to confirm this advice.

Rapid City Plastic Surgeon

Implants alone or Lift also?

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Thank you for your inquiry and the photo.  Congratulations on the wight loss and as you have experienced, there are some changes that occur as a result which can be improved surgically.  Based on your picture and  information, I would suggest an augmentation and a lift procedure.  Naturally we can achieve some improvement in the appearance with an implant alone, but it would take a significant volume to fill the deflated skin envelope and u=you still would have a sagging appearance.  It would be best to restore the volume and correct the Nipple position at the same time, in my opinion.

Best wishes,

John J Obi, MD

John J. Obi, MD
Jacksonville Plastic Surgeon

Depends upon expecations

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This is probably the most common question asked by my cosmetic breast patients with any droopiness or ptosis of their breasts. There is no absolute or correct answer. It depends on your (the patient's) expectations and desires. Just remember the implant needs to be centered directly behind the nipple, so wherever your breasts/nipple sit currently this is approximately where you can expect the implant to be positioned/settle. Breast implants alone simply add volume to your breasts. They do not lift or shape your breasts. If you are happy with the look of your breasts and just want them to be a bit fuller then a breast augmentation alone may work.
In my practice, my patient's generally expect superior pole fullness/cleavage and a youthful, perky breast appearance without wearing a push-up bra so I tend to offer more lifts. Most of these patients are initially hesitant about the scarring, when in fact they should be more concerned about breast shape, contour and nipple position. I educated them that scars mature and fade over 6-12 months, when breast shape, contour and nipple position generally don't improve and, may in fact, worsen over time.
In my experience you could certainly have an augmentation alone and end up with a "natural" or "matronly" result. You may be perfectly happy and satisfied with your result. However, many of my patients who chose this route then will come back with a horizontal tan line across their chests (above the top of their implants) from a sundress or tube top, asking why when they wear a sundress or top without a bra, their breasts sit low, or do not have superior fullness. I re-explain that the implant must be centered behind their nipple and that generating this superior fullness would require a larger implant combined with a lift. Some elect to have the lift, and others chose to push their breasts up in a bra to generate superior fullness and cleavage.
Finally, attempting to avoid a lift by using an extremely large, high or extra high profile implant is a nothing more than a short term Band-Aid, and does not address the root cause/problem (i.e. stretched/lax and excess skin/tissue). This does nothing but postpones the lift for a short period of time and will only lead to further tissue stretch and thinning requiring an even larger lift to fix. Ultimately, this approach generates a much more complex (and expensive) surgical problem just months to a few short years down the road, so I never encourage patients to go with this approach.
Some of you may then ask why some surgeons you've seen offer this approach to droopy breasts, typically without discussing the other abovementioned options and each options pros and cons. The truth is that it's far easier and quicker for a surgeon to place a large implant without regard for the durability, or lack thereof, than perform a more technically challenging, and longer, lift procedure.


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With patients who can "get away with just an implant", often times I find they are less than satisfied with that. It means you can have an "acceptable" result that does not look abnormal, yet may be far from your expectations of position and shape. Of course the trade-off is the scars of lift. In general, if want any part of your breasts "higher", especially your nipple position, you should seriously consider a lift as well.

Implants with uplift or just implants alone?

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Thank you for the question and picture.
I think that you will be best off undergoing breast augmentation and breast lifting surgery.

Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery ( regarding breast implant size/profile selection) is:

1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work.
2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals.
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. For example, I have found that the use of know words such as “natural” or "C orl D cup” etc means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice.
3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery, after the use of temporary intraoperative sizers.
I hope this (and the attached link, dedicated to breast augmentation surgery concerns) helps. 
Be careful with your decision-making; revisionary breast surgery can be more costly in many ways. Best wishes.

Breast lift with implants, some advices:

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Thank you very much for enquire.
After having analyzed all the information and photos provided to us, I realize that you have very sagging and small breasts. In this regard, you need volume (implants) and projection (the lift): Breast Augmentation w/Breast Lift.
I recommend you to use microtexturized highly cohesive silicon implant ("gummy bear" implants), with high projection, and 400-450ml will be excelent on you, to fill the breasts properly.
Finally, to perform the breast lift I recommend a Periareolar Round Block Breast Lift ("Benelli mastopexy"), which has an unnoticed scar around the areola, and if we see (in the surgery) that we can't obtain adecuate projection just with the Benelli Lift, we have to perform a "Lollipop breast lift".
Dr. Emmanuel Mallol Cotes.-

Emmanuel Mallol Cotes, MD
Dominican Republic Plastic Surgeon
4.7 out of 5 stars 372 reviews

Breast Implants Alone or with an Uplift

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Thanks for your photo and the question.  At first glance it appears that you don't need an uplift as long as the implants are sufficient in size to fill the loose skin and enhance your contour.  Having a limited or full uplift remove small or large amounts of skin respectively permitting fullness with a relatively smaller implant.  All of these considerations need to be discussed with your Bd Certified plastic surgeon.  Keep in mind that there is a chance that you will need/want an uplift in the future if you don't have one now.
Best wishes for a good result.  I expect that you'll do well with whichever decision you make.  Enjoy your results and review options carefully with your surgeon.

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 34 reviews

Lift or not

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If your nipples are above or at the inframammary fold then I would just do a staright forward aug.Why have all the extra expense and scarring that come with a lift.

Robert Brueck, MD
Fort Myers Plastic Surgeon
4.9 out of 5 stars 69 reviews

Up to you

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Bottom line, it's really up to you and what you are willing to put up with. If you are dead set against the scars that are the inevitable result of a breast lift then follow your current plan. However, an implant is not going to address any sagging issues or the fact that one is lower than the other. But keep in mind that no one's breasts are perfectly symmetrical. Hope this helps -- Dr. Nazarian

Sheila S. Nazarian, MD
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 56 reviews

Implants with uplift or just implants alone? (Photo)

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Thank you for your question. Depending on your final goals you may require a lift but an examination would be required to make that final determination. Breast augmentation surgery is individualized to each patient.The method of implant selection and size is best done in consultation with a board certified plastic surgeon. The shape and size of your breasts prior to surgery will influence both the recommended treatment and the final results. I tell all of my patients “Dimensions and proportions are the determinants of a beautiful breast; not volume.” I recommend that you make an appointment with your plastic surgeon to discuss your breast augmentation and implant choice.

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.