Could I get away with just implants with fat grafting or would I need a lift too? (photos)

Question

Hello! I have always wanted implants as I my breasts were a 12B from puberty. Now at 38 years old and after breastfeeding three babies I’m a 12DD. They are lacking fullness and I’d love them to be perkier like the used to be. I’m about 7kgs away from goal weight so i wonder if they could loose more fullness once I achieve this. Could I get away with just implants with fat grafting or would I need a lift too? Thanks kindly for your time.

Ted Eisenberg, DO, FACOS, FAACS · Answer

I recommend an in person consultation with a plastic surgeon to discuss your goals and be measured. After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants, if interested. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what size and style breast implant is right for them. Mildly Sagging Breasts: If your breasts are mildly droopy, a saline or silicone gel implant placed behind the pectoral muscle might help create the illusion of perkiness. That’s because as the implant fills out the top of the breast, it also fills out the bottom, making it look as if the nipple has moved higher. It hasn’t. You can always get a lift later if you feel you are not perky enough when fully settled and healed. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Zoran Potparic, MD · Answer

Based on these photos, you are a borderline case; you can achieve nice rersult with implant augmentation only providing that you want larger implants. In person evaluation which will include assesstment of your skin and breast tissue would help. You may consider doing augmentation first and, if not happy, breast lift 6-8 months later? Good luck.

Gary M. Horndeski, MD · Answer

The technique I recommend is The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Ronald J. Edelson, MD · Answer

You need a lift along with implants. Adding fat around implants is now done by some surgeons but I don’t see the need if there are implants. Don’t get fat injection along with implants. Another poorly thought out misadventure

Daniel Barrett, MD · Answer

Dear claireb46,
determining whether you need simply a breast augmentation versus a breast lift can be somewhat complicated. It depends on a number of factors including skin laxity and current nipple position. Generally speaking, if the nipples are lower than the inframammary line the patient will most likely need a breast lift. If the nipples are at or above the inframammary line we can generally get by with just a breast augmentation depending on the size of the implant the patient wants. I often still using implant when I perform a breast lift because it provides more upper breast fullness after the lift. To be sure a consultation with a board-certified plastic surgeon will help determine what the patient actually needs.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Mark Hanikeri, MBBS, FRACS · Answer

Hi there

Based on the photos you provided you could potentially get a good result with anatomical implants with fat grafting to your upper poles and cleavage but that would not be my advice.  I think a lift will provide better breast aesthetics but will need a scar around the nipple. You will probably lose further volume with 7kg weight less so a lift may be even more beneficial if that happens.
You should discuss these options with a Specialist Plastic Surgeon in a face to face consultation.
Good luck

Dr Mark Hanikeri. MBBS FRACS
Perth Specialist Plastic Surgeon

Connie Hiers, MD, FACS · Answer

First, reach your weight goal. Second, naturally your breasts sit low on your chest and your bases cannot be raised. Even with a lift, your breasts will still sit somewhat low. A lift and implants will do better, and implants can help give upper breast fullness, especially when placed behind the muscle.

Could I get away with just implants with fat grafting or would I need a lift too? (photos)

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