Will I need a breast lift in addition to implants to get my desirable cleavage look?

Question

I am a 25 year old female, and for as long as I can remember my breasts (36C) have always been saggy compared to women my age who have perkier and voluminous breast. I want to add volume to the upper part of breast because it seems very flat and I can never get an “appealing” cleavage look, regardless if I wear a push up bra. Will I need a breast lift in addition to an augmentation to get my desirable cleavage look?

Irena Karanetz, MD · Answer

Hello,
Thank you for the question.
Based on your photos, you appear to be a good candidate for breast augmentation in combination with breast lift. Mastopexy (breast lift) will put your nipples into the correct position, make the areola smaller and allow excess skin to be taken away, giving you a more youthful and lifted breast appearance. Adding breast implants will add upper pole breast volume that you desire.
Some people are a little apprehensive to the full breast lift due to the scars (lollipop or anchor), but typically they do very well and scars fade over time. 
I would encourage you to seek a consultation with a Board-Certified Plastic Surgeon to further discuss your options, specific techniques, concerns and expectations.
I hope this helps.Best regards, Dr. Karanetz
Dr. Irena KaranetzFellowship-TrainedBoard Certified Plastic Surgeon

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. 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

Gary M. Horndeski, MD · Answer

You can achieve your desired cleavage without implants. The technique I recommend is a lift using 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.

Daniel Barrett, MD · Answer

Dear annydiggs,
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

Harry T. Haramis, MD, FACS · Answer

Implants will give upper fullness and raise breasts slightly.

However, for very perky look, a small lift should be added.

An exam and consultation with a plastic surgeon is recommended to further discuss your options and expectations.

Boonchai Taweerattanasil, MD · Answer

Thank you for your question and photos. From you photos, you have low nipples and sagging breast tissue. To obtain the upper pole fullness and cleavage result that you want, I advise you should have Breast Lift with Silicone Implants.The breast lift can be vertical-scar technic (lollipop) and the implants should be round shape implants.Hope this help,Dr.BoonchaiCertified board of plastic and reconstructive surgery (Thailand). International Society of Aesthetic Plastic Surgery (ISAPS) Member. American Society of Plastic Surgeons (ASPS) Member.

Frederic H. Corbin, MD (license restricted) · Answer

Thank you for the question and photos and I would go on some consultations with experts and compare recommendations after a full examination and discussion of desired results and look at photos of similar patients and become fully informed about the desired procedure

Dr Corbin

Dr Corbin

Douglas J. Raskin, MD (retired) · Answer

Greetings, 
For patients with empty upper breasts on their chest wall and significant ptosis, breast lifts with implants can help provide upper breast fullness and a size increase.  Implants alone will result in longer, larger, and lowered breasts. Your desire for higher breasts is a very important part of the discussion of options with your plastic surgeon(s) at your consultation. To achieve your desired outcome All of your objectives must be clearly discussed during your consultation(s) and before your surgical care. 
Best Regards,

Will I need a breast lift in addition to implants to get my desirable cleavage look?

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