Breasts starting to sag - Breast lift or augmentation or both? (photos)

Question

Im 40 and my breasts are really starting to sag. Im wondering if i could get away with implants or if a lift would be best? Im really worried about scarring

Gary M. Horndeski, MD · Answer

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.

Martin Jugenburg, MD · Answer

Hello, thank you for your question. If you are looking for just bigger breasts but same positioning of your breast tissue then you can go above the muscle no lift but if you want a implants under the muscle then a lift would be needed. Discuss your options with your plastic surgeon and be sure to bring in wish pics of someone with a similar frame and size. Feel free to check out website for some before and afters.

Leila Kasrai, MD, FRCSC · Answer

Your nipples are located below your breast fold therefore a lift is recommended. Without a lift, your implants would sit low on your chest and you wouldn’t have any upper pole fullness.

Marguerite E. Aitken, MD, FACS · Answer

The only way to get the breast off the upper abdomen is to do a lift...This will leave a scar around the areolar and down like a lollipop. A implant lives behind the muscle and without a lift the breast will waterfall off the implant, it wont scoop the breast up/off the abdomen.

Richard Zienowicz, MD · Answer

Hello and thank you for your question. From your photos it appears as if an implant alone would not be recommended by most surgeons as it could cause deformities and not provide optimal results. I would recommend at least a breast lift, and an implant could offer shape and volume if that is part of your goal.

Daniel Barrett, MD · Answer

Dear Bright37149,
my preferred lift is a lollipop lift when a periareolar won't do (ie greater than 2cm lift required). The lollipop technique was created by a Canadian plastic surgeon named Elizabeth Hall-Findley and treats the breast as a three dimensional structure instead of two dimensions (anchor - lift). Most importantly it does not require the horizontal component scars that the anchor-lift requires and breasts appear much more natural, lifted, and less boxy. Lastly, the lift lasts longer because the lollipop doesn't rely on the skin to hold the breast up, its actually breast tissue thats being brought together to support the breast and hence improves longevity. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Finny George, MD · Answer

Hi, thank you for sharing your question. Based on these photos you seem to have glandular ptosis and would benefit from a breast lift. If you are happy with the size of your breasts then augmentation is not necessary.

Randal Haworth, MD, FACS · Answer

Hello !

It looks like you would benefit from a breast lift + breast augmentation. Implants alone won’t fix the sagging breast and can cause bulging if a lift is not performed. The scar can be treated.

I hope this helps, 
best of luck !

Michelle Copeland, MD, DMD · Answer

Thank you for sharing! To perk up a drooping breast, your surgeon will remove excess skin, reposition the nipple, and redrape and tighten the remaining skin to support the breast. The areola may also be reduced in size. A mastopexy (breast lift) raises droopy breasts from one to several inches and excess skin is removed. The great thing about these techniques is that they can now be down with minimal scarring and performed as an outpatient procedure without the need for general anesthesia. It's important to be sure expectations are realistic and you have an understanding of the commitment needed for the healing process. Make sure that you understand the nature of your surgery, the recovery process, and that you feel comfortable and emotionally ready to make these changes to your body. I suggest you make an appointment with a board-certified plastic surgeon who will examine you and go over your surgical options in detail.

Connie Hiers, MD, FACS · Answer

You need a lift. With just implants, you will be larger and still sagging. The radiofrequency skin tightening with minimal incisions might give some improvement, but will not be a full lift.