No one wants to do a breast implant without a lift. Why? (Photo)

As a patient with significant existing breast tissue and breast ptosis (droop), a breast implant will simply give you a slightly bigger version of what you have. This is because your breast implant is placed underneath the breast tissue you already have. As you can imagine, your natural breasts will be on top of whatever implant is inserted, so the change in size and shape will be very limited. The actual aesthetics of your breasts will only change very slightly if you have just an implant without a lift. If you are wanting to address any aspects relating to shape, symmetry, cleavage, or upper pole, you will not be able to achieve this without a breast lift as your natural breast tissue will always sit on top of your implants. It is likely that any surgeon who has consulted with you is declining to perform a standalone breast augmentation as they do not believe the aesthetic changes are worth the risks involved with invasive surgery.

It's possible that this fact could give the appearance of 4 breasts. 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 and they choose what looks right for them. 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. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Your nipples are pointing downward and will point further with 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.

Best Wishes,

Gary Horndeski, M.D.

Hello, thank you for your question. Implants do not lift the breast tissue and if you need a lift they would not be able to achieve the look that you want. Keep in mind that implants place on the chest wall may even sit higher than you natural breast tissue and may not make for a nice aesthetic appearance. Talk to your Plastic Surgeon to see your options.

I agree with your surgeons and would not do an augmentation only on you because it would make you look worse. Your nipples are at the bottom of your breast and just adding an implant would make the nipples look even lower and would be an unattractive result. I suggest you consider a lift with your augmentation or leave your breast alone and have no surgery. Good luck.

Dear Hepburnn,
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

In your case, your nipples are sitting on the lower portion of your breast. Patients whose nipples are slightly lower but not at the bottom portion of the breast can get away with only an implant. In your case I would recommend a breast lift as well to place your nipple in the proper location on your breast.

Based on the photographs, achieving a high quality result with implants alone would be very difficult. A very large implant might get you mostly toward your goals, but could also cause longer term problems for you. A full consultation to review your goals, tissue quality, etc. would be necessary to give more insight. I recommend you work with a Board Certified Plastic Surgeon.

You have sagging and uneven breasts, and without a lift, will just have large sagging breasts. With implants and no lift, the increased weight from the implant will cause more sagging. Big breasts sitting on your lap are not pretty.

From your photos it appears you need a lift. Augmentation alone will likely leave you with a shape that you will find unacceptable. Augmentation adds volume to the breasts but it does not raise the position of the nipple.