Do I need a lift? Or should I try a less invasive approach first? (Photo)

Question

One surgeon said yes immediately, the other said an augmentation would provide some lift and that we could do additional lifting later if needed. Surgeon #2 recommended not lifting on first procedure to try a less invasive approach first. What do you think?

Johanna D'Agostino, MD · Answer

Hi!Thanks for sharing! Based on your photos, it's evident that there is some asymmetry on breast size, nipple position and level of ptosis (sag). Although an augmentation "only" could improve some of the ptosis and volume symmetry, the difference between areolas would remain. In your case, I think a augmentation with a lift would provide the best results. All the best!

Martin Jugenburg, MD · Answer

Hello, thank you for your question. Every surgeon is a bit different in their recommendations and approach. I would suggest bringing in a wish pic  with you to your next appointment, one that closely resembles you as a before. Also implants just take what you already have and make them bigger, it wont lift or change the shape. At first they maybe perkier but eventually will fall. Feel free to check out our webpage for more before and afters.

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 or small implants can be placed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Ted Eisenberg, DO, FACOS, FAACS · Answer

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 then get to 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. 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

J. Jason Wendel, MD, FACS · Answer

Thank you for your question regarding a breast lift and for including photos.

Although photos are great, it will ultimately depend on your breast measurements taken by your board certified plastic surgeon.

To know what might be right for you, see two or more experienced, board-certified Plastic Surgeons for a complete evaluation to make sure you are a good candidate and that it is safe for you to have breast implant surgery.

I hope this helps.

Daniel Barrett, MD · Answer

Dear Versatile34571,
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

George Bitar, MD · Answer

Based on your photographs, the nipple position appears low on the breasts with the left side being higher than the right.  The left breast is smaller and higher on the right.  The nipples are also facing towards the sides.  The aesthetic outcome of breast augmentation in your case could be optimized with a lift, which could address the asymmetry of the nipple position and place them more centrally on the breast.

David Plank, MD · Answer

Breast augmentation with high profile implants will give you the lift you are looking for. Later on, you can get a lift after the implants settle.

Karl William Schwarz, MD · Answer

Lift. If there is one thing I have learned it is not to get caught up with the philosophy of trying to avoid a lift at all cost. The results are always disappointing and you are far better off just to get a lift and get the very best result possible. Trying to avoid a lift always leads to a worse result. I see photos at meetings where surgeons present cases and the patient is a little droopy afterwards and doesn't look good and the surgeon always says "the patient didn't want a lift and she is very happy" but I seriously doubt that the patient is happy. In my experience patients will accept a scar if the result is good. Never avoid a scar for a worse shape. Always choose the path where you can get the best shape possible. Watch the video below.