What Size Will Be Great for Me Lift or No Lift That is the Question? (photo)

I want to be a full B and small C cup. One PS told me 300cc with a lollipop lift. The other told me 400cc making me a full C or small D cup. I am so nervous about 2nd option. PS #2 says it goes with my frame I am 5.7 ht wt and ht. 137. I really concerned about the no lift. Any sugestion base on my pics. I really dont want to look huge. Both told me i have barely and tissue and lots of stretch skin. I am confussed now. Thank you for your response.

Doctor Answers 21

Perfect size is based on chest dimentions, not estimated cc's.

Hello, and thank you for the question and photos.

Your perfect size should be based on your chest and breast dimentions.  Not on cc's guess.  The implant diameter should be equal to the diameter of your breasts.  This is the first parameter that should be obtained.  Next, projection is determined by what cup size you would like to be.  In general a moderate profile implant will gain approximately 1 cup size, moderate + will gain 2 cup sizes, and high profile about 3.  Be careful with the cup size you choose however.  In your case, you have a fair amount of laxity in you skin.  If you chose a larger cup size, there is a good possibility you would not need a lift, vs. chosing a smaller cup size.

Pablo Prichard, MD

Phoenix Plastic Surgeon
5.0 out of 5 stars 47 reviews

Will implants alone be enough for a good result?

Based on your nipple location, there is no question that you should have a mastopexy, (breast lift). Your areolas are at the bottom of your breast and nipples appear below the inframammary fold. I would recommend a circumvertical mastopexy. The cup size is less an ideal way to look at breast size and proportion than to look at the dimensions of your breasts and your body habitus.  At 5' 7" you can go with a larger implant that works within the width of your breasts. Going too small will risk loosing too much breast shape. The proper surgery, using silicone implants in the sub-muscular position will reduce your risks of re-operative and complex, (and expensive), corrections in the future. The trade off of scars in your darker skin type can be minimized but not eliminated by meticulous skin closure and scar care. The procedure can be done in one stage or two with the mastopexy first and implants later. This reduces the risk of tension on the incisions and worse scars that  require surgical correction than both procedures done at one time. 

David R. Stephens, MD
Bellevue Plastic Surgeon
4.1 out of 5 stars 13 reviews

Breast Augmentation Options


You are understandably confused because, in my opinion, there is not one absolutely "correct" answer:

  • From your pictures, you appear to be on the borderline as to whether an uplift procedure is necessary for the best result.
  • You have to consider the possibility of keloid scarring with the more extensive uplift incisions.
  • Final cup size cannot be guaranteed. I don't think a 400cc implant is "too big" for your frame. But, I recommend reviewing lots of before/after pictures of patients of your height, weight, and breast shape to help you make a size decision.

Thanks for your question and best of luck!

Stephen M. Lazarus, MD
Knoxville Plastic Surgeon
4.9 out of 5 stars 9 reviews

No Question You Need a Breast Lift with a Breast Augmentation

The decision between breast augmentation only and an augmentation plus a lift is sometimes a difficult question.  In your particular case, from reviewing your photographs, the answer is clear.  You need a breast lift or mastopexy in addition to the increased volume of a breast implant.  Your nipples are at least 3 cm below the inframammary crease and your nipples point almost straight down.   Yes it would be possible to give you a relatively satisfactory result with only a breast augmentation using a large implant but your soft tissue is not going to be able to support this implant over time and you will get recurrent sagging over time.  If you want to be a small C cup size then your only option is an implant in the 300 cc range with a vertical mastopexy.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 19 reviews

Breast lift surgery question

Based on your first picture I think you would benefit from a lift with implants. Size is your choice but somewhere between 300cc and 375cc moderate plus profile should fit your frame. I really like the a circumvertical or lollipop lift and that will allow to help improve your breast asymmetry as well as the areola asymmetry. Good luck and do not feel awkward about seeing a board certified plastic surgeon for a second or third opinion.

Gregory T. Lynam, MD
Richmond Plastic Surgeon
4.9 out of 5 stars 59 reviews

Breast Lifting Necessary? Breast Implant Size?

Thank you for the question and pictures.

The best pictures to evaluate your breasts are with your arms down. In my opinion, these pictures demonstrate breasts that will benefit from breast lifting. I think it is very likely that you will be disappointed if you undergo breast augmentation surgery only.

 In regards to breast implant sizing concerns,  it is not possible to give you precise  advice online.

The best online advice I can give to ladies who are considering breast augmentation surgery is:

1. Concentrate on choosing your plastic surgeon carefully.  Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you're looking for. Ask to see lots of examples of his/her work.

2. Have a full discussion and communication regarding your desired goals  with your plastic surgeon. This communication will be critical in determining  breast implant size/type/profile will most likely help achieve your goals. 
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “very natural”  or “C cup” etc means different things to different people and therefore prove unhelpful.
 Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.

3.  Once you feel you have communicated your goals clearly,  allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals.  Again, in my practice, this decision is usually made during surgery.

I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,487 reviews

Lift or No Lift


It would be a mistake, I believe, to proceed with an augmentation alone, unless you understand that you will most certainly wind up needing a lift in the near future. If the lowest part of the areola is lower than the breast fold (determined with arms at the side, not elevated) you can expect the breast to appear to be hanging off the implant if no lift is done. Plan A sounds much better to me.

Thanks for your question and for the attached photos. Best wishes.

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.6 out of 5 stars 45 reviews

Breast Lift and Implant Choices

It is very difficult to determine the best lift  you will need (recommended based on your photos) or the exact size and shape implant you will require to best match your ideal breast image without an examination by a board certified plastic surgeon. Not just any board certified plastic surgeon, but one with many years of frequently performing breast augmentation surgery including different approaches, techniques and implant choices. This is because several measurements not to mention your breast characteristics are needed to determine the optimal implant size to obtain your goals. Without knowing these dimensions it would be difficult to make this determination. For example, the existing base width of your breast will determine, in many cases, the maximal volume per implant profile that you can accommodate. To illustrate; a 100 cc difference may make a significant difference with a narrow base width breast, but much less of a difference if you have a wide chest wall and wide breast “foot print”. Therefore, just because your friend may have a great result with let’s say a 300 cc implant to make her go from a “A” cup to a “C” cup size does not mean that you will have the same result with the same size implant. The same process goes for just filling in the upper part of your breast without becoming much larger. Further simply placing implants in a bra to determine the size best for you is not always accurate as the bra often distorts the size, is dependent on the pressure the bra places plus the implant is outside your breast and not under it among other variables. Computer software morphing programs that automatically determine the best implant size can be helpful in some but not all cases (e.g. doesn’t work well in my experience with existing implants, sagging or asymmetric breasts). Using “want to be” photos however are useful if simply provided to the surgeon as I will further explain in the link below including silicone vs saline implants:


Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 154 reviews

Breast Lift or No Breast Lift with Implants?

   If the areola are in the lower portion of the breast, you will need a lift.  If the areola and most of the breast is below your fold, you will need a more extensive lift.  Adding an implant will make your cup size greater and breasts larger but will do little to lift truly droopy breasts.

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

Size of breasts/implants and lifts

Breast implants are just pillows and fill out the breast from behind the base of the breast but do not lift it. Implants are sized by matching the width of the implant to the width of the breast across the center (subtracting the skin) and then choosing a forward profile volume of low, medium, or high in order to go up about 1, 1 1/2 , or 2 cup sizes from what you're starting with. 

The need or benefit of a lift is a separate issue but if the nipple-areola is too low relative to the crease behind the breast (and the base of the breast), then an implant cannot be properly positioned behind the breast and look right -- the breast has fallen off the pillow or base of the breast.

Although it is hard to be sure from photos, it appears that your nipple-areola position is too low relative to the crease behind it and therefore a lift would be required before an implant could be considered. This has nothing to do with skin tone which wouldn't change. A minimum lift requires at least a periareolar incision scar. I would recommend considering the lift first and then see if you still want an implant and more volume. 

Scott L. Replogle, MD
Boulder Plastic Surgeon
4.0 out of 5 stars 1 review

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.