Do I need lift? (photos)

One boob is bigger than the other and there super droopy. what kind of lift would I need? And why all can I do to help this

Doctor Answers 14

Do I need lift?

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I appreciate your post!

After performing hundreds of breast augmentation-mastopexies (breast lift with implants), I think the most important thing I try to convey to patients is that this surgery is a lot more complex since it is a combination. We are increasing the size of the breast by placing implants while simultaneously making the breast smaller by removing skin to perform the lift, which tightens the breast. 

This could lead to complication loss of skin and the nipple due to vascular compromise. Also since most breasts are asymmetrical there is a larger possibility of having asymmetry after the procedure and meeting a revision.

I have found that the size of implant best for you is dictated by your chest wall measurements. Once we determine that we can choose the profile based on what you want or need to achieve.  

If you are seeking a natural look, then the diameter of the implant should be equal to or, more ideally, smaller than the width of your breast. The breast width is a measurement of how wide your breast is at the base, which should be measured at the level of the nipple. Choosing an implant that is smaller in diameter than your breast width will avoid the "side breast" fullness that is often associated with a more artificial appearance. Bringing photos as well can help us to finalize, but please understand that these are of other people’s bodies and your results will probably be different.

Silicone will give you fullness at the top (upper pole fullness). Silicone implants come pre-filled with a silicone gel and are the softest implant available. They feel more natural, which makes them a good option for women with less natural breast tissue; but they require a larger incision. It may be more difficult to realize if this type of implant has ruptured, so it is important to monitor them with annual follow-up visits. Additionally, because this implant contains a softer silicone (less cross-linked), if this implant should rupture, it may leak but only into the scar capsule formed. However, the newer silicone in these implants may not leak even when the implant shell is ruptured. 

Anatomic gummy bear implants might be a good choice to give you a more natural look. These highly sought after, anatomic implants offer a look that more closely resembles the natural silhouette of a breast and is a very attractive option for individuals seeking a natural-looking breast augmentation.

Additionally, these implants are an especially excellent option for patients undergoing restorative or corrective breast surgery because they provide more stability and shape. Compared to other types of silicone gel implants, the silicone in the cohesive gel implant is more cross-linked; therefore, should the implant shell “rupture,” it maintains its shape and silicone does not leak.

Saline implants tend to be firmer and less natural looking. They are a silicone shell that is filled with water. They have a higher chance of rippling if you are thin especially on the side. However if the implant does structure your body will absorb the water and you will know right away about the deflation. 

During your breast augmentation consultation, you will feel the different types of implants available, and try on various implant sizers in front of a mirror to help you to get an idea of how you will look following the surgery. You should also bring pictures of the look you would like to achieve, as well as a favorite top to wear when trying on implant sizers. I also use a 3D imaging system to allow you to try on a variety of shapes and sizes. I prefer this method to adding volume due to implants being under the muscle.

We will also discuss the possibility of needing a lift along with an implant. This will depend on the amount of ptosis (nipple position) as it relates to your breast, inframammary crease and chest wall. Needing a lift or not will also determine where to place the scar for the incision.  

In some cases if the breast and nipple is really ptotic (low) it might be best to stage the procedure by performing a lift first and then doing an implant at a second stage. This will also allow you to have a better understanding of the true size and shape of your breast. The Scar patterns are determined by how much is skin we need to remove how are high up we need to move the nipple. If your breasts are very large, you might benefit fro  my lipo-lift procedure and the fat we remove could be used to increase the size of cleavage of your breast while lifting them.

The best way to assess and give true advice would be an in-person exam. Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.

Best of luck!

Dr. Schwartz

Board Certified Plastic Surgeon 



Do I need lift? (photos)

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Thank you for your questions. You would be a good candidate for a breast lift. It will help with the asymmetry and droopiness. I recommend meeting with a board-certified plastic surgeon to discuss your options, but I believe a breast lift will help immensely.

Best of luck! 

Krishna Dash, MD
Colorado Springs Plastic Surgeon

Do I need a lift?

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Thanks for posting your questions and photographs.  The right procedure for you depends on many factors, most importantly your goals.  Based on your photographs you display significant breast ptosis and its possible you have weak skin tissue which is prone to sagging.  You would be able to achieve a good result with a breast lift but you need an in person consultation to determine the right surgical approach for you.  Arrange a consultation with a fully qualified plastic surgeon to discuss your options.

Candidate for a Lift

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Candidates for Breast Lift (#Mastopexy) surgery are women who have #saggingbreasts due to past pregnancies, genetics, or aging. Often times the sagging is too great to be treated by implants alone. Women with asymmetric or enlarged nipples or areolae (pigmented areas around nipples) also may be candidates for a breast lift or a modification of a lift. #Asymmetric breast can be adjusted by adding or removing volume.  One side can be tightened more or less than another.

A mastopexy or breast lift operation is designed to improve the shape and position of the breast without reducing their size. It is used for breasts which sag or droop (ptosis). Sagging of the breasts may occur with normal development for some women, or as part of the aging process. Pregnancy, breast-feeding and weight loss are other conditions which increase breast ptosis. Some patients will have a better shape to their breast such as increased superior fullness if an implant is used at the time of mastopexy. The procedure can also be combined with a minor breast reduction to reduce the breast width if desired. The surgery will create an elevated, more youthful breast contour. Also, the procedure will create nipple and areolae of the desired size and at the correct height. I prefer to  use a #shortscar technique, #LollipopScar or #DonutLift” rather than the majority of surgeons in the United States that use an anchor pattern lift which involve more significant scarring.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Breast lift

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Based on your photos, you appear to have very weak tissues which will be prone to re-drooping after surgery. As a result, I would be very cautious about adding an implant which would increase the weight of the breast.  A lollipop or anchor scar lift technique would be appropriate (I would need to see you in person to know which I would recommend), and you could do a small reduction on the larger side, or an asymmetrical reduction on both sides to even out the volume.  If you wanted to be a little larger after surgery, I would lean toward fat grafting the upper breasts to improve volume without loading the breasts with as much weight as you would have with implants. Make sure you see a very experienced breast surgeon as your anatomy will be more challenging than average. Best of luck!

Robert Cohen, MD
Santa Monica Plastic Surgeon
5.0 out of 5 stars 58 reviews

You Need a Lift

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In my practice, the right choice of procedure for any patient will depend on the answer to a few simple questions;
  1. Do I like the size of my breast? If the answer is yes, then augmentation is out of the question (even if your doctor tells you that you need implants to lift your breasts). If the answer is that my breasts are too big, then the answer is you need a reduction (still no implants). If the answer is that I would like to be bigger, then any procedure should include an augmentation.
  2. Do you like the shape of my breasts? If the answer is yes, then any lift is off the table and return to question 1 for volume discussions. If the breasts are sagging, then you need to decide if you get only a lift (if the volume is fine) or an augmentation-mastopexy (for small breasts) or with a reduction (if they are too big).
A few caveats:
  1.  Breast implants do NOT lift breasts, if anything they make sagging breasts sag more!
  2. Breast lifts will reduce the volume a little bit.
  3. There are many different techniques for breast lifts and augmentation mastopexies, be sure that your physician has a great deal of experience and that the results you see in their photogallery looks like what you want.
Looking at your photos suggests that you would be an ideal candidate for a Lejour Breast Lift. In my experience. this technique creates the best shape, as well as the most durable result.If you would like more information on this, please read my book "Cosmetic Breast Surgery - A Complete Guide from A to Double D".

Robert M. Freund, MD
New York Plastic Surgeon
4.8 out of 5 stars 34 reviews

Lift without implants

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Based on these photographs you appear to be an excellent candidate for a breast lift.  I would suggest that you will not get the position shape and symmetry that you would like with an implant

Lift vs implant

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If you want your breast fuller and are happy with the shape of them, then an implant will be fine. Keep in mind an implant will only "fill our breast up" it will not "lift them up". They will look just like they do now, they are just bigger and fuller with an implant only. If you feel this will meet your goals, then an augmentation should be fine. If you are unhappy with the position of your breast and feel they are too low, then an implant will likely not satisfy you and you will want to consider the lift. A lift will "lift them up" and put them in a higher position, change the size of the areola and "lift" them off of your chest. Often times both of these procedures are combined to achieve an optimal result. By lifting them and adding volume, the breast will not only sit higher on your chest but will also have the nice fullness from the implant. In your case, you will be better off with both a lift and an implant.
Dr Scott Ennis

Lawrence Scott Ennis, MD, FACS
Pensacola Plastic Surgeon
5.0 out of 5 stars 162 reviews

Need a lift?

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Thank you for your question and photographs.  It does appear that you would need a breast lift to address the droop that you are describing and give you a perkier breast.  Asymmetry could be addressed with an implant or reduction of the larger breast.  Best to consult with a board certified plastic surgeon for an in-person examination.  I wish you good luck.

Do I need lift?

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Aloha, it does appear that a lift would be helpful to you.While a Donut Lift would limit the scar to around the areola, a Vertical or Lollipop lift would lift more and last longer. Although you have good size, if you want more upper fullness, you may also need/want a small implant under the muscle.I recommend that you see an experienced board certified plastic surgeonto review your options after an office consultation and thorough exam.
Mahalo, Dr. D

Kevin Dieffenbach, MD
Oahu Island Plastic Surgeon
5.0 out of 5 stars 34 reviews

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.