55, two children, 25 lb weight loss - 34B breasts sag but the nipples do not point downwards - Breast lift? Implants? (Photos)

If you want to be larger, you will need a breast implant. If you want better shape without increasing your size, a breast lift alone will work. You also have the option of a small implant without a breast lift. I would consult with your surgeon and determine what is best for you.

Breast lift would be a great option for you if you don’t mind going down in one cup size. The current volume of the breast is very important in this decision. During breast lift surgery, since it is taken higher and some skin and breast tissue can be removed, the lifted breasts appear a little smaller than normal. Breast augmentation can also be achieved by placing implants in breast lift surgery for breasts that have lost volume after pregnancy and breastfeeding, for women who need upper part fullness. You are suitable for both.

With pushup lift, getting a lift without implant is possible for every size of breast, according to patients desire. In your case we recommend to perform the lift with implants, maybe a mini projection implant can be used to give a good round shape and cleavage. Internal bra is not essential for any type of breasts, if the implant pocket is created due to implant used. Additionally we can support the inframamarian fold during lift

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 with different size and style breast implants. 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

The technique I recommend is a breast 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 and nipple sensation (in 95%) is maintained. Later, fat transfers or small implants can be placed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Hi there, I just evaluated your pictures. I can surely say that you don’t have actual breast ptosis, you have glandular ptosis. This condition can be perfectly treated by breast implants. According to my experiences, you don’t need breast lift and internal bra either.

Hi Kristin- this is a great question! you have something called "pseudoptosis". This is where the lower part of your breast sags but the nipple remains in good position. The best management depends on your goals. A lift alone would help with the sagging breast but would result in a rather small breast. In my opinion, adding a modest sized implant would greatly enhance your result and give you more upper pole fullness. Adding an "internal bra" generally refers to placing an absorbable mesh to support the soft tissue. In my opinion (and this varies greatly amongst surgeons), this is most beneficial if your select a rather large implant (over 350cc) and/or have a goal cup size of D or larger. Because you do not require a particularly large lift, I think that it would be completely reasonable to omit the internal bra. Best wishes for your plastic surgery journey!Alex Neusner, MDBeverly Hills, CA

Depending on the implant size you are considering you may be able to achieve your desired look with implants alone. You do have some asymmetry, which is normal, but could also be addressed at the time of surgery. Visit with a board certified plastic surgeon near you to discuss your surgical goals and learn more.

pursuing a lift vs a lift combined with an implant is very dependent on your personal goals. I generally counsel patients that a lift is designed to reshape the breast and reposition the nipple. The decision to add an implant or not is dependent on whether you are pleased with your current volume or would like to increase volume globally or upper pole fullness. If either of these is the case, than combing an implant with a lift would be advisable. Using an internal bra is often dependent on patient tissue quality, selected implant size, and patient preference/desire to increase longevity of the result as much as possible. Meeting with a well-trained plastic surgeon who can assess your anatomy and get an understanding of your goals before recommending a surgical plan that fits these.
Sean Fisher, MDAesthetic Plastic SurgeonSeattle, WA