Lift or not with breast augmentation? (Photo)

It sounds like you've spoken with two surgeons who like to impose their opinions on patients rather than listen to what the patient wants. You haven't said what you're actually looking for here (stay the same size, go a bit bigger like the 400 or go WAY bigger like the 600). In my experience letting a surgeon talk you into a procedure, especially one that nearly doubles the size of your implants, will lead to you being very unhappy afterwards. I would suggest you keep searching for the right surgeon because to be anything you're looking for can be accomplished it's just a question of the best way of doing it. Speak to a breast revision expert who is capable of all of these techniques and let them figure out how to give you what you want rather than telling you what you should be looking for. Hope that helps!

Dear brg059905,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Your breasts are low on the chest wall. I would recommend explantation and lift using The Bellesoma Method. The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated 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 if not injured during your previous surgery. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Actually if you’re okay with your breasts the way they are you could do nothing at all. If you do get a lift I would not go with implants any larger than those you already have. Going to 600 cc will accomplish absolutely nothing except leaving you appearing very too heavy. I wouldn’t even consider than a reasonable option.

First, saline implants can leak, but when they do, your body absorbs the saline and you just deflate. Second, you need a lift now. Do not go with the 600 cc implant for this will be too large and heavy for your frame and tissue. Your neck and shoulders will feel the excess weight and your tissue will just sag more since it will be so stretched and thinned from that size. Trying to avoid a lift by going with a larger size does not work long term. Go with the first surgeon's advice. I would suggest placing the implants behind the muscle for better upper breast fullness and support and doing the lift. I also suggest considering something between 330-350 cc's for better long term results.

Dear brg,
First of all, after 2 children and a big weight loss, you and your breasts look great. Secondly, saline breast implants don't just partially leak (bleed). If they are leaking, they would deflate completely. Your second surgeon is correct in that regard. However, 600cc implants are enormous and heavy, and tend to "age", i.e. sag quicker because of that weight. So, yes, you might avoid a lift now with implants that large, but expect to need one much sooner than you might have anticipated with a smaller implant. Also, you have to consider whether you want double or even triple D cup breasts. You have many options, including a lift alone. Good luck!

I have a few different opinions. In my experience, when saline implants SATRT to leak, they do NOT stop leaking and generally empty dramatically within a week.
You are a little ptotic (low), so I would ONLY consider doing a revision with a mastopexy (lift called an augmentation mastopexy). You may increase your size if desired, however, consider that with a lift you get rounder breasts and more upper pole fullness. I would consider increasing by a max of 500cc fill to avoid further stretching and dropping over the course of time.
Best wishes,
Dr. Taranow