Considering a breast revision - will I need a lift or can I achieve a perky look with silicone implants alone? (photos)

You are too large to be "perky", but you can have another lift and be raised some. Your areolae will not go back down in size, but can be made smaller with the lift.

Dear 40girl,
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

Thank you for your question. In order to achieve some more cleavage, I would recommend tightening the breast capsule and changing your implants to a silicone high profile. Additionally, I would add some fat grafting to the upper and medial areas to specifically focus on the cleavage. I would not recommend dissecting the breast pocket to bring your breasts closer together as this can lead to Symmastia or the breasts touching. Good luck.