I am 5'5" and 185 pounds. I have had 4 children and am currently a 38 D. I am terrified that I will get a double bubble or snoppy breast. My surgeon said I don't have enough droop to need a lift. I have surgery set for 3 weeks and I just need another opinion. Please help!
My Surgeon Said a 400 Cc Gel, High Profile Implant Will Work Great with No Lift. Is He Right? (photo)
Doctor Answers 11
It's tough to say if you will need a little lift but I would probably not lift at the same time of surgery. I'd let the implants settle (moderate projection in your case) and see in 6 months if a little nipple raise will be necessary in the office.
Implants and nipple position.
When implants are placed they will fill out the skin envelope of the breast by varying degrees depending on the size of the implant. The nipple will be positioned higher following placement of the implant. Whether or not to have a lift depends upon your desired outcome. Based on your photos and on the low position of your nipples, I do not think that your nipples/breast will be elevated as much as most patients desire. If you want your nipples above your inframammary fold and centered over the implant you will likely need a lift. There are pros and cons to performing a lift at the same time as the augmentation, but it can be done. Consider asking your surgeon to perform a lift if during surgery it appears that your nipples are not elevated as much as you would prefer. This leaves the option open for your surgeon and gives the surgeon the flexibility to do want is necessary to achieve your goal.
If you are happy with your size when wearing a bra, then you should have a lift only. If you want to be bigger, then an implant only will make you larger, but you will still have some sagging. If you want larger and perkier, then a lift with implants will be needed.
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Lift or No Lift
Based on your photos, the nipples and lower portion of the breast are below the breast fold. The implants will lift the breast out but not up and this effect will help, but you will still have some sagging. I would suggest trying the breast augmentation alone and waiting 6 months. If you are not satisfied at that time you could consider the benefits and risks of a periareolar lift.
Hello. It is hard to answer these questions based on pictures alone but I agree with your surgeon. With the right dissection you could get away with implants without the lift depending on the look you want.
Jaime Perez, MD
Breast Augmentation Specialist
Plastic Surgery Center of Tampa
Breast Augmentation Candidate?
Thank you for the question and pictures. I think that you are wise seeking additional opinions. At least based on your pictures, it seems that you would benefit from breast lifting surgery. Of course, the “downside” associated with breast lifting is the necessity of additional incisions/scars.
Many patients (If properly selected and who are doing the operations at the right time of their lives psychosocially) accept the scars associated with breast augmentation/breast lifting surgery as long as they are happy with the improvement in contour, size, and symmetry. This acceptance of the scars is the essential “trade-off” associated with many of the procedures we do in the field of plastic surgery.
Please be careful about the choices you make...
Implants and no lift?
It looks like from your side view that the nipples are below the fold. If so, then you need a lift. The implant will not lift the breast.
Small Implant with Lift
A smaller implant of 250 cc or so for superior pole fullness may be appropriate or you could opt to have no implant placed at all. A lift would help the look of your breasts. Kenneth Hughes, MD Los Angeles, CA
My Surgeon Said a 400 Cc Gel, High Profile Implant Will Work Great with No Lift.
I am not sure what your goal is, but whatever it is, I feel that implants alone will give you an unsatisfactory result.
As a rule, if the lower edge of the areola is lower than the breast fold, a lift should accompany any enlargement. Otherwise, there is a high likelihood of having your own breast tissue appear to be hanging off your breast.
If all you want is a higher areola and nipple, a breast lift is the procedure to consider.If you are content with the current size, note that a 400 cc implant may increase you by one to two cup sizes.
If you also wish to be larger, then a lift and enlargement can accomplish that. Implants alone will not lift the nipples and areolas, and can result in a bizarre appearance.
I would check out another opinion. RealSelf has listings of surgeons in your area. You should consider cross referencing the listings from the The American Society of Plastic Surgeons (plasticsurgery dot org). A listing in the ASPS website assures you that your surgeon is not only board certified, but also is a member in good standing of the major plastic surgery organization in the U. S. Thank you for your question, best wishes.
Lift or Not
I would agree that you need a lift and an implant will not correct the situation. The position of your nipples appears to be below the inframammary fold. In this instance a lift is needed. If you try to correct your situation with a large implant, your breasts will only be larger and still droopy. It could look worse. If you are happy with your size, get a breast lift alone. A small implant could be used if you wanted better shape and fullness at the top but this is not necessary.