Will implants alone achieve my desired rounder and fuller 32d breasts with centered nipples, or is a lift needed? (Photo)

Dear LadyNYC4911,
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

Hello. I would recommend a dual plane 2 breast augmentation with a circumareolar ( Benilli) mastopexy to optimize your results. Based on the photographs provided, you appear to have differences not only on areolar position and size, but also in the location of the inframmary folds. For this reason, I would utilize an infra areolar approach for implant placement rather than placing the incision in the existing folds. This would allow a more precise lowering of the left fold. Estimation of size is best provided with Vectra imaging. I hope this helps.