Should I get a breast lift with my augmentation? (Photo)

First, schedule a consultation with an additional board-certified plastic surgeon. That will likely provide a better perspective about the best surgical plan moving forward. It's not possible to estimate the degree of your breast sagging based on the photo, but if you're satisfied with the size of your breasts, a lift may accomplish the aesthetic goal you want. As others have pointed out, the "wish" photo you've included appears to be of a woman with small breasts and little existing tissue. If you do want the perkier look represented in that photo, you will need to combine a breast lift with implants. 

Hello dear, thanks for your question and provided information as well, yes I recommend you a lift with augmentation. The breasts may lose their elasticity and firmness which can be caused by different factors such as pregnancy, massive weight loss, lactation and aging. To reaffirm the breasts and restore the natural look your surgeon can perform a mastopexy or breast lift. A breast lift restores a firmer, perkier, and more aesthetically pleasing shape to sagging breasts. This not only can improve a patient’s appearance by restoring her youthful, feminine proportions, but  also help bras and swimsuits fit more comfortably and attractively. By removing excess, stretched out skin, reshaping the breast tissue, and raising the nipple & areola into a more forward position, a cosmetic surgeon can create a more youthful breast contour. Stretched, large areolae can also be reduced during breast lift surgery, creating an overall better proportioned, natural looking breast, Actually the perkiness on a person or another, depends on patients skin and breast tissue…Breast augmentation surgery increases or restores breast size using silicone gel implants, saline implants or in some cases, fat transfer. One of the most popular and frequently performed aesthetic surgery procedures, breast augmentation has a long and successful track record in satisfying women who wish to enhance, regain or restore balance to their figures.

Thank you for your inquiry and photos. It is difficult to assess from the angle of your photo but It appears that you have grade 2 ptosis. Based on your comments, since you "don't want to be any larger", then perhaps you should reconsider having implants put in. Placement of an implant will be able to correct minor degrees of ptosis but may not provide enough of a lift if the sagging of your breasts is your main concern. It is true that a mastopexy (lift) will leave scars on your breasts but these scars tend to fade with time and can become fairly inconspicuous. I believe the scars are an excellent trade off for a youthful shape and form to your breasts. A consultation with a board certified plastic surgeon will explore what you are expecting as far as breast size, shape and different techniques used for this procedure. A breast sizing session and/or a 3D Vectra imaging session are excellent tools used to help you envision results. Be sure to find a physician you are comfortable with to give you the results you want. Good luck. James Lee 

It is very difficult to determine the best lift you will need (recommended based on your photos) or the exact size and shape implant you will require to best match your ideal breast image without an examination by a board certified plastic surgeon. Not just any board certified plastic surgeon, but one with many years of frequently performing breast augmentation surgery including different approaches, techniques and implant choices. This is because several measurements not to mention your breast characteristics are needed to determine the optimal implant size to obtain your goals. Without knowing these dimensions it would be difficult to make this determination. For example, the existing base width of your breast will determine, in many cases, the maximal volume per implant profile that you can accommodate. To illustrate; a 100 cc difference may make a significant difference with a narrow base width breast, but much less of a difference if you have a wide chest wall and wide breast “foot print”. Therefore, just because your friend may have a great result with let’s say a 300 cc implant to make her go from a “A” cup to a “C” cup size does not mean that you will have the same result with the same size implant. The same process goes for just filling in the upper part of your breast without becoming much larger. Further simply placing implants in a bra to determine the size best for you is not always accurate as the bra often distorts the size, is dependent on the pressure the bra places plus the implant is outside your breast and not under it among other variables. Computer software morphing programs that automatically determine the best implant size can be helpful in some but not all cases (e.g. doesn’t work well in my experience with existing implants, sagging or asymmetric breasts). Using “want to be” photos however are useful if simply provided to the surgeon as I will further explain in the link below including silicone vs saline implants

Thank you for your question and pictures. From your picture it does look like you may be a candidate for a breast lift + augmentation to give you the results you are looking for. I would want to examine you in person to give you my final recommendation. Its possible that with the breast lift alone your breasts would not be as full as you want them to be, so I assume that is why the surgeon you met with recommended breast implants instead. You should consult in person with another board certified plastic surgeon who specializes in breast procedures to make sure you get the best advice prior to surgery. You want to feel 100% comfortable and confident with your surgeon before you schedule your surgery date. Good luck!

Hello and thank you for your question.  The best advice you can receive is from an in-person consultation.  With that being said, based on your photographs, the best shape and contour could be achieved with an implant and a wise pattern breast lift. Your nipple sits below the inframammary fold and without a lift in addition to the implant, this will not have a natural shape.  A wise pattern lift with an implant can result in a very nice shape if good technique is used.  The size of the implant is based on your desired breast size/shape, your chest wall measurements, and soft tissue quality.  This decision should be based on a detailed discussion with equal input from both you and your surgeon.   Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.   The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Hello,

Thank you for the question and photos. The photo of you isn't head on. A side and quarter angle would be useful. Based on your desired look and concerns, It appears that a full lift will be necessary to meet your expectations. Sometimes implants alone can improve slightly sagging breasts and give a filled-out, slightly lifted look, but you will not achieve the high/perky goal that you have without a lift. This could be done with or without a small implant.

I recommend that you have another consultation. Seek out board certified Plastic Surgeons in your area whose work appeals to you.

All the best

Thank you for the question and photos. You appear to be a good candidate for a lift with implants. 

A lift alone will not give you the fullness in the upper part of the breasts and that's what the implants will do. 

So ideally a combination of a lollipop lift and a small implant will give you perkier breasts with a longer lasting result however it will not look like the wish photo because the wish photo is only an augmentation without a lift. 

Discussing this with your plastic surgeon will help you determine what's best for you. 

All the best,

Dr. Khuthaila 

Hello,

Thank you for your question. Based on your photos, it is safe to say that you have ptosis. Without a true side-view photo and without an exam, it is difficult to grade your ptosis.

The treatment for most grades of ptosis is a breast lift to one degree or another (periareolar, vertical, Wise pattern/anchor scar, etc). If sagging is your primary complaint and you would like for your nipple to be in a higher, more youthful position, then a breast lift is the surgery that will most likely meet your expectations. Breast implants can create a very mild "lifting" effect for patients with minimal excess skin, good skin elasticity, and very mild ptosis. This would be reserved for patients who meet that criteria, are relatively volume deficient and would like to have a larger breast size.

I personally measure every patient I examine during a breast consultation. This helps to guide my treatment plan as a surgeon as well as objectively clarify what is bothering the patient, which helps the patient clarify their goals.

Without an exam it is impossible to give a fully accurate recommendation, but it seems like you would benefit from a lift without an implant to meet your goals of a higher nipple position with improvement in breast shape. Adding a SMALL implant may be considered to round out the top of the breast and enhance upper pole fullness (that Victoria's Secret push-up look), as opposed to a more natural sloping contour that would come with a lift alone.

I would caution you to consider the photo of your "goal look." This patient looks as though she had a tight skin envelope and small breasts to start with. While it is possible to achieve a very pretty breast shape/size/contour for you, it will likely be different from the photo you've chosen. It's important to have a candid conversation with a well-trained plastic surgeon who will be forth-coming and honest about what he or she can obtain for you before proceeding with an operation, so everyone is on the same page.

Best of luck!