To implant or not to implant....will I get the same effect with only a lift, or do I also need implants? (photo)

    If you are happy with the size of the breasts but think that they are droopy, a breast lift may be advised.  If you would like your breasts fuller or larger, an implant can be placed at the same time.Kenneth Hughes, MDLos Angeles, CA

Thank you for the photo, although we really need what they look like now.  If the desire is for upper pole fullness, the usual way to do that is with an implant. The implant does not necessarily have to be large. If you need or want volume, then a larger implant will help. Nipple/areola positioning is a different matter and may necessitate more work, (i.e.; a lift). Please see a board certified plastic surgeon. Discuss your goals. Together you will come up with a plan. 

If you like your size and simply want lifted, perkier breasts, then an expert breast lift surgeon will remove no more than around one ounce of tissue (skin). Some plastic surgeons, however, have received training that has taught them to remove much more than that, and add implants. These surgeons usually say that this technique "adds upper pole fullness," which many breast lift patients are seeking. If you only add back what you remove, this is hogwash. If you add more, then why not remove less tissue and use smaller implants?The question I would ask you if you came to me for consultation would be: "Do you want to be bigger than your present size?" Forget perkiness and lifting for a minute, and just answer the size question, since a properly-performed breast lift removes only an ounce of skin per side (in most women). If you want to be bigger, then you need to decide how much and choose the proper implant volumes. Add 30cc to account for the skin removed with the lift and there you go!Certainly, lift only is a less expensive and less complicated procedure, but lift alone will not add volume; in fact, as I have stated above several times, mastopexy (breast lift) removes one ounce of skin (30grams). Strictly speaking, your surgeon is incorrect if he stated that a lift does the same as an implant, since implants NEVER lift, they only fill up the loose skin and can give the breast an improved nipple/mound relationship. This occurs as the implants drop behind the breast and better fill the loose skin brassiere.But only a lift lifts. A lift plus implant both lifts and enlarges. For several examples of my patients with lift plus implants, click on the web reference link below. You can also navigate in our photogallery for examples of lift only. These are my patients as well. Best wishes! Dr. Tholen

In my experience breast lift alone in patients who have lost volume and stretched skin after pregnancy can improve the shape of the breast and lift the nipple but the rest tissue is often loose, jiggly and not full and normally firm.  In some patients who have an extreme amount of breast tissue a lift can be enough, but rarely, post pregnancy, in patients of normal weight and height does a breast lift alone give a satisfactorily firm full breast.