Lift or Implants. (photos)

I've lost over 150 pounds do I need a breast lift with implants or just implants

Doctor Answers 13

Breast augmentation and lift candidate, some advices:

Thank you very much for enquire.
After having analyzed all the information and photos provided to us, I realize that you have very sagging and small breasts. In this regard, you need volume (implants) and projection (the lift): Breast Augmentation w/Breast Lift.
I recommend you to use microtexturized highly cohesive silicon implant ("gummy bear" implants), with high projection, and 550ml will be excellent on you, to fill the breasts properly.
Finally, to perform the breast lift I recommend a Periareolar Round Block Breast Lift ("Benelli mastopexy"), which has an unnoticed scar around the areola, and if we see (in the surgery) that we can't obtain adecuate projection just with the Benelli Lift, we have to perform a "Lollipop breast lift".
Dr. Emmanuel Mallol Cotes.-

Dominican Republic Plastic Surgeon
4.7 out of 5 stars 147 reviews

Breast augmentation or breast uplift, borderline case

You are a border line case between breast lift and breast augmentation. That means that different factors will play role in the decision of the appropriate surgery.

Obviously, in these cases an in person exam is very useful in order to take the correct decision.

As far as I can see from the photos, I think that if you want more than one and a half size of bra augmentation, the operation of breast enlargement alone will give you a good result.

The method that has to be used is not the same as in non ptotic cases and the surgeon where you will be refered to, must have the knowlage of all the techniques.

If you decide to do breast augmentation alone, you must try to find an experienced surgeon to these cases.

I wish all the best.

Breast lifting necessary?

Congratulations on your significant weight loss; you should be very of your accomplishment. Based on your history and photographs, I think you will do best with breast augmentation/lifting surgery.

Personally, I find that the breast augmentation/lifting procedure to be one of the most challenging of the breast operations I perform, even compared to somewhat complex revisionary breast surgery. On the one hand, when performing breast augmentation/lifting surgery we are increasing the breast size with breast implants; on the other hand, we are reducing the breast “envelope” in order to achieve the breast lift. These two “forces” must be balanced as perfectly as possible in order to achieve the desired results. Removing too much skin/ breast tissue is problematic; removing too little breast skin/tissue can also be problematic. Remember also that patients presenting for breast lifting surgery and general have lost some skin elasticity/thickness making potential incision line healing problems and/or recurrent drooping/sagging important concerns to communicate. 

To achieve a surgical result where the breast implant and breast tissue “come together” and behave like a single breast is one of my goals but can be difficult to achieve. Essentially, we are trying to create a breast implant/breast tissue interface that feels and behaves as naturally ( as a single unit) as possible. Generally speaking, making sure that the breast implant has some sub muscular and some sub glandular component ( dual plane) and tailoring the overlying skin/subcutaneous tissue/breast tissue as precisely as possible over the underlying breast implant is key.

Despite these efforts, breast implants are after all a foreign body that don't necessarily stay where we wish they would; therefore, breast implant related problems such as positioning ( too high, too low, lateral displacement etc.) can occur and may be a reason for returning to the operating room for revisionary breast surgery. I use a “tailor tacking” technique that allows a determination of what breast implant should be used to SAFELY produce the results the patient is looking for. This technique involves use of a temporary sizer and temporary “closure” of the overlying breast skin over the sizer. The use of the tailor tacking technique is very helpful. Breast lifting involves removal of skin ( and tightening of the breast skin envelope) while breast augmentation involves expansion of the breast skin envelope. These 2 forces are counteracting each other. Again, despite these efforts, breast implant and/or tissue/skin complications may arise causing minor or significant complications. 

Generally speaking, it is difficult to achieve the “perfect” result with breast augmentation/lifting surgery, despite best efforts. Patients should be aware of the complexity of this combination procedure, achieve REALISTIC EXPECTATIONS prior to proceeding, and understand that additional surgery ( along with the additional recovery time, stress, expenses etc) may be necessary in the short or long-term. Patients should understand that the results of the procedure will not necessarily match aesthetically the results of patients who have undergone breast augmentation surgery only.  

Potential risks associated with breast augmentation/lifting surgery include infection, bleeding, incision line healing problems, loss/change of nipple/areola complex sensation, and blood flow related issues to causing skin or tissue necrosis. Poor scarring, pigment changes, areola/nipple asymmetry etc. are also potential problems. Again, patients may experience implant related problems such as encapsulation, leakage, displacement problems ( too high, bottoming out, lateral displacement, asymmetric positioning etc.), rippling/palpability of breast implants etc. Patients may also be dissatisfied with breast size, shape, and/or how the breast implants and overlying breast tissues “interface” with one another. Occasionally, a breast implant may even have to be removed and the patient will generally be “implant free” for several months at least. Obviously, this situation can be quite physically, emotionally, and psychosocially stressful to the patient involved.   Having discussed some of the downsides and potential risks/complications associated with breast augmentation/lifting surgery, most 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. I hope that this summary of SOME of the issues surrounding breast augmentation/lifting surgery is helpful to you and other women considering this procedure in the future.  The attached link may also be helpful. Best wishes.   

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Lift or Implants? Answer: both

Thank you for your question and congrats on your weight loss.  Based on your photos, you would likely need breast implants with a limited lift.  This would give you upper pole fullness, improve cleavage,  eliminate loose breast skin and make the breasts perkier and rounder.  Be sure to consult with an experienced board certified plastic surgeon.  Good luck!

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Breast Lift / Breast Augmentation/ Breast Implants/ Anatomic Gummy Bear Implants/ Silicone Implant

I appreciate your question. Congratulations on your weight loss!From your photos, it appears that you would benefit from a  breast lift.  A breast lift would reposition your nipples and reshape your breasts, giving them a more youthful appearance.  If you are interested in also increasing volume, I would recommend breast augmentation as well. The best way to assess and give true advice would be an in-person exam. Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery. Best of luck! Dr. Schwartz

To Lift or not To Lift

You are on the border.  If you don't mind if you breasts sit a touch low on your torso, then no lift is needed.  If you would like them to be high on your torso, then you should have a lift with an implant.  I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with and who is a board-certified Plastic Surgeon certified by the American Board of Plastic Surgery. Best wishes! Dr. Desai
Harvard Educated, Beverly Hills & Miami Beach Trained, Double-Board Certified Plastic Surgeon

Your breasts

You really need to be seen and evaluated to know for sure -- but from the photo it looks like a small lift and implants would do the trick. I doubt implants alone would make you happy or give you a good result. 

William B. Rosenblatt, MD
New York Plastic Surgeon
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Breast augmentation

Hello and thank you for your question. You are a great candidate for a breast augmentation.  Based on your photographs, you on the borderline between needing a lift with an implant vs an implant alone with a dual plane technique.  An in-person examination would be able to most accurately determine which is better.  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

Richard G. Reish, MD
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Lift vs aug

I hate putting scars on the breast, so you should start with an aug if you're desiring more fullness, and then potentially wait and see if you like it.  A lift for you, after that, would be small (guessing off photos).  Other option is to allow the surgeon to make the decision on the OR table, which is nice if you trust your PS and their judgement.

Cain R. Linville, MD
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Massive weight loss and subsequent cosmetic breast surgery

Typically after massive weight loss, breast skin laxity is severely redundant and breast tissue in comparison is deflated and atrophic - especially in the upper breast pole.  After massive weight loss, most patients require both an implant for volume correction and skin excision and tailoring to lift the nipple and help shape the breast.  It is very important to see an ABPS board certified plastic surgeon for proper evaluation, including a history and physical exam, before deciding on the appropriate surgery.

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