How do I know if I need a lift before boob job?

Hi im a mother of 3 with c cup+ boobs with a bit of sagging i have never breastfed either if that helps at all I weigh 65kgs slim build. Want to have nice perky boobies thinking of boobjob but dont wont the lift. How do I know i need one?

Doctor Answers 13

Lift needed?

Thanks for your question.  Without photos or in-person exam, it is difficult to advise.  Generally, if you have breasts that sit low on the chest with a nipple at the bottom of the breast or lots of overhanging breast below the breast fold, then a lift would be required.  An exam is really necessary to give you the best information.  Would recommend talking with a few board certified plastic surgeons to get some recommendations. Best wishes. 

Breast Lift with Implants

Women may find that pregnancy and breastfeeding contribute to loss of volume and firmness. To perk up a drooping breast, your surgeon may be able to use an implant alone, if you also want to be bigger. If, however, you just want to be perkier and like your breast size, you will need a breast lift. A mastopexy (breast lift) raises droopy breasts from one to several inches and excess skin is removed. The great thing about these techniques is that they can now be down with minimal scarring and performed as an outpatient procedure without the need for general anesthesia. 

Michelle Copeland, MD, DMD
New York Plastic Surgeon
4.6 out of 5 stars 9 reviews

Need a lift

If your breasts can hold a pencil underneath, you probably do need a lift. I would suggest meeting with a board certified plastic surgeon to discuss all your options. During the consultation, you will be examined and measured, and your surgeon can let you know if a lift is needed.

Connie Hiers, MD
San Antonio Plastic Surgeon
4.6 out of 5 stars 13 reviews

When is a lift needed?

Thank you for your question.

Only with an in-person breast exam can we conclusively say if you need a breast lift in order to make the breast augmentation beneficial.

The risk factors for sagging/drooping includes aging, history of significant weight loss (>50 pounds), higher BMI, large bra cup-size, pregnancy, and smoking. Sagging is not related to breast-feeding, but it gets worse with the number of pregnancies. If you have a healthy diet and keep a healthy weight, then your risk of further sagging is lowered. Another recommendation is to be wearing a sports bra during exercise because the constant pull of gravity and excessive movement during running can stretch the breast tissue possibly leading to further sagging.

If your nipple is pointing downward, have a deflated upper pole with most of the breast tissue hanging low on the chest, and/or if your nipple is near or below the fold under your breasts (inframammary fold), then you generally need a breast lift.

If you receive breast implants without the correction, then you will not only have to go with a larger than usual implant, but it will also appear too low on your chest (bottoming out). The weight of the implant will worsen the amount of sagging. You may also have a double bubble deformity where the breast tissue overlying the implant droops below in front of the implant. It may also cause a snoopy deformity (named after the cartoon character snoopy) that happens when the implant is held sitting in a high position by tight pectoral muscles, while the natural breast tissue falls off the implant and hangs below at the bottom curvature of your breast.

If you are afraid of scars brought on by a breast lift, you can get an initial breast augmentation, and if you become unhappy with your results, then you can definitely opt for a breast lift in the future.

Make sure to choose a surgeon you can trust. Your surgeon should be someone who does not rush you, and someone who does not agree to everything you say because safety should be the first thing on their mind. Clearly, you wouldn’t know what is best for you, so they should guide to make decisions that will minimize complications and allow you to have beautiful breasts in the long-term.

Verify their skills, education, and certification. Ask about your surgeon’s experience about the procedure you want and ask to review photographic examples of your surgeon’s work. Check to see if the aesthetic ideal is consistent with what you are hoping to achieve. Please make sure that you look at pictures of patients who had the same pre-operative breast characteristics that you display. Also make sure the before and after images have the same perspective, the same lighting.  Read the surgeon’s reviews for the procedure you want.

Please book an in-person consultation with a board-certified surgeon and make sure to fully and comprehensively share your desires, expectations, and concerns.

Hope this helps.

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 427 reviews

Lift with implants

Breast Lift with Implants or Implants Alone

One of the more common scenarios that we as aesthetic plastic surgeons deal with in cosmetic breast surgery is the patient from either weight loss, or post pregnancy has a little bit of drop of the breast off of the chest wall that we call ptosis. The question then becomes in the patient's mind, can we just fill the space with an implant and create a youthful looking breast. It all depends on what the patient's perception of youthful is. My patients, more than likely, would like to have upper pole fullness of the breast without the necessity for wearing a push-up bra. In these situations, a breast lift plus an implant both centers the nipple and areola complex on the breast while replacing the lost volume with an implant. Most patients’ hesitation in doing the breast lift as well as implants, are the potential for bad scars. In my experience, we talk a lot about the scars of a breast lift preoperatively, but hardly ever in the postoperative phase. It seems to me, that when the breast is up high on the chest wall, youthful and perky, that one does not even see the scars. Most of the time, these incision lines heal uneventfully anyway. In the small chance that the scars are more red or thicker than one would like, we have many options in lasers, light sources, and laser assisted drug delivery techniques to mitigate against unsightly scars. Sometimes, patients who I've seen have seen other physicians who have recommended simply placing a large implant to "fill the space". This seems to be a very temporary fix for the situation in that the stretched out soft tissue that the implant is placed into, usually will allow very rapid descent of the breast, such that in just a few months, it looks like a bigger version of the breast that they first started with. They will then sometimes have a secondary mastopexy, and at that time, I would often recommend that they replace the very large implant with a smaller one. In my opinion, a large lift, meaning taking out as much of the stretched out skin as possible, and placing a more modest size implant will make a breast that will remain perky and up on the chest wall for a long period of time. In my opinion, perky breasts, not necessarily large breasts, look youthful. Patients will then ask, "why then does Dr. so-and-so tell me that I can just have implants?" My answer to this is very simple. It is far easier in most plastic surgeons’ skill sets to place a large implant then do a breast lift with an implant. The simultaneous lift and implant procedure is a little more challenging in that you're trying to do opposite things at the same time. One, you're trying to make the skin envelopes smaller and at the same time make the breast larger. One easy way to decide whether a lift is good for you, is to see your image in 3-D on a Vectra camera system. In our office, we can then compare two images: one with mastopexy with implants and the other with implants alone. In that way, both the patient and plastic surgeon can see what the difference in the look of both procedures are. Usually when implant is placed only, and a breast lift was really needed, what the patient will see is a breast that is falling off of a properly placed mound that's higher in the chest wall than the breast is. The breast seems to be falling off the implant. They will commonly squeeze the end part of their breast and ask,  “why hasn't the implant filled this space out?” For me, the in between operation is to use a tall shaped implant. These anatomically shaped implants can create the illusion, that although the nipple has not really been raised, that the nipple is now more centered on the breast. While these implants do cost more than round implants, it still less expensive than adding a breast lift. All things considered, it's best to consult with a few talented and busy cosmetic breast surgeons to get different opinions. Good luck with your decision.

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 44 reviews

Do i need a lift with my boob job

Its very difficult to answer this question without seeing you and giving you a full evaluation.  Speak to a board certified plastic surgeon he will do some measuring to see the position of your breast, nipples and depending on the size implants you are looking for he can recommend what is best for you and what your looking to achieve. *

N. Bill Aydin, MD
Paramus Plastic Surgeon
5.0 out of 5 stars 47 reviews

Do I Need A Breast Lift With My Boob a job?

If your nipples point down or are very low on your breast or if most of your breast tissue hangs below your breast crease, you might be a candidate for a breast lift. It is difficult to give you a personalized answer without an inperson examination. 

Millicent Odunze-Geers, MD, MPH
Sacramento Physician
4.6 out of 5 stars 5 reviews

Breast augmentation/lift

Thank you for your question.

You will need to schedule a consultation with a board certified plastic surgeon to have a physical examination to accurately determine whether a lift is needed. It really depends on the degree of sagginess the breasts have. Minor sagging can be corrected with the placement of an implant alone but greater sagging will require a breast lift to give you the perky appearance that you desire. Best of luck in your endeavors.
Sincerely,

James Fernau, MD, FACS
Board Certified ENT
Board Certified Plastic Surgery
Member of ASPS, ASAPS, ISAPS, The Rhinoplasty Society, AAFPRS, OTO/HNS, ASLMS, International Federation for Adipose Therapeutics & Science

James Fernau, MD, FACS
Pittsburgh Plastic Surgeon
4.9 out of 5 stars 68 reviews

Breast lift

After a consultation with a Board Certified Plastic Surgeon you will be able to determine if you are in need of a mastopexy or mastopexy augmentation. There are different stages of breast deformation, and the incision technique will depend on the patient’s breast size and shape as well as the amount of sagging and the desired results

You can determine what type of breast lift is necessary by viewing your profile in a mirror. The natural crease of the breast determines the amount of skin elasticity and sagging. A youthful breast will have a nipple that is above this crease.

Mastopexy Augmentation Breast will mild sagging will require a small crescent-shaped incision above the areola. This procedure is often combined with breast implants to restore firmness and volume to the breasts.

Periareolar Mastopexy Breasts with moderate sagging will require a technique that involves a circular incision around the areolas. Excess skin between the areola and incision is removed. This procedure allows the areolas to be reduced in size.

Full Breast Lift Breasts with severe sagging will require a full breast lift. With this technique, Dr. Shapiro will make an anchor-shaped incision that goes around the areola, vertically down to the crease, and then across the creast of the breast. This procedure allows us to lift the nipple to its more youthful position and reduce the size of the areola.

Find the right surgeon to help you decide

Far more important than the technique is the skill and experience of your plastic surgeon. Choose your surgeon rather than the technique and let them explain why one technique may be better than another. 
See the below link on some suggestions on finding the most qualified Plastic Surgeon for a  Breast Augmentation.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.