Breast augmentation and no lift for saggy breasts (Photo)

Is it possible for me to get a nice result with just an augmentation? Because I lost a lot of weight, my chest lacks Volume. I Want to get a natural result and my PS told me that he will do it with just an augmentation and no lift. He will do the dual plane technique with 350-400cc (i Want a full C/small D). Thank you for your answers :)

Doctor Answers 10

Lift without implants

Based on these photographs you appear to be an excellent candidate for a breast lift.  I would suggest that you will not get the position shape and symmetry that you would like with an implant

Breast Augmentation without the lift

I think you will get a very nice result with breast augmentation.  The augmentation will not elevate your nipples, but you will NOT have the extra scars that are required for the lift.  In the future, the weight of your implants added to the current drooping of your breasts, may lead you to desire a lift.  But for now, you should be very pleased with the outcome of the dual plane approach.You could consider one of the less invasive breast lift options that don't require the "anchor" scars.  You can ask your plastic surgeon about these if you are interested.  Best of luck!

Jonathan Heistein, MD
Fort Worth Plastic Surgeon
4.9 out of 5 stars 22 reviews

Breast lift needed with augmentation?

Thank you for your inquiry and photos. You can get good results with natural look with only augmentation, however he can also do the areola lift only without doing the vertical lift. 350-400 cc would be a good option for you. Best of luck. 

Ricardo Vega, MD
Mexico Plastic Surgeon
4.5 out of 5 stars 39 reviews

Breast augmentation and no lift for saggy breasts

It sounds like you have chosen a very good surgeon. As long as you are happy with a more natural look, your planned surgery is exactly right. Too many surgeons jump into a lift when it is not needed. We have over 30 years of followup of more conservative surgery to indicate that. 

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 24 reviews

Breast augmentation and no lift for saggy breasts

Breast augmentation and no lift for saggy breasts will not work. Placing heavy implants (350cc-400cc) using a dual plain technique means that the muscle is cut to allow the implant to lie directly over low lying breasts. Once the muscle is cut, there is nothing supporting the implants allowing them to migrate to the sides of your chest. Not a good look. Yes, they look great initially, but you won't enjoy them for very long. You will then require revisionary surgery to put them back in place I'm afraid. You actually have enough tissue to undergo The Horndeski Method breast lift without the extra cost, maintenance, risks and complications associated with breast implants. I have attached a brief video of what you can expect with this technique and I invite you to visit my gallery to find women with similar deflated breasts that did not need implants with this technique. I hope this helps. Best wishes to you,

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.7 out of 5 stars 208 reviews

Breast result

Thanks for your inquiry and excellent pictures.  Ultimately,  it about your expectations.  With a dual plane technique I think your surgeon can get the implant well centered on your mound, but the whole mound will stay low.  I do not know the result you are expecting.  Please have you surgeon show you a before/after result of someone who had your plan.  Good Luck.  

Augmentation or lift aug

in principle the correct operation is a lift augmentation. Having said that however given the relatively good position of your nipple you may well get away with a large enough dual plane augmentation. It's difficult to tell without an examination. Good luck 

Ross Farhadieh, MBBS, MD, FRACS, FRCS
Sydney Plastic Surgeon
5.0 out of 5 stars 8 reviews


You need a lift (mastopexy) + implants.  Breast Augmentation is an excellent way to both add volume to smaller breasts and when combined with a lift, it can restore a youthful appearance for breasts, like yours, that have started to droop or sag. No one wants a mastopexy (lift) but unfortunately some women need them. I would strongly discourage just implants. Implants will cause your breast to sag further and your result will be less than desirable, and will highlight the assemetry they already have. Best Of Luck.

Breast augmentation and no lift for saggy breasts

Thank you for the question and pictures.   Based on your history of weight loss and photographs, it is most likely that you will benefit from breast lifting plus/minus breast augmentation surgery. In my opinion, you will not do well with breast augmentation surgery alone. You will do best by seeking consultation with well experienced board certified plastic surgeons. Ask to see lots of examples of their work and communicate your goals clearly. 

Generally speaking, patients who are considering breast augmentation/lifting surgery should understand that this combination surgery is significantly more complex than either one of the procedures done separately. In other words, the combination breast augmentation / mastopexy surgery differs from breast augmentation surgery alone in that it carries increased risk compared to either breast augmentation or mastopexy surgery performed separately. Furthermore, the potential need for revisionary surgery is increased with breast augmentation / mastopexy surgery done at the same time. This revisionary rate may be as high (or higher) than 20%. 

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.

For example, some patients who wish to maintain long-term superior pole volume/"roundness" or "implanted look" may find that this result is not achieved after the initial breast augmentation/lifting operation. 

An additional operation, possibly involving capsulorrhaphy, may be necessary to achieve the patient's longer-term goals ( with superior pole volume/roundness). It is helpful if patients understand that this breast implant capsule used to provide the support for the breast implant is not present during the initial breast augmentation/lifting operation. The capsule (layer of scar tissue) forms around the breast implant and may be a good source of supportive tissue during revisionary breast surgery, Including correction of breast implant displacement/malposition problems ( such as bottoming out, symmastia, lateral displacement etc). 

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.  

Breast augmentation with no lift for saggy breasts

Absent consideration of a lift, a dual plane technique is the best approach. A lot depends on your shape expectations and your tolerance of scar. In borderline cases the result is not always 100% predictable. If you proceed with an augmentation alone and after several months feel the shape is suboptimal, you could always have a lift performed at that time. Best wishes.

David A. Bottger, MD
Philadelphia Plastic Surgeon
4.9 out of 5 stars 48 reviews

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.