Told I borderline need a lift and that it would give the best outcome. Does that seem like a reasonable recommendation? (photo)

Hi there! I'm booked in to have my lift and augmentation done this coming June and absolutely cannot wait!! My PS has recommended a full anchor lift, 350cc round, smooth, cohesive gel implants, under the muscle with a moderate plus projection. Also does Raynaud's syndrome increase the risk of necrosis? Any help and advice is greatly appreciated! Thank you!

Doctor Answers 10

Long Term

Thank you for reaching out and sharing photos! From looking at your photos I do agree with previous answers that it looks like you would benefit the most from a full lift and augmentation. It is important to consider long term, you will want to love the results and have them last for years! So it might be best if you are borderline to get the lift done. Of course an in person consultation is always best and measurements can be done to determine whether or not a lift is needed. I would also suggest finding some "goal" photos of an end result you would like to get so that you are your surgeon are on the same page. Best of luck! Dr. Kachenmeister

Long Term

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Thank you for reaching out and sharing photos! From looking at your photos I do agree with previous answers that it looks like you would benefit the most from a full lift and augmentation. It is important to consider long term, you will want to love the results and have them last for years! So it might be best if you are borderline to get the lift done. Of course an in person consultation is always best and measurements can be done to determine whether or not a lift is needed. I would also suggest finding some "goal" photos of an end result you would like to get so that you are your surgeon are on the same page. Best of luck! Dr. Kachenmeister

Breast lift with augmentation

You would most likely get the best result with a full breast lift with breast augmentation. Be sure to express your goals and expectations to your chosen surgeon. In my practice in the San Francisco Bay Area I have come to the conclusion that the happiest patients are those that have realistic expectation on what a procedure will and won’t do for them. Good luck!

Dean Vistnes, MD. 

Vistnes Plastic Surgery 

San Francisco Bay Area 

#realself #drdeanvistnes #breastlift #breastaugmentation

Breast lift with augmentation

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You would most likely get the best result with a full breast lift with breast augmentation. Be sure to express your goals and expectations to your chosen surgeon. In my practice in the San Francisco Bay Area I have come to the conclusion that the happiest patients are those that have realistic expectation on what a procedure will and won’t do for them. Good luck!

Dean Vistnes, MD. 

Vistnes Plastic Surgery 

San Francisco Bay Area 

#realself #drdeanvistnes #breastlift #breastaugmentation

Borderline Lift?

Your photos were taken with one arm raised which changes the position of your breast, but it appears that you would have a better overall outcome with a lift in addition to an implant. It can be difficult to tell without seeing you in person but it looks like a so called lollipop lift could work for you, and you don't need the full anchor lift.


It is important that you understand that the combination of simultaneous lift plus implant is associated with a high complication and revision rate. This risk increases with more extensive lifts (anchor) and larger implant sizes. Also someone with Raynaud's syndrome is at risk for vasospasm and this will increase your risk of tissue necrosis. I personally would not do a full anchor lift with an implant in a single operation on a person with Raynaud's. Others have suggested a donut lift and I think that would be a poor choice. Donut lifts sound appealing because there is less of a scar but the donut lift does not do much to elevate your nipple position and it does nothing at all to reposition breast tissue. In addition the donut lift tends to flatten your breast (which you don't need), and your breast would end up too low on your chest wall.

Borderline Lift?

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Your photos were taken with one arm raised which changes the position of your breast, but it appears that you would have a better overall outcome with a lift in addition to an implant. It can be difficult to tell without seeing you in person but it looks like a so called lollipop lift could work for you, and you don't need the full anchor lift.


It is important that you understand that the combination of simultaneous lift plus implant is associated with a high complication and revision rate. This risk increases with more extensive lifts (anchor) and larger implant sizes. Also someone with Raynaud's syndrome is at risk for vasospasm and this will increase your risk of tissue necrosis. I personally would not do a full anchor lift with an implant in a single operation on a person with Raynaud's. Others have suggested a donut lift and I think that would be a poor choice. Donut lifts sound appealing because there is less of a scar but the donut lift does not do much to elevate your nipple position and it does nothing at all to reposition breast tissue. In addition the donut lift tends to flatten your breast (which you don't need), and your breast would end up too low on your chest wall.

Breast lift with implant

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, I agree that the best shape and contour could be achieved with an implant and a breast lift.  The size, profile, and shape 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.  

Best wishes and good luck.

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

Breast lift with implant

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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, I agree that the best shape and contour could be achieved with an implant and a breast lift.  The size, profile, and shape 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.  

Best wishes and good luck.

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

Implants and a lift

Thank you for your question. It does appear from your photos that your best outcome would be achieved with both implants and a lift. Ideal breast shape is accomplished only when the volume and the skin envelope are matched. In your case, adding an appropriate volume will not overcome the excess skin of your breasts. The scars from a Wise pattern (aka anchor) lift will be well worth it. Your history of 
Raynaud's should not increase your risk of necrosis, but should be discussed with your PS so the surgery can be performed safely. Best of luck!

Implants and a lift

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Thank you for your question. It does appear from your photos that your best outcome would be achieved with both implants and a lift. Ideal breast shape is accomplished only when the volume and the skin envelope are matched. In your case, adding an appropriate volume will not overcome the excess skin of your breasts. The scars from a Wise pattern (aka anchor) lift will be well worth it. Your history of 
Raynaud's should not increase your risk of necrosis, but should be discussed with your PS so the surgery can be performed safely. Best of luck!

Borderline Mastopexy

Thank you for your photos and question.

A breast lift accomplishes more than raising the nipple to the most projecting point on the breast. It tightens the skin, unweights the lower pole of the breast and reduces the diameter of the areola creating better proportions to the breast. 

Adding an implant to your breast without the lift will make the areola larger. A larger implant than you may want may also need to be used to appropriately fill the skin envelop.

This is all based on your photos and is not a substitute for a formal consultation but I believe the best aesthetic result for you would be accomplished with a combination augmentation and lift.

Seek out a board certified plastic surgeon to evaluate you and review your options.

Good luck and I hope this was helpful.

Borderline Mastopexy

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Thank you for your photos and question.

A breast lift accomplishes more than raising the nipple to the most projecting point on the breast. It tightens the skin, unweights the lower pole of the breast and reduces the diameter of the areola creating better proportions to the breast. 

Adding an implant to your breast without the lift will make the areola larger. A larger implant than you may want may also need to be used to appropriately fill the skin envelop.

This is all based on your photos and is not a substitute for a formal consultation but I believe the best aesthetic result for you would be accomplished with a combination augmentation and lift.

Seek out a board certified plastic surgeon to evaluate you and review your options.

Good luck and I hope this was helpful.

Lift

Yes, I agree that I lift with an implant would get you the best outcome. The implant selection should be based on a combination of your desired size, soft tissue dynamics, breast base diameter and skin elasticity.  I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with.   Finally, make sure your surgeon is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery (ABPS), a member of the American Society of Plastic Surgery (ASPS) and the American Society of Aesthetic Plastic Surgery (ASAPS).
Best,
Dr. Desai
Beverly Hills Institute for Aesthetic Plastic Surgery
Harvard Educated, Beverly Hills & Miami Beach Trained, Double-Board Certified Plastic Surgeon

Lift

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Yes, I agree that I lift with an implant would get you the best outcome. The implant selection should be based on a combination of your desired size, soft tissue dynamics, breast base diameter and skin elasticity.  I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with.   Finally, make sure your surgeon is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery (ABPS), a member of the American Society of Plastic Surgery (ASPS) and the American Society of Aesthetic Plastic Surgery (ASAPS).
Best,
Dr. Desai
Beverly Hills Institute for Aesthetic Plastic Surgery
Harvard Educated, Beverly Hills & Miami Beach Trained, Double-Board Certified Plastic Surgeon

Breast Augmentation and Mastopexy (breast lift): Information

Dear  Ms. Jo.is.gettin.cha.chas,

Thank you for your question and photos. 
Nothing substitutes for a personal evaluation and a face to face discussion of your options.

Based on your photos and not being abel to examine you or take measurements I believe you will need both a mastopexy (lift) and augmentation to attain a normal looking breasts.
If you just have a breast augmentation alone  your breasts (while larger) will  most likely will have the "snoopy dog" appearance (see below) and appear odd while viewed in the nude.

You have several choices to consider:
BREAST LIFT
1) the reason the breast sags is that the "skin covering" is proportional larger than the breast tissue.
2) the majority of your breast tissue is below where the breast mound should anatomically should be located.
3)if you refill the volume only(breast implant)... the nipple areolar complex (NAC) will rotate over the top of the implant like a "waterfall" resulting in a full breast mound but unfortunately a downward rotation and the resultant location of the NAC pointioting downward like the face of  "snoopy" the dog. In addition your NAC will most likely increase in size because of the weight and size of the implant stretching the more expansile NAC skin.
4)the only method known to create a aesthestically acceptable breast will require trading incisions/scars on the breast for a pleasing contour and relocating/reducing the NAC.
5)I base the type of Mastopexy based a detailed discussion with the patient and her "model photos" on your desires (shape and size) the scar may vary from:
A) just around the nipple (doughnut)
B) to a added vertical incision (lollipop)
C) to include a horizontal incsion in the breast crease (anchor)
6)while breast incisions/scars are required....there are ways to modulate/improve the appearance of the scarring process.

BREAST AUGMENTATION 
1)size: Bra manufactures unfortunately have not standardized their bras...therefore 
cup sizes (A,B,C, etc.) are rough measurements. Breast implants are filled by cc.'s
which is much more accurate. So purchase several full bodied non padded bras and place rice (1 oz. = 30 cc) in a nylon and try on with some form fitted clothing. 
2)types of fillers:
A) silicone gel
B) normal saline 
(newest variation on this is the Ideal breast implant)
3)shaped vs non shaped
4)projection vs base width (high to low)
5)placement of the implant
A)under the the muscle
B)above the the muscle
C)combination: dual plane.

I suggest you bring several nude ideal/model photos of what you want your breasts to look like. I trust you have chosen a experienced Plastic Surgeons who performs both procedures together and who are Certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (denoting by membership as having met additional criteria and a focus on Cosmetic Plastic Surgery).

My best wishes,

R. A. Hardesty, MD, FACS
Diplomate and Certified by the Am. Bd. of Plastic Surgery
wwwimagineplasticsurgery.com
4646 Brockton Ave
Riverside, Ca 92506
(951) 686-7600

Breast Augmentation and Mastopexy (breast lift): Information

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Dear  Ms. Jo.is.gettin.cha.chas,

Thank you for your question and photos. 
Nothing substitutes for a personal evaluation and a face to face discussion of your options.

Based on your photos and not being abel to examine you or take measurements I believe you will need both a mastopexy (lift) and augmentation to attain a normal looking breasts.
If you just have a breast augmentation alone  your breasts (while larger) will  most likely will have the "snoopy dog" appearance (see below) and appear odd while viewed in the nude.

You have several choices to consider:
BREAST LIFT
1) the reason the breast sags is that the "skin covering" is proportional larger than the breast tissue.
2) the majority of your breast tissue is below where the breast mound should anatomically should be located.
3)if you refill the volume only(breast implant)... the nipple areolar complex (NAC) will rotate over the top of the implant like a "waterfall" resulting in a full breast mound but unfortunately a downward rotation and the resultant location of the NAC pointioting downward like the face of  "snoopy" the dog. In addition your NAC will most likely increase in size because of the weight and size of the implant stretching the more expansile NAC skin.
4)the only method known to create a aesthestically acceptable breast will require trading incisions/scars on the breast for a pleasing contour and relocating/reducing the NAC.
5)I base the type of Mastopexy based a detailed discussion with the patient and her "model photos" on your desires (shape and size) the scar may vary from:
A) just around the nipple (doughnut)
B) to a added vertical incision (lollipop)
C) to include a horizontal incsion in the breast crease (anchor)
6)while breast incisions/scars are required....there are ways to modulate/improve the appearance of the scarring process.

BREAST AUGMENTATION 
1)size: Bra manufactures unfortunately have not standardized their bras...therefore 
cup sizes (A,B,C, etc.) are rough measurements. Breast implants are filled by cc.'s
which is much more accurate. So purchase several full bodied non padded bras and place rice (1 oz. = 30 cc) in a nylon and try on with some form fitted clothing. 
2)types of fillers:
A) silicone gel
B) normal saline 
(newest variation on this is the Ideal breast implant)
3)shaped vs non shaped
4)projection vs base width (high to low)
5)placement of the implant
A)under the the muscle
B)above the the muscle
C)combination: dual plane.

I suggest you bring several nude ideal/model photos of what you want your breasts to look like. I trust you have chosen a experienced Plastic Surgeons who performs both procedures together and who are Certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (denoting by membership as having met additional criteria and a focus on Cosmetic Plastic Surgery).

My best wishes,

R. A. Hardesty, MD, FACS
Diplomate and Certified by the Am. Bd. of Plastic Surgery
wwwimagineplasticsurgery.com
4646 Brockton Ave
Riverside, Ca 92506
(951) 686-7600

Breast augmentation +/- breast lift

Dear Jo,is.gettin.cha.chas,

Determining whether you need simply a breast augmentation versus a breast lift can be somewhat complicated. It depends on a number of factors including skin laxity and current nipple position. Generally speaking, if the nipples are lower than the inframammary line the patient will most likely need a breast lift. If the nipples are at or above the inframammary line we can generally get by with just a breast augmentation depending on the size of the implant the patient wants. I often still using implant when I perform a breast lift because it provides more upper breast fullness after the lift. To be sure a consultation with a board-certified plastic surgeon will help determine what the patient actually needs.


Daniel Barrett, MD, MHA, MS 

Certified, American Board of Plastic Surgery 

Member, Am. Society of Plastic Surgery


Breast augmentation +/- breast lift

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Dear Jo,is.gettin.cha.chas,

Determining whether you need simply a breast augmentation versus a breast lift can be somewhat complicated. It depends on a number of factors including skin laxity and current nipple position. Generally speaking, if the nipples are lower than the inframammary line the patient will most likely need a breast lift. If the nipples are at or above the inframammary line we can generally get by with just a breast augmentation depending on the size of the implant the patient wants. I often still using implant when I perform a breast lift because it provides more upper breast fullness after the lift. To be sure a consultation with a board-certified plastic surgeon will help determine what the patient actually needs.


Daniel Barrett, MD, MHA, MS 

Certified, American Board of Plastic Surgery 

Member, Am. Society of Plastic Surgery


Is a lift necessary?

You have several choices given the shape of your breasts.  You could do an augmentation alone which would look reasonable although the lower portion of your breasts may not be as tight as you would like. On the other end of the spectrum you could do an augmentation with a full anchor lift, as you described, which would give you the tightest overall look at the expense of scars around your areola, down the front of your breast and along the entire breast crease.  A great intermediate approach, one which I would advocate, would be implants with a periareolar mastopexy.  In addition to enlarging and filling out your breasts this more minimal mastopexy approach would tighten your breast skin significantly, raise your nipples, reduce your areolar size and result in a scar only around your areola. Patients are generally very happy with this approach if they are a good candidate of which you are one! I hope this information was helpful!

Thomas Taylor, MD, FACS 

Is a lift necessary?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

You have several choices given the shape of your breasts.  You could do an augmentation alone which would look reasonable although the lower portion of your breasts may not be as tight as you would like. On the other end of the spectrum you could do an augmentation with a full anchor lift, as you described, which would give you the tightest overall look at the expense of scars around your areola, down the front of your breast and along the entire breast crease.  A great intermediate approach, one which I would advocate, would be implants with a periareolar mastopexy.  In addition to enlarging and filling out your breasts this more minimal mastopexy approach would tighten your breast skin significantly, raise your nipples, reduce your areolar size and result in a scar only around your areola. Patients are generally very happy with this approach if they are a good candidate of which you are one! I hope this information was helpful!

Thomas Taylor, MD, FACS 

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.