Wanting natural looking breast implants but not interested in lift (I have enough scars!). Do I have other options? (Photo)
Doctor Answers 14
Surgery without a lift
Best of luck!
With midsternal scars
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Lift is Necessary for Normal Appearance.
The breast lift is absolutely necessary to achieve a natural look. Without it your breasts will be not be pleasing in appearance, with implant fullness well above your natural tissue and low lying nipples. This appearance will change very little regardless of implant size.
Unlike the skin of your central chest, breast skin is much more forgiving to place incisions, and your scars will look nothing like your sternotomy scar.
Best of luck!
Breast lift or not
You will not have a great breast shape without a lift
To explain this in more detail, the easy way to decipher what each procedure produces is that implants increase breast volume and add upper pole fullness. Implants are placed in either a subglandular or subpectoral pocket centered over the left and right chest breast footprint. When you have ptosis/sagging, where the nipple-areola complex is at the fold or lower (as in your case), your breasts will continue to hang off of your chest onto your upper abdomen even after implants. In fact, in patients with such sagging who undergo an augmentation without a lift, their breast tissue hangs off of the implant that is sitting on their chest, creating a shape like Snoopy's nose, hence called a "snoopy" deformity. Implants can not give a therapeutic lift and taking shortcuts will only lead to suboptimal results.
With respect to implant sizing, I want to start off by telling you what I tell many of my patients: Do not focus on cc's or bra sizes as many women see their friend with "x" number of cc implants etc and think that they have an idea of what they want. There is a lot that goes into implant selection -- your breast volume, the amount of cleavage you want to achieve, your base width, your rib shape/projection, etc. Also, when it comes to bra sizes, most women are not accurately sized for their bras. Please keep in mind that a breast implant is a round object and has a certain diameter. Your base width on each side of your chest will determine "how big of a ball" or what diameter implant you can reliably go up to with a socially acceptable cosmetic outcome. The implant will "augment" or increase the size of your breasts to an amount acceptable to you and your surgeon. There is no correlation between height and weight and base width; therefore you need an in person examination to be accurately measured. The most important thing to consider is really the size and look that is appealing to YOU with the implants you choose. Many surgeons have sizing models whether using bras with implants or computer simulation. I encourage you to discuss with your surgeon many of these considerations when deciding which implant and size to use during your surgery.
Two lifting techniques that are very good ones in the right patient and I use are based on the following:
1) if it is mainly the nipple position that needs lifting, I like the circumareolar approach (also called a donut lift)
2) if a large portion of the breast tissue/weight needs to be lifted, a circumvertical and sometimes a full anchor incision is needed as the circumareolar approach in my mind is not strong enough to hold the weight of the breast and results in stretching of the areola and drooping over time.
Make sure to seek consultation with a board certified plastic surgeon with expertise in aesthetic breast surgery. I hope this helps answer your question. I wish the best of luck to you.
Dr. Sean Kelishadi
Keep what you have
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