Wanting natural looking breast implants but not interested in lift (I have enough scars!). Do I have other options? (Photo)

I want to enhance the size of by breasts but am not interested in a lift. I have lived with a large scar my whole life that I HATE and am not wanting to add another scar. I posted on here earlier and surgeons are advising a lift w/ implants. Because of the scars with a lift, this is of no interest me and if that is my only option I likely won't proceed. I want a natural looking breast (very important). Nothing high or round. Do I have any other options if not interested in lift?

Doctor Answers 14

Surgery without a lift

If you do not mind the position of your breasts and you simply wish for more upper breast (or overall breast) fullness then you can absolutely get an augmentation without a lift.  If you have realistic expectations that your breasts will sit in the same position as they are now, but they will just be bigger then an augmentation alone will be fine for you.  Best of luck to you!


Orange County Plastic Surgeon
4.8 out of 5 stars 36 reviews

Breast lift?

Thank you for your question and photo.  You absolutely need a breast lift to achieve the best result possible.  If you are not willing to undergo this procedure though, I suggest you do not move forward with the breast augmentation.  You will not be pleased with the result.

Best of luck!

With midsternal scars

your blood supply is impacted in an adverse way and would suggest you not have implants and only have an autoaugmentation mastopexy to minimize disrupting your blood flow with the scarring (lollipop only) and consider lateral based pedicles to provide blood supply to your nipples.  Disasters can happen when trying to do too much with your scars.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 32 reviews

Lift necessary?

Thank for your inquiry. Add the lift or do nothing.  I do not think you would be pleased with the apearance of your breast with an implant and no lift.  Good luck.  

Lift is Necessary for Normal Appearance.

Hello,

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!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 79 reviews

Breast shape

Thank you for the photos and without a lift you will have larger droopy breasts whether with your own fat or implants

Dr Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 60 reviews

Breast lift or not

You definitely need a breast lift; this will position your breasts on your chest rather than on your abdomen. In addition, your breasts implants will be lateralized, with no improvement of your medial cleavage and lack of upper pole fullness if you do not get a lift.

Arian Mowlavi, MD
Orange County Plastic Surgeon
4.9 out of 5 stars 44 reviews

You will not have a great breast shape without a lift

Dear Kalena.  I appreciate your desire to have fewer scars.  Plastic surgeons in general do not like visible scars either.  In your case, the main trade-off is that if you don't get a lift, your breast shape will be poor, and although your scar burden is less, your investment in breast augmentation will be poor as you will have odd looking breasts.  In your case, having a lift will give you more scars, but the scar around the nipple-areola complex will usually camouflage well with the surrounding breast, the vertical component of your scar will be within the shadow of your breast and the horizontal part hidden within your crease.  Long story short, you will benefit greatly from a lift and possibly a lift with implants, and the scar burden is minimal compared to the gains in breast shape you will acquire with a breast lift.  And in patients with a breast lift OR a breast lift with implants, you will still acquire a very nice, natural looking result.

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)
vs
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.

Sincerely,

Dr. Sean Kelishadi

Sean Kelishadi, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 22 reviews

No Lift

It is always better to choose to do nothing than to make a bad choice. You cannot get what you want without a lift so best to stick with no changes. 

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

Keep what you have

You need a lift. So do not get surgery unless you get a lift. You probably will look very saggy if no lift is performed. Some times it is better to keep what you have then to go down a path that is destined to make you look worse instaed of better. Good Luck!

Gregory T. Lynam, MD
Richmond Plastic Surgeon
4.9 out of 5 stars 53 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.