31 5'7 180lbs 38DD. Should I get implants w/ my breast lift?

Hi Celeste0613,

Determining whether you need simply a breast implant versus a breast lift or both 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 breast augmentation depending on the size of the implant the patient wants. I often use an implant when I perform a breast lift because it provides more upper breast fullness after the lift.

These two surgeries can be done at the same time and this may be optimal as the risks can be minimized. 

My preferred lift is a lollipop lift when a periareolar won't do (ie greater than 2cm lift required). The lollipop technique was created by a Canadian plastic surgeon named Elizabeth Hall-Findley and treats the breast as a three dimensional structure instead of two dimensions (anchor - lift).

Most importantly, it does not require the horizontal component scars that the anchor-lift requires and breasts appear much more natural, lifted, and less boxy. Lastly, the lift lasts longer because the lollipop doesn't rely on the skin to hold the breast up, it is actually breast tissue that is being brought together to support the breast and hence improves longevity.

In addition, upper pole fullness is achieved with appropriate implant selection but more importantly, submuscular placement, and precise pocket dissection. The submuscular placement allows the muscle to cover the top part of the implant which allows the upper pole to appear fuller. Keeping away from the lateral chest during pocket dissection allows the implant to remain higher and prevents it from falling off to the side.

You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.

Daniel Barrett, MD, MHA, MS

Certified, American Board of Plastic Surgery

Member, American Society of Plastic Surgery

Member, American Society of Aesthetic Plastic Surgery

Sometimes I have patients that are unhappy with their stomach and their breasts. Of course we recommend a healthy lifestyle and sometimes weight loss. If they are at a stable weight and doing well then sometimes, we consider doing a tummy tuck or some type of fat reduction, like VASER lipo or Coolsculpting. I have found that once you subtract from the abdomen, that the breasts actually seem to appear larger in comparison. So it important to look at the adjacent area too. Breast implants are great devices, but they will make you larger and that is important to know before considering surgery. Implants will also require some type of maintenance or surgery in the future. So it is nice to avoid them if patients already have a lot of breast volume. Sometimes doing the mastopexy or breast lift first is a good idea. It will still have a natural shape but more lifted and many times patients are happy with just that. It is possible to add an implant later if desired.

Breast implants do no lifting and will make you larger. I recommend a consultation to be measured and discuss your goals. After I do this with my patients, we look at women with similar measurements. My patients tell me that this process is very helpful in giving them a sense of what can be achieved.Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author

Hello and thank you for your question. Based on your photograph, you are a
great candidate for a breast lift.  You have significant breast volume and do not appear to need an implant.  This can be designed to result in an
improved shape and contour of your breasts while minimizing scar
appearance.  Make sure you specifically look at before and after
pictures of real patients who have had this surgery performed by your surgeon
and evaluate their results.  
Best wishes and good luck.
Richard G. Reish, M.D.  FACS
Harvard-trained plastic surgeon