To lift the breasts or not
Your nipples don't point down but I can't tell where they are relative to the crease below the breast. You are very bottom heavy with excess lower pole skin. You might be able to get away with a HP implant and no lift and if you don't like the look a lift can always be done later.
Breast implants do not lift breasts, they weight them down
Thank you for your question.
I realize that you are hoping for a natural look, and do not want a breast lift because of fear of scarring.
Based on your photo, you seem to have grade 1-2 ptosis (sagging) and this means that your nipple is near the fold under your breasts (inframammary fold), and your breast tissue is hanging mildly below the breast fold.
Unfortunately, an implant-based breast augmentation alone will not be effective. In fact, you will not only have to go with a larger than usual implant, but it will also appear too low on your chest (bottoming out). The weight of the implant will worsen the amount of sagging. You may also have a double bubble deformity where the breast tissue overlying the implant droops below in front of the implant. It may also cause a snoopy deformity (named after the cartoon character snoopy) that happens when the implant is held sitting in a high position by tight pectoral muscles, while the natural breast tissue falls off the implant and hangs below at the bottom curvature of your breast.
As such, you need a breast lift for best aesthetic results. Since you are against a breast lift, you can get an initial breast augmentation (preferably using a Dual Plane approach), and if you become unhappy with your results, then you can opt for a breast lift in the future. We want you to be happy with your results not only in the short-term but also in the long-term.
To best provide a rounder shape to your breasts, you want to have the implant placed above the muscle (subglandular). This way the implant can directly apply pressure on breast tissue. This direct pressure can correct some sagging. The upper and inner breast areas can also be more adequately filled. However, the setbacks are that all this direct pressure may cause breast tissue wasting overtime and implants can be more visible as breast tissue wastes. The implant may also be exposed to endogenous bacteria of your breast tissue resulting in capsular contracture.
As such, to overcome most of the setbacks of the subglandular approach, the dual plane approach is most recommended. In dual plane, the lower portion of the implant is behind the breast tissue to varying degrees, and the upper portion is behind the pectoralis major muscle. This approach can still add fullness and a rounder look to deflated breasts, and still correct some sagging.
I urge you to have an in-person consultation with a board-certified plastic surgeon to assess your options and risks to make an informed choice.
Hope this helps.
Pseudoptosis and breast augmentation
If you can accept having large breasts, a large volume augmentation would give you your best cosmetic result with invisible scars. We don't often recommend textured implants, but a dual plane augmentation with textured anatomic implants that adheres to your chest wall would potentially avoid the problem of increased pseudoptosis.
Breast lift with augmentation
With your current shape putting in a larger implant to fill things out will inevitably lead to a large sagging breast, A lift on you carries the risk of more scars so it is a difficult situation. If you have small incisions that have been treated appropriately after surgery that heal well you may be a good candidate for a lift with anchor or vertical incisions. Be careful you don't trade one thing you don't like (shape) for something else you don't like (scars). Good luck!
Vistnes Plastic Surgery
San Francisco Bay Area
#breastaugmentation #breastlift #drdeanvistnes #realself
The photos suggest that you need a lift. Implants alone do not raise the breasts to any great extent. Best of luck.
Will implants fix my breasts without a lift?
An in person exam is necessary to propely answer your question.
If your nipple is above the fold under your breast a high profile implant may be all that you need. You could procede with an implant if you understand that you may need a lift as a second procedure. Please read below to understand:
Breast implants without a lift
If you were to have breast augmentation you would likely have a good result. Your nipple position appears to be above your breast crease, I can not tell for sure without an exam however. My recommendation is that if you are completely opposed to the scars of a breast lift I would proceed with the augmentation and you can always have a lift at a second stage (if needed). Consult with a few plastic surgeons in person to see if you are a good surgical candidate.
Breast Implants without a Breast Lift
#BreastAugmentation without a #BreastLift is usually a mistake looked back on by many patients. Most breasts will look larger and more droopy.They will sag more and sooner because of the excess weight altering the longevity of the results. The shape will usually not be satisfactory and sometimes results with “Snoopy” breast or double bubble.
I usually prefer to both lift and augmentation in one surgery. A number of plastic surgeons prefer two separate stages or surgeries; the mastopexy followed by implant surgery. These procedures are usually staged at 2-3 months minimum to allow for swelling and healing to be at a reasonable point.
My revision rate for one stage or a combined surgery, is less than 15%. Two stages is not necessary for at least 85% of the patients when performed by and experienced Plastic Surgeon.
There are a variety of techniques for these operations. Lollipop lift (vertical lift), donut (periareola) lift, Benelli lift, crescent lift, #anchor lift(inverted T ).
I prefer to use a #shortscar technique, #LollipopScar or #DonutLift” rather than the majority of surgeons in the United States that use an anchor pattern lift which involve more significant scarring.