Breast Implants and do I need a lift? (Photo)

Hello! Thank you for sharing your doubts with us. In your case I recommend a breast lift with implants to give your breasts more projection, and reposition of the areola.  

Breast perkiness can be affected by weight fluctuations, aging and other factors that may not be related to pregnancy. Your nipples are located just below your breast fold, so a lift may be recommended. Without one, your implants may sit a bit too low on your chest.

Your breasts are too low on the chest wall. If you undergo augmentation alone, the inframammary fold will be released and the breasts will bottom out and look even lower in the future. The technique I recommend is The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. At the same time, fat transfers or small implants can be placed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants. They then get to choose what looks right for them. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what size and style breast implant is right for them. Mildly Sagging Breasts: If your breasts are mildly droopy, a saline or silicone gel implant placed behind the pectoral muscle might help create the illusion of perkiness. That’s because as the implant fills out the top of the breast, it also fills out the bottom, making it look as if the nipple has moved higher. It hasn’t. You can always get a lift later if you feel you are not perky enough when fully settled and healed. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Dear raychel11,
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
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Although an examination and measurements are needed to be sure, you probably can get by with just an augmentation. You do have some breast tissue that is sagging, but your nipples are in a decent position.

From your photos it appears you are borderline needing a lift. If you would like a perkier look then you will need to consider a lift. This will raise the position of your nipple and remove excess skin. If you are simply wanting more volume and don't mind your breasts being lower on the chest wall you may be able to have augmentation alone.

Unfortunately, I agree with your surgeon. You are in the ‘grey zone’ to lift or not to lift. Your right breast certainly should be lifted and as such, I would do both at the time if your augmentation.
As you she, your breasts will further descend so you would need one in the ‘near’ future anyway.

Hi and welcome to our forum!From your photos, I note that the distance from the top of the breast bone to the nipples is increased, the nipples reside at the level of the fold beneath the breasts, and you demonstrate minimal-moderate sag. Augmentation alone will provide you with larger breasts of the same shape, while a lift will elevate the nipple areolar complexes into anatomic position and will conify the shape of the breasts.Best wishes...