Do I need a breast lift + breast augmentation? (Photo)

Thanks for your question.
I would encourage you to pick the implant size and determine if you need a lift when you're at your ideal weight. If that first photo is from when you're at 110, it doesn't appear you need a lift. But if your skin doesn't retract as you get back to that weight you might still benefit from a lift.
Given the implant size goals and your potential propensity to stretch I'd likely recommend an internal bra supporting matrix to provide more longevity.
I hope that's helpful!

Patient concerns regarding the appearance of their breasts can typically be divided in two pools: volume, ptosis (droop). The procedures to address these issues are as different as the issues themselves. However, these concerns are not mutually exclusive. Many patients, whether they are aware or not, will benefit from both.
There are two factors which can help to answer the question of which surgery will deliver the most satisfying result: mastopexy, augmentation or both. Patients must first consider the position of the NAC (nipple areolar complex i.e. the pigmented portion of the breast) as it relates to the inframammary crease. If the nipples are at or below the level of the crease the patient may benefit from a lift or mastopexy. The breast lift is designed to elevate sagging breasts to a more youthful position. It also helps to reshape and tighten the skin of the breasts. This is typically accomplished via a periareolar (around the nipple) incision with or without a vertical incision.
Mastopexy is an effective way to address sagging breast, however, the changes which accompany weight loss or pregnancy can also decrease volume of the breasts. When a woman wants the volume restored, or increased, a breast augmentation will also be needed in conjunction with mastopexy. Augmentation can help restore the volume loss which is well known to women following children. There are a number of options available to women considering augmentation ranging from size and implant type to access incision.
A breast augmentation alone may also be appropriate if ptosis is mild. If the patient is comfortable with the natural appearance of the breasts but desires them to be larger, a breast augmentation alone is the right procedure. Augmenting significantly ptotic or sagging breasts tends to magnify the problem. In these cases, a mastopexy performed in conjunction with an augmentation is preferred.
Based on your photos alone, you appear to have good nipple position and would be a good candidate for an augmentation alone.
There is a procedure for every problem. To determine which technique is right for you, consult with a board certified plastic surgeon Patient should discuss their concerns with their physicians in order to make an educated decision.

Only a breast lift would be adequate to get you a nice breast shape. You do not need implants and if you were to use 400-450 implants these would be very large and subject to recurrent ptosis

Dear Mimi553,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

A larger implant will accelerate the rate of sagging. So, you may be happy with your results shortly after surgery but with time, you may find that the sagging is exacerbated.

Thank you for your question! It’s difficult to fully assess your condition based on the photos you have submitted. It appears that the nipple positions on your breast are not below your breast fold (if significant can mandate a full mastopexy), however, the left nipple looks lower, compared to the right. You may need a doughnut mastopexy on the left side to make the nipples more symmetrical. The volume of an implant, I believe, requires evaluation of the laxity of the breast skin and the diameter of your breast width. Since we do not have those values, it is difficult for me to assess whether the 400cc volume you requested is ideal in your situation. It’s best to see a couple plastic surgeons with experience in breast surgeries to determine what strategy is your best option. All the best!

Thank you for posting your question here!My answer will be based on the limited pictures and information provided , for a more detailed and bespoke plan please consult with your plastic surgeon.
It is hard to tell if you will need a lift based purely on the images provided , usually through physical exam your surgeon will determine the location of your nipple in relation to the inframammary fold ( the fold under your breast) to decide the need for a lift. A lift will help reposition the nipple , remove excess skin and resize the areola.
An implant will help fill in the upper pole which appears to be a little deficient in the pictures. I would advise you to choose an implant that works for your frame and goals and not to be talked into going for a massive implant just to avoid having a breast lift. You can always go for an augmentation and if you are not pleased with the end result and need a lift then you can have that done later.
good luck! I hope this helps

You are an excellent candidate for a breast lift using 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. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Thank you for your photographs. Your breasts have a slight downward slope, but from all I can see, your nipple is above the level of the fold underneath your breast, which is its correct position. At the age of 21, I believe it would be best for you to just have an augmentation and avoid having permanent incisions on the front of your breast, which, while they can be excellent quality, may not be. If after your breast augmentation, you are not happy with your nipple position, you may opt to have a breast lift, but at least you have had a chance to see if you are happy with only the augmentation and it’s minimal incision lines. Your areola is also larger and may pose a problem with pigmentation being left outside your incision lines after a lift. Have a detailed discussion with your plastic surgeon. Best wishes.

I recommend an in person consultation with a plastic surgeon to discuss your goals and be measured. 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 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