Can you give me suggestions/recommendations for my breast lift and augmentation? (Photo)

The breast lift is the most important part of your procedure. You need to raise the areolas and decrease their diameter.  A small implant is optional.  If you add an implant, I would recommend a small implant of approximately 200cc or less. Good luck.

You
are an excellent candidate for a new technique called The Mini Ultimate Breast
LiftTM. Using only a
circumareola incision it is possible to reshape your breast tissue creating
upper pole fullness, elevate them higher on the chest wall and more medial to
increase your cleavage. This technique
avoids the ugly vertical scars of the traditional technique, maintains nipple
sensation and the ability to breast feed.
If you are size 36 B each 200 cc’s of implant corresponds to 1 cup size
change. You would require approximately
200 cc implants to take you up to a full C and this can be done simultaneously. Aligning the areola, breast tissue and
implant over the bony prominence of the chest wall maximizes anterior
projection with a minimal size implant.
Small round textured silicone gel implants placed retro-pectoral look
and feel more natural, are more stable, less likely to ripple or have
complications needing revision. Implant
profile is irrelevant in the retro-pectoral position since the muscle compresses
it. Best Wishes,Gary Horndeski, M.D.

Because plastic surgery is art as well as science and because there is insufficient scientific data to support one technique over others, controversy exists among surgeons about the "best" way for many procedures, including those you are considering.  As it turns out, the best way is often the way an individual surgeon has found that he or she achieves their best results.  One answer certain, there is little if any justification for "armpit" (axillary) approach for implant placement in your situation, because breast lift necessitates scars on breast.  This more direct approach should be utilized for augmentation.  Your surgeon should pay significant attention to scar management during and after your procedure.

Thank you for your question.  From your photos it is pretty clear you will need a vertical breast lift and augmentation to get the result you want.  This can be done in either one or two stages depending on your exam.  I typically place the implants under the muscle to prevent rippling.  The implant will be placed through the lift incision so an armpit incision is not needed.  Good luck!

Please find an experienced Board Certified Plastic Surgeon
and member of the Aesthetic Society using the Smart Beauty Guide.These Plastic Surgeons can guide you on all
aspects of facial surgery, breast augmentation and body procedures including
tummy tucks or mommy makeovers!

It is in the nature of plastic surgery that you will receive many different opinions  as to the best way to proceed.  As you have found, whether the breast lift and augmentation should be done the same time  is not a question agreed-upon by all plastic surgeons. There are good plastic surgeons who will insist on doing the procedures separately and there are good plastic surgeons who can produce excellent outcomes in a single stage.
The combination breast augmentation / mastopexy surgery differs from breast augmentation surgery alone in that it carries increased risk compared to either breast augmentation or mastopexy surgery performed separately. Furthermore, the potential need for revisionary surgery is increased with breast augmentation / mastopexy surgery done at the same time.
In my opinion, the decision  to do the operation in a single or two  staged fashion becomes a judgment call made by a surgeon after direct examination of the patient.  

For me, if I see a patient who needs a great degree of lifting, who has lost a lot of skin elasticity, or  whose goal is a very large augmentation then I think it is best to do the procedures in 2 stages (in order to avoid serious complications). However, doing the procedure in one stage does increase the risks of complications in general and the potential need for further surgery. This increased risk must be weighed against the practical benefits of a single stage procedure (which most patients would prefer).

Conversely, if I see a patient who requires minimal to moderate lifting along with a small to moderate size augmentation (and has good skin quality), then doing the procedure one stage is much safer. Nevertheless, the potential risks  are greater with a 1 stage  procedure and the patient does have a higher  likelihood of needing revisionary surgery.
 Again, ultimately, I think you will be best off selecting the plastic surgeon who you feel will most likely be able to achieve the results you are looking for and follow his/her recommendations.I hope this,  and the attached link, helps.

I would recommend a breast lift (mastopexy), and then adding implants at a later time if you still want more volume. The first operation can reduce your areaolar diameter, in addition to creating a better shape. You will feel like you have more volume after just the lift (even though no more volume is added) because your breast tissue will not be as "spread out". If you do wish to add an implant later, I would go under the muscle, and your old scar of the breast lift can be used so no new scars are added at that stage. Good luck!Matthew Concannon MD

To get your best results, it would seem that two goals need to be achieved.1.  More Volume and 2. Better Shape.  Although an implant can improve the volume, it will not improve the shape. To get a good shape is likely to require an incision around the areola and the bottom half of the breast (lollipop).Of course an exam may suggest otherwise.  To do both operations at once and get a good result can be a challenge. Be sure to select a surgeon you trust in an office you like. 

Dear nadalimage,You will definitely need a breast augmentation and breast lift to accomplish the goals that you have listed.  You have several options to achieve this including implant type, on top vs under the muscle, as well as the type of breast lift.  My preference would be for shaped silicone implant under the muscle with a circum-vertical (lollipop) lift.  Of course there are other options all with their own advantages and disadvantages and its this decision that will require a careful evaluation and discussion with your plastic surgeon.All the best,Dr. Remus Repta

Although our intentions will be good, online opinions for this complex of a problem pale in value when compared to an in person evaluation.That said, easiest question first--it makes no sense to use an arm pit incision for you. You will need incisions on the breast to reposition the nipple and areola, and to recontour the skin around the implants, and those incisions can be used to insert the implants. In general, I would prefer to place the implants under the muscle, but occasionally a tuberous breast may present an indication for above the muscle. Part of the breast lift procedure you will need will reduce the size of the areolas. A vertical incision will most likely be recommended to get the best possible improvement in breast shape.Consider getting several opinions.  All the best.