What Procedures Can You Recommend to Improve the Look of my Breasts?

I have been considering breast surgery since developing them as a teenager. They have never been very perky but since after birth of my son and awful milk engorgement, they sagged more and are covered in stretch marks (luckily the color has faded in the past couple of years). Would I need both implants and a breast lift? I really don't want an anchor scar. They're currently size 34A (US). Thanks

Doctor Answers 15

Is a lift and augment needed after pregnancy?

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Your photos suggest you could get a way with an augmentation alone and that is what I would suggest if you came into my office.  However if you wished to have the fake excessive fullness in the upper pole, you will need a lift as well and a lollipop scar should be adequate.  If you were going for a more natural look, I would start with augmentation and then consider a lift if you felt it was necessary to give yourself the look you desire.

Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Improving the look of your breasts

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Stretch marks are common after breast feeding and volume loss can make them much more visible. An implant is certainly your first consideration to provide some lift and fullness, and smooth out the skin. You might consider a lift, however if you are young, or might consider further pregnancies, think carefully. A lift scar is a forever propostion, and the implants alone just might do.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

What Procedures You Recommend to Improve the Look of my Breasts? #implants ANS:

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You have what I call the "In-Between" breast! Your nipple is in OK position but you do have just a little droop. I think you should do well with just an implant, provided it is placed a little lower on your chest, and not too high....And remember, you can always get a lift later, but you can't take it back once it's there!

John J. Corey, MD
Phoenix Plastic Surgeon
4.7 out of 5 stars 48 reviews

How can I improve the shape of my breasts?

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Hello there.  The first question that I would ask you is 'are you happy with the volume of your breasts?'  If you are happy with your current cup size, but unhappy with the shape, then I would recommend a lift as this would bring your breasts back up on to a higher position on your chest.  However, there will inevitably be scars and potential complications with this that you would need to discuss with your surgeon.

If you wanted to be bigger, then you would need implants, with or without a lift.  Implants alone, do not produce any significant lift and your nipples would still sit low, although it would be possible to restore some fullness to the upper pole of your breasts with implants alone.  I am afraid that there is no simple answer - implants alone would give less scarring, implants with a lift carries more complications and scarring, but would potentially give a better shape.  I really think that you need to have a consultation with a plastic surgeon (look for FRCS(Plast) after the name, or membership of BAPRAS and/or BAAPS) to go over your options.  Good luck and thanks for the question.

Post-pregnancy breasts - how can they be improved?

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Dear Lisa

From your pictures you may be suitable for any of the following:

  1. Breast augmentation
  2. Breast lift (with a vertical scar technique)
  3. Combined breast lift and augmentation

Each has their pros and cons - a face-to-face consultation to discuss the options are what is needed after a careful clinical examination.

Good luck with your plastic surgery journey

Kind regards, 

Mr Marc Pacifico

Tunbridge Wells


Options for breast lift and or implants

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When a patient tells me that she has been considering breast surgery since she was a teenager and the main issue is sagging, then a breast lift will probably be necessary to give her the result she is looking for.  If you want more breast volume you could also undergo augmentation along with the lift, but I wouldn't overdo it on the size.  One thing I wouldn't recommend is for a surgeon to place big implants in an attempt to correct the sagging.  Ultimately this just produces a big saggy breast.

There are a number of lift techniques that diminish the extent of the scars.  For one possibility feel free to visit my website and go to the Structural Mastopexy section in the Breast portion of the site.


It is perfectly possible to get a good result with implants alone, but the breasts will be significantly settled and low, which may not be to your liking.

John Q. Cook, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 12 reviews

Breast augmentation to correct minimal sagging

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Without a specific examination it is difficult to give you a precise answer to your question about needing a breast lift.  From your photograph it appears that you have minimal breast sagging.  Your nipples appear to be just at or slightly below the level of the inframammary crease (fold under the breast) in general if there is less than 2 cm of breast tissue below the crease and your nipples are facing in a forward direction a breast augmentation will give you a satisfactory result.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

What Procedures Can You Recommend

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Although a lift might help, I don't think you need to rush into that. Since you would prefer no lift I think it would be OK to go through with the Breast Augmentation using a subpectoral dual plane technique. This allows the fullness of the implant to fall into the lower part of the breast out from under the muscle pushing the lower breast forwards. That wil make your nipples look a little higher like a small lift. Then, if you still feel like it's not quite what you want you can always go back and get a lift later. but you might find you are satisfied with the augment alone and avoid the lift scars. I have done this quite a few times and the patients are OK with just the augment about half the time.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 29 reviews

Natural Breast Augmentation and Lift

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Mothers may find that pregnancy and breastfeeding contribute to loss of volume and firmness. If you're looking for perkiness, you'll need a lift. A breast lift raises droopy breasts from one to several inches and excess skin is removed. To perk up a drooping breast, your surgeon will remove excess skin, reposition the nipple, and redrape and tighten the remaining skin to support the breast. The areola may also be reduced in size. The great thing about this technique is that they can now be done with minimal scarring and performed as an outpatient procedure without the need for general anesthesia.

Autologus fat transfer (autologous simply meaning "your own") can also be incorporated into a breast lift providing very natural looking and feeling, larger, perkier breasts. In this procedure your own fat is placed under the breast tissue to provide increased breast size without the need for artificial implants. If you're sagging or asymmetrical, and are looking for perkiness, you'll need a lift--or, if you also want more volume, a lift and fat transfer. And who doesn't have a little fat to spare?

Michelle Copeland, MD, DMD
New York Plastic Surgeon
4.6 out of 5 stars 10 reviews

Improve the Look of my Breasts

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Assuming you wish to have larger breasts, the operation of choice would be  a breast enlargement with implants, and a breast lift. The type of lift needed would be determined at a consultation based on an in person exam. From the photos alone I would guess that a vertical mastopexy (incision around the areola and down to the fold) would give you the best result. 

If the breast size is satisfactory, a lift alone would be in order. You might need a full anchor incision without implants because excess skin will have to be addressed in addition to low nipple/areolar position. 

When you ready for an in person consultation, RealSelf has listings of surgeons in your area. You should consider cross referencing the listings from the The American Society of Plastic Surgeons (plasticsurgery dot org). A listing in the ASPS website assures you that your surgeon is not only board certified,  but also is a member in good standing of the major plastic surgery organization in the U. S.

Thank you for your question, best wishes.

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.