Pseudoptosis options? (Photo)

Thank you for your question. My inclination as a first step would be a breast augmentation alone. This may give you the 'lift' you need without the scars of an actual breast lift. This approach does not burn any bridges or prohibit a mastopexy in the near or distant future. Good luck and I do recommend you see board certified plastic surgeon.

You would need an in-person exam with a board-certified plastic surgeon to get the best options for you.
Your nipple position is fine, so it does not appear any elevation is needed. Your skin envelope is stretched out, mainly on the bottom, as you were an "h" during breast feeding. A 600 cc implant in a stretched skin envelope will continue to stretch and would even if you had some skin removed in the lower pole. It looks like any vertical excess is below the nipple, and removing that if desired usually is best done with an inframammary incision. Your surgeon would like to know your nipple to fold distance. A donut lift could take a small amount of vertical excess below the nipple, and then determining the size that you would like be the next step. Be advised that a donut lift, tends to stretch out the areola, particularly with a large implant.
Since you are on the small size, being a 32, a 600 cc implant, would seem inadvisable due to stretch problems down the line.

The technique I recommend is a 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.

Your nipples appear to be above the level of inframammary fold, which means that you have pseudoptosis (deflation without sagging). Correction with breast implants would create excellent result without need for lift. Good luck.

Dear Pioneering030320,
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