I have read that you should not get big implants with a periaerolar mastopexy- is this true?

Something about a flattened appearance? Is 400 cc's too big? Will it cause bottoming out?I am an A/B to start. Will it cause bottoming out? I am 34 5'7" and 130 lbs with 1 child that I breastfed

Doctor Answers 10


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It depends but yes, I usually do not recommend combining a very large implant with such a lift as you can expect a ball-in-sock appearance.

Toronto Plastic Surgeon
5.0 out of 5 stars 35 reviews

Avoid large implants by using simultaneous Mini Ultimate Breast Lift(TM)

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If you are a 32 or 34 each 100 cc’s of implant corresponds 1 cup size change. If you are a 36 or 38 each 200 cc’s of implant corresponds to 1 cup size change. From this, you can compute the volume required to achieve your desired goal. 400 cc implants would not fit retro-pectoral, extrude inferiorly and laterally requiring revision. The advantage of a simultaneous periareolar lift is that 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. Avoiding large implants decreases the probability of bottoming out. I recommend a new technique called Breast Augmentation with Mini Ultimate Breast LiftTM.

Best Wishes,

Gary Horndeski, M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

Implant Size with Mastopexy #breastlift #breastimplants

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I am definitely not a big fan of that approach either. There are some special cases where the nipple only needs to be moved 0.5-1 cm or maybe a little more that will work with a good result. If you are having an implant and require more tightening of the breast around the implant I favor other types of lifts because the scars are much better. At the end of they you have to trust your surgeon and if you do then proceed.

Richard J. Brown, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 54 reviews


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Periareolar mastopexy tends to flatten the breast. If you have enough ptosis to need a mastopexy, you might as well have a vertical-incision lift, since it will give your breasts a better, more perky shape. Implants can be done at the same time as a vertical mastopexy.

Robert S. Hamas, MD (retired)
Dallas Plastic Surgeon

Implants and a lift

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there are several concerns to think about when addressing a breast lift and implants. I wouldn't consider 400cc to be an exceptionally large implant. Any circumareolar lift has the risk of some flattening and also for the areola to stretch out again with time and increased pressure from the implant

Should not get big implants with a periaerolar mastopexy?

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There is no doubt that the combination of breast augmentation and lifting surgery done together is more complicated and more complication prone than either one of the procedures done separately. The issues at hand, however are more and complex than what you have described in your question.

Depending on the patient's anatomy and goals, a 400 cc implant is not necessarily too large of a breast implant and will not necessarily lead to an increased risk of bottoming out of the breast implant.

Some degree of “flattening of the breast profile” may occur with the use of the circumareolar breast lift, regardless of the breast implant size.

I hope this, and the attached link, helps.

Big implants and peri-areolar mastopexy concerns

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Your two questions are separate. Large implants will increase your chance for bottoming out and trying to do too much of a lift with a peri-areolar mastopexy can lead to a flat appearing breast. I recommend that patients commit to a more complete lift such as lollipop or inverted T if much more than 2 cm is needed to be lifted. Hope this helps. Breast augmentation and a lift is an art in plastic surgery, make sure you choose a physician competent in this procedure.

Brian Dorner, MD
Columbus Plastic Surgeon

I have read that you should not get big implants with a periaerolar mastopexy- is this true?

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Based on the limited information we have about you and no photos, it would be a hard question to answer. However I have gotten excellent results for many years with silicone implants in the size range you mention coupled with periareolar lift in the properly chosen patient. It is a difficult operation to get right and takes considerable experience so choose your surgeon carefully.

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

Aerola Size and Implants

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You have a very good question that is not always addressed. With an augmentation, there is going to be some expansion of the skin. How your skin reacts depend on a number of factors: age, elasticity and implant size. If one already has fair large areola, placing significantly large implants for the size of the breast may lead to even more stretch to the areola making them appear larger. You can try to evenly stretch out our skin to get a rough idea as to how much your skin might stretch. This is best done with your doctor. In general adding a donut or periareolar mastopexy does not prevent the stretching.

A big breast implants can be difficult to insert during periareolar mastopexy

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Thank you for your question. You should of course discuss this with your plastic surgeon.

However in my view one problem with very large silicone implants is that they can be difficult to place through a periareolar incision.Saline implants however are no problem as they are placed empathy and inflated once they are inside.

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.