Do I need a lift or just go a bigger size ? (photos)
Doctor Answers 19
Do I need a breast lift?
In addition, I would prefer to reduce the size of your areola to make them more proportionate with the rest of your breasts. This would give you a much nicer result than just placing very large implants.
I really hope that helps!
The decision to have a lift
All the best,
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You will benefit most from a lift and with implants that are appealing to you
With respect to implant size, you will need your base width measured and then from there can decide what implant volumes and projections would best satisfy your goals and expectations. A breast implant is like a ball, and a ball has a certain diameter. Your chest also has a certain width on each side between your sternum and where each side of your chest ends near the axilla. It is important to pick an implant that has a base width that is not greater than this width to be able to satisfy your goals and expectations. I can not give recommendations about implant sizes without examining you.
When I discuss with my patients about breast lifting techniques and also use of implants, I break down the different topics into parts.
The easy way to decipher what each procedure produces is that implants increase breast volume and add upper pole fullness. Implants are placed in either a subglandular or subpectoral pocket centered over the left and right chest breast footprint. In patients like yourself with sagging who undergo an augmentation without a lift, their breast tissue hangs off of the implant that is sitting on their chest, creating a shape like Snoopy's nose, hence called a "snoopy" deformity."
Implants can not give a therapeutic lift and taking shortcuts will only lead to suboptimal results. In some borderline cases of ptosis, breast augmentation can be performed and if there is unsatisfactory sagging, then a lift can be performed later at a second stage, but in your case, an in person examination with a board certified plastic surgeon will be most instrumental in going over your lifting options in conjunction with implants.
Two lifting techniques that are very good ones in the right patient and I use are based on the following:
1) if it is mainly the nipple position that needs lifting, I like the circumareolar approach (also called a donut lift)
2) if a large portion of the breast tissue/weight needs to be lifted, a circumvertical (also called a lollipop lift) and sometimes a full anchor incision is needed, as the circumareolar approach in my mind is not strong enough to hold the weight of the breast and results in stretching of the areola and drooping over time.
I hope this helps you!
Dr. Sean Kelishadi
Revision Breast surgery
Aside from your aforementioned asymmetry, your nipples are in a suboptimal position, even though your arms are up or shoulders back, which in turn make them look less droopy. With your arms at your sides and shoulders in repose, I would imagine your nipples are rather low.
The surgeon who told you you need a lift is correct. No implant, no matter how big can rotate the nipple into an optimized position. Only a lift can do that. Be certain that you visit and ultimately choose as your surgeon is an expert in cosmetic breast surgery, which includes lifts, reductions, and revisions, not just implants. This surgeon is likely not only certified by the ABPS, but also a member of the ASAPS.
Best of luck!
Dr. Sheila Nazarian
@drsheilanazarian on Instagram
Mastopexy (breast lift) vs Breast Augmentation: Information
Thank you for your story, question and photos. I applaud you for seeking additional information and continuing your research. I am certain it will pay off for you.
The real question is what do you want?
Based on your photos and not being abel to examine you or take measurements I believe you will need both a mastopexy (lift) and augmentation.
If you just have a breast augmentation you may have the "snoopy dog" appearance:
When/if breast mound is in the correct position on your chest the resultant effect is that the nipple areolar complex (NAC) auto rotates down (like a waterfall) and probable enlargement of the areolae. Resulting in a odd shaped breast and the NAC pointing downward.
You have several choices to consider.
1) the reason the breast sags is that the "skin covering" is proportional larger than the breast tissue.
2) the majority of your breast tissue is below where the breast mound should anatomically be located.
3)if you refill the volume only(breast implant)... the nipple areolar complex (NAC) will rotate over the top of the implant like a "waterfall" resulting in a full breast mound but unfortunately a downward rotation and location of the NAC.
4)the only method known to create a aesthestically acceptable breast will require trading
incisions/scars on the breast for a pleasing contour and relocating the NAC.
5)depending on your desires (shape and size) the scar may vary from:
A) just around the nipple (doughnut)
B) to a added vertical incision (lollipop)
C) to include a horizontal incsion in the breast crease (anchor)
6)while breast incisions/scars are required....there are ways to modulate/improve the
appearance of the scarring process.
1)size: Bra manufactures unfortunately have not standardized their bras...therefore
cup sizes (A,B,C, etc.) are rough measurements. Breast implants are filled by cc.'s
which is much more accurate. So purchase several full bodied non padded bras and place rice (1 oz. = 30 cc) in a nylon and try on with some form fitted clothing.
2)types of fillers:
A) silicone gel
B) normal saline
(newest variation on this is the Ideal breast implant)
3)shaped vs non shaped
4)projection vs base width (high to low)
5)placement of the implant
A)under the the muscle
B)above the the muscle
C)combination: dual plane.
I suggest you select several nude ideal/model photos of what you want your breasts to look like and make a appt. with experienced Plastic Surgeon who performs both procedures together and who is Certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (denoting by membership as having met additional criteria and a focus on Cosmetic Plastic Surgery).
My best wishes,
R. A. Hardesty, MD, FACS
Diplomate and Certified by the Am. Bd. of Plastic Surgery
4646 Brockton Ave
Riverside, Ca 92506
Lift, implants or both?
Patients who goes to a consultation for drooping breasts (ptosis) or volume loss after pregnancy (pseudoptosis) almost always have one very important question. "Can my drooping be corrected with just implants or do I need a lift".
Implants alone will correct drooping when:
- Breast drooping is mild
- The nipple is still near the center breast and does not point downward
- There is some visible skin beneath the nipple/areola when looking at the breasts straight on.
- The patient is okay with being at least a cup size larger
- Breast drooping is moderate or severe
- The nipple is at the bottom of the breast or points downward
- There is no visible skin under the nipple/areola when looking at the breasts straight on.
- The patient is already a C or D cup breast size and doesn't want to be larger
- The areola is too large and the patient wants it reduced
I use implants in combination with a lift when:
- The patient wants to be larger in addition to being less droopy
- The patient desires to maintain projection and roundness of the breast mound
- The drooping is severe..... I recommend to see a board certified plastic surgeon for a personal evaluation and also to talk about your goals. Good luck :)
Lift or bigger
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.