Do I need a lift or just go a bigger size ? (photos)

One side of my boob is lower and the other is higher, I've gone to two consultations in Beverly Hills, and they said I needed a lift, the other one said I didn't. Just needed to go bigger. What do you think?

Doctor Answers 19

Do I need a breast lift?

From the photos, it looks as if you could get away with a breast augmentation alone but that is probably not what I would recommend.  You have a mild/moderate amount of droop and placing larger implants is simply going to increase the weight of your breasts and make them droop even more.  

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

should be determined by you and your goals and breast location on your chest wall.  Your surgeon should be able to help you visualize the results from the lift and augmentation versus augmentation alone.  If you don't mind a slight droop, you can certainly have the augment first and see what you think.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 32 reviews

Breast lift?

Thank you for your question and photos.  It does not appear that you need a breast lift.  An augmentation alone should give you the result you desire.

All the best,

Dr. Results
Miami, FL

Breast Lift

You'll require a lift to acheive a nice result. You may want to increase the implant size as well. Good luck. :)

Justin Yovino, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 80 reviews

You will benefit most from a lift and with implants that are appealing to you

Hello vbribiesca1 and thanks for reaching out to us. Without an examination, it is hard to tell you exactly what would be of most benefit to you. The short answer to your question is to go to a board certified plastic surgeon with expertise in aesthetic breast surgery who is not afraid to do a lift and augmentation at the same time. I have found that some surgeons are not comfortable with lifting techniques and do not perform an aggressive enough lift and this leads to continued sagging (even though some patients can get recurrent sagging due to gravity/genetics/tissue quality).

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

Sean Kelishadi, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 21 reviews

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!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 78 reviews

Breast lift

Without seeing you in person, it is impossible to say for certain. However, based on your photos, I would recommend a lift. I'm not sure that you will be happy with your results from an implant alone. But the final choice is up to you. Weight the pros and cons of each. 
My best,
Dr. Sheila Nazarian
@drsheilanazarian on Instagram

Sheila S. Nazarian, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 44 reviews

Mastopexy (breast lift) vs Breast Augmentation: Information

Dear Ms. Vbribiescal,

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.

My responses:
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
(951) 686-7600

Lift, implants or both?

Hello dear, thanks for your question and provided information as well.. The breasts may lose their elasticity and firmness which can be caused by different factors such as pregnancy, massive weight loss, lactation and aging. To reaffirm the breasts and restore the natural look your surgeon can perform a mastopexy or breast lift with augmentation such as silicone implants, you will get very nice results, contact a board certified plastic surgeon, I recommend you soft cohesive silicone implants about 350 cc's you will look pretty and they will be perky.

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:
  1. Breast drooping is mild
  2. The nipple is still near the center breast and does not point downward
  3. There is some visible skin beneath the nipple/areola when looking at the breasts straight on.
  4. The patient is okay with being at least a cup size larger
A breast lift (with or without an implant) is better when:
  1. Breast drooping is moderate or severe
  2. The nipple is at the bottom of the breast or points downward
  3. There is no visible skin under the nipple/areola when looking at the breasts straight on.
  4. The patient is already a C or D cup breast size and doesn't want to be larger
  5. The areola is too large and the patient wants it reduced
I also show the patient photographs of a spectrum of breast scar present after a breast lift in order to check their tolerance for this scar. Most patients are surprised how little the scar shows and are okay with proceeding. If the patient really needs a breast lift, but is concerned about the scars, I will suggest they wait on surgery. In time the breast appearance problems will usually outweigh their concern about the scars.

I use implants in combination with a lift when:
  1. The patient wants to be larger in addition to being less droopy
  2. The patient desires to maintain projection and roundness of the breast mound
  3. 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 :)

Tania Medina de Garcia, MD
Dominican Republic Plastic Surgeon
4.6 out of 5 stars 329 reviews

Lift or bigger

I highly recommend you consider getting a breast lift and implant replacement; this will allow you to move your breast mound position higher on your chest as well as to lift your nipples and reduce your areola size. Please see link below and take advantage of our implant giveaway.

Arian Mowlavi, MD
Orange County Plastic Surgeon
4.9 out of 5 stars 41 reviews

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.