Breast Aug in September - Do you think I'll end up needing a lift? (photos)

I'm scheduled for a breast aug in September. I want to do it with the surgeon who did my mother's, but now I live states away, so he assessed pictures and we are doing the consultation and pre-op all in one. After looking through many pics on real self I am really questioning if implants alone will be enough to give me the fullness I want. I hope I don't need a lift because I don't like the scars. I don't want huge breasts, but am willing to go as large as it takes to eliminate the sagging.

Doctor Answers 18

To lift or not to lift

Your situation is very common.  With nipples and areola above the crease, I feel you will not need a lift.  In situations like yours, where I feel the patient will be happy with a good result, I recommend delaying the question of a lift until the augmentation result is finalized. 9/10 times a lift is not requested.  If you feel later that you want one, it can be easily performed under local anesthesia and based on your new size and shape.

Santa Rosa Plastic Surgeon
4.9 out of 5 stars 33 reviews

Would suggest you stay 'home' to have your surgery

unless you have the ability to come back for follow-ups.  I don't' think you will need a lift but that is determined by what outcome you expect.  You have narrow bases and should anticipate a double bubble on the inferior pole but its just part of the package if you want fuller breasts and less space between the mounds.  Make sure your surgeon is going to do that and not limit you to your natural base dimension.  It would always be suggested that you do your augmentation first and heal from that and make sure your upper poles are level and then decide if you still need a lift or not.  Why?  Because there is a reasonable chance that you may be happy without a lift and why take on the additional costs, risks, and scars just to have it done with your augmentation?

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Breast Aug in September - Do you think I'll end up needing a lift?

Dear Torielle, from your photos, I believe you will need a breast lift to eliminate the sagging.  Opting for a larger implant, in and of itself, will not correct the sagging.  Discuss the various options of breast lift with your surgeon. Best wishes, Dr. Lepore.  

Vincent D. Lepore, MD
San Jose Plastic Surgeon
4.8 out of 5 stars 56 reviews

Breast Aug in September - Do you think I'll end up needing a lift

You have what would be called a grade 2-3 breast ptosis, (4 being the greatest degree of sagging), meaning your nipple is at the infra-mammary crease but most of your breast tissue is below the crease. An implant alone will make you fuller and larger, but it will not correct any sagging. If anything, with time, it will make you look more saggy. To place an implant and have the nipple centrally located you would be able to have little to no breast tissue below the muscle.

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.8 out of 5 stars 27 reviews

Lift versus no lift

Thank you for your question and photos.  Based on the photos alone it appears that you will be best served with a lift.  If you go too large just to fill up the upper pole you will likely end up with larger breasts that are still sitting low on your chest.  Do not let the scars make you too afraid.  The scars do take time to fade but when they do the overall result is much better.  Best of luck to you

Milind K. Ambe, MD
Orange County Plastic Surgeon
4.8 out of 5 stars 42 reviews

Do I need a lift or not

With borderline cases where there is definitely sagginess the question of doing a lift + implants or implants alone often arises.  You have to balance how much improvement with the shape of your breast vs. the scarring that you will have.  You may have a perfectly shaped breasts early on with the lift but if you don't scar well it will be a perfectly shaped breast with ugly scars.  I tend to be quite conservative when the nipple is sitting at or above the breast fold.  Often we can shape the saggy breast with a higher projecting implant and totally improve the look of the breast with just implants alone.  9/10 times our patient is happy with just the implants alone.  This approach leads to far less scarring happy patients and significantly reduced costs.  However if the breasts have grade III to IV levels of droopiness I would recommend a lift for my patients.  I rarely recommend a periareolar or Benelli lift because of the nature of the pressures that is placed upon the incisions.  You have a lot of pressure coming from below by the implant and a large circular incision made into a smaller one.  This will often cause the areolar and the scars to widen over time. 

Benjamin Chu, MD, FACS
Honolulu Plastic Surgeon
4.8 out of 5 stars 92 reviews

Will I need a lift?

From the photo that you provided, I would definitely suggest a lift.  Unless your surgeon is suggesting placement above the muscle (which I would not recommend), your nipple position if far too low to be addressed with augmentation alone.  Instead, you would benefit far more from areolar reduction and superior repositioning using a lollipop incision so that the breast skin can be tailored and redraped over the implant to create a more optimal appearance.  
Following surgery, I would then recommend a series of micro needling treatments to your scars (4-6 total) to further optimize healing of the scars.  I hope that helps!

Gregory A. Buford, MD, FACS
Denver Plastic Surgeon
4.9 out of 5 stars 42 reviews

Breast implants with or without uplift?

Thank you for your photos which make it quite clear to me that in my practice I would be discussing a periareolar or Benelli uplift in combination with placement of appropriately sized but not excessively large breast implants.  The benefit of raising your nipple position as well as narrowing your areolae diameter make the change worthwhile.  Remember that the implants will stretch your areolae making them wider. Discuss this option or other types of uplift with your plastic surgeon but I think you be well advised to consider his/her recommendations for an uplift.  Please enjoy the video linked to above for more information. Best wishes and good luck. Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery
Member, American Society for Aesthetic Plastic Surgery (ASAPS)
ABC-TV Extreme Makeover Surgeon
Beverly Hills, California

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 31 reviews

Breast Augmentation/Breast Implants/Anatomic Gummy Bear Implants/ Silicone Implants/Breast Implant Revision

I appreciate your question. From your photos, it appears that you would benefit from a lift with your augmentation.  A breast lift would reposition your nipples and reshape your breasts, giving them a more youthful appearance.The best way to assess and give true advice would be an in-person exam.
Please see a board-certified plastic surgeon that specializes in aesthetic and restorative plastic surgery. Best of luck! Dr. Schwartz Board Certified Plastic Surgeon Director-Beverly Hills Breast and Body Institute #RealSelf100Surgeon

Jaime S. Schwartz, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 93 reviews

Breast lift, breast augmentation, sagging breasts

After looking at your photos, I absolutely suggest a lift with your breast augmentation.  This can be done with a lollipop type incision and the scarring is really not bad.  As a bonus you can reduce the areola size as well, giving a more youthful appearance.  Placing a large implant will not lift the breasts.  The breasts will still fall off the implant and you will be unhappy with the outcome.  Wishing you the very best outcome.

Paul Watterson, MD
Charlotte Plastic Surgeon
5.0 out of 5 stars 42 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.