Do I need a breast lift along with my breast augmentation?

Hi you are borderline. In my experience, you can avoid a lift with larger implants totally above the muscle or dual plane (half under, hangs above muscle).

Your breasts will stay slightly lower and more natural while avoiding mastopexy scars.

​An exam and consultation with other plastic surgeons is recommended to discuss your options and expectations until you feel comfortable.

You are correct that your nipple is at or only slightly below the inframmamary fold (IMF), however I do agree that you would still need a breast lift. Performing the breast lift is not just about moving the nipple up, it is really to reshape the entire lower pole of the breast. In order to reshape the pseudoptosis, you would have to shorten the nipple to IMF distance. If you did this without lifting the nipple, it would pull the nipple down into an unacceptable position. Therefore, the nipple is lifted and the nipple to IMF distance is shortened in order to center the nipple over the implant.

While it is difficult to truly say without doing a formal and person evaluation of your breasts, It appears that you have a very mild amount of ptosis. It is true that an implant may provide you with the right amount of volume to give your desired result. Staging the augmentation and the left would allow you to see if the augmentation alone would provide you with your desired appearance. If you and your surgeon felt that a lift was still necessary after the augmentation had healed, this is easily done.

Based on your photos, a lift would provide the optimal outcome in addition to an implant. This is a complex procedure. You should see a board-eligible or board-certified plastic surgeon with experience in augmentation-mastopexy.

All woman have some breast asymmetry and your right breast has a bit more skin excess on the lower area of the breast and the nipple is slightly lower. Depending on the implant chosen a mastopexy (lollipop) scar may be best. Just implants will often magnify your asymmetry leading to the need for revision surgery. It is scary to think about the scars but at the same time a poor cosmetic outcome IMHO is worse then scars in most all cases I see. Hope this helps. Good Luck!

Your nipples appear to be above your breast fold, therefore a lift may not be necessary. However, your surgeon has more details about your situation, and they may have based their opinion on those details.

Please note that the larger the implants the heavier they are, and this may accelerate sagging. Therefore, it might be a good idea to choose implants that are proportionately sized rather than going too large.

You don’t need a breast lift, if you want bigger you just use a breast implants, you don’t need a lift for the moment

It is always hard to judge based on pictures, but my feeling is that you would not need a formal lift. Yor appear to have some glandular ptosis, but no actual nipple-areola ptosis. In these cases, a breast augmentation alone will usually fill in the tissues and provide good volume and shape. The best thing to do is to have a few consultations with board-certified plastic surgeons and see what they recommend. I hope this helps.

I would suggest that you have breast augmentation by itself. I think a lift is unnecessary since the scars that would be required would not be worth the benefit of the lift. In the future, if your breasts sag more, then you can have a lift. But for now, I think you can have a very nice and natural result without the lift. Go to get a few opinions from well-respected surgeons in your area so you can find someone that can give you options and explain the expectations with each approach. Best of luck!

Augmentation alone will not be sufficient. You will need a lift and the technique I recommend is a mini lift. Using a circumareola incision, your breast tissue is reshaped, elevated higher on the chest wall and more medial to increase your cleavage. At the same time, fat transfers or small implants can be placed totally submuscular.

Best Wishes,

Gary Horndeski, M.D.