Breast Augmentation - minor lift necessary? Should I put in two different sized implants? (photos)

I am 41 and breastfed two kids. My goal is to be natural. I want to fill the breasts back up. Three out of four doctors I visited stated i should do a minor lift. If I have had the nipple height difference my whole life and it isn't an issue for me, and I don't think I would go braless or feel going braless is a big factor. One breast is slightly bigger than the other. Therefore my questions are: should I get a small (minor lift) would it be worth it for nipple symetry/braless?

Doctor Answers 6

Breast Asymmetry

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Thank you for your question and photos. I often try to have my patients think about two separate aspects of their breasts: 1. size and 2. shape/position. A breast augmentation alone (adding implants) will increase your breast size, but not significantly alter the shape or position of your nipple (or existing asymmetry). If you are overall happy with the appearance of your breasts, but just want them fuller, you may be okay with an augmentation alone. However, in order to address the nipple position/asymmetry and lower position of your breasts, a lift would also be necessary. This could be done during the same operation or at a later date. Deciding on what is most important to you will help guide you in the decision process.Best of luck, Dr. Kludt

Stockton Plastic Surgeon
4.8 out of 5 stars 32 reviews

Breast Augmentation Questions

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Hello,If you are going to get a lift, get the correct lift, regardless of what you call it, eg circumareolar, lollypop, or anchor. On the other hand, you are not burning any bridges by getting implants alone. Just be forewarned you may not like your result. No assessment can be made looking at your photos you post as your arms are up in the air.  Go visit a few ABPS certified/ASAPS member surgeons that specialize in all forms of cosmetic breast surgery, not just implants.Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 97 reviews


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Thank you for your question and photos. Even though your breasts aren't large, the lower position of your nipples and slight asymmetry may mean that you require a lift to meet your aesthetic goals. Your plastic surgeon could even out the position of the nipples somewhat and place a conservatively sized, moderate implant as well to fill out the breasts with a natural result. I recommend that you book an in-person consultation with a board certified Plastic Surgeon in order to discuss your options as they will want to measure you and discuss the pros/cons of each approach.All the best

Breast Lift with implants

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Hello, thank you for your question and photos.  I would recommend you to have breast lift with implants under the muscle.   Asymmetry of the nipple position can be corrected at the same time.   Have a great day. 

Derby Sang Caputo, MD
Dominican Republic Plastic Surgeon
5.0 out of 5 stars 97 reviews

Breast lift with breast augmentation?

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Thank you for your question and photos.

I realize that you are hoping for a natural look.

Based on your photo, you seem to have grade 1-2 ptosis (sagging) and this means that your nipple is near the fold under your breasts (inframammary fold), and your breast tissue is hanging mildly below the breast fold.

Unfortunately, an implant-based breast augmentation alone will not be effective. In fact, you will not only have to go with a larger than usual implant, but it will also appear too low on your chest (bottoming out). The weight of the implant will worsen the amount of sagging. You may also have a double bubble deformity where the breast tissue overlying the implant droops below in front of the implant. It may also cause a snoopy deformity (named after the cartoon character snoopy) that happens when the implant is held sitting in a high position by tight pectoral muscles, while the natural breast tissue falls off the implant and hangs below at the bottom curvature of your breast.

As such, you need a breast lift for best aesthetic results.

If you are afraid of scars brought on by a breast lift, you can get an initial breast augmentation, and if you become unhappy with your results, then you can opt for a breast lift in the future.

To best provide a rounder shape to your breasts, you want to have the implant placed using the dual-plane approach. In dual plane, the lower portion of the implant is directly behind the breast tissue to varying degrees, and the upper portion is behind the pectoralis major muscle. This approach can still add fullness and a rounder look to deflated breasts, while correct some sagging. This approach is superior to subglandular (over the muscle) in almost all ways.

Please seek an in-person consultation with a board-certified plastic surgeon and share your full concerns, desires, and expectations.

Hope this helps.

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 508 reviews

Breast augmentation with a donut lift

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Thank you for your question. During your consultation I like to find out your goal (i.e. what cup size you would like to be).  It's important to measure the width of your breast to determine which implant you need. There are four different profiles of implants. They are moderate ,moderate classic ,high and ultra high profile.  I use the bloodless breast technique which I invented. Bleeding is minimal, typically there is no bruising after surgery and recovery is quicker versus traditional technique.You would benefit from a donut lift. The incision is just around your aerola. Patients typically don't complain of pain. Feeling after surgery is typically normal .

Joshua Halpern, MD, PA
Tampa Plastic Surgeon
4.8 out of 5 stars 64 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.