Saggy 36B looking to be a small lifted D. (photo)

A
breast augmentation is often performed in patients looking to
replace volume lost from weight loss, breast-feeding, or age or to increase the
size of the breast for aesthetic reasons. The ideal candidate for an
augmentation alone is a woman with good skin quality who lacks breast volume
but whose breasts do not sag and are otherwise in good position. This procedure
often uses silicone or saline filled implants inserted through a small incision
to replace the lost volume.



A breast lift (mastopexy), in contrast, is often
performed in patients with breasts that are adequately sized but saggy. This is
a powerful procedure that can lift the nipple, remove excess skin (and
sometimes breast tissue), and reshape the breasts to sit higher on the chest in
a more youthful position. The trade off is a scar on the breast around the
nipple with a possible extension down towards the
breast crease creating a lollipop or inverted “T” pattern. The
size and location of the scar depends on the amount of lift needed, the patient’s
anatomy, and surgeon preference.



For patients with both a lack of volume and sagging
breasts, a combination of a breast lift and augmentation (mastopexy
augmentation) can address both issues. The incisions are often the same as for
a mastopexy alone.



A detailed examination will help delineate the best
surgical treatment. Consultation with a plastic surgeon would be the next best
step.

From your photos and desired results, it looks like you would be best served with a combination of breast lift with augmentation.  The parameters of both the breast lift and the position of the breast implants should be designed to keep the implants relatively low while lifting the breast tissue and nipple to sit directly over the implants.  Many techniques exist in breast surgery, and combined lifting with augmentation is especially tricky.  The key is working with an expert, board certified plastic surgeon to get the best plan for the individual.I hope this was helpful. Please let me me know if you have any other questions regarding the procedure. Thank you and best of luck. Dr. Campbell