Will need a lift with my breast augmentation? I would like my implants in the 380-500 range if at all possible. (Photos)

How much of your breast hanging below your inframammary fold and/or the position of your nipple relative to the fold will determine whether a lift is necessary to achieve a beautiful result.

Thanks for your question. Based on your pictures, it seems you would be a good candidate for a breast lift with implants for optimal results. However, an in-person evaluation would be best to determine a tailored plan for your breast enhancement. I suggest scheduling a consult for a proper evaluation. Be sure to always consult with a board certified plastic surgeon. Take care, Dr. Salama, Board Certified Plastic Surgeon.

Dear Friendly392933,

determining whether you need simply a breast augmentation versus a breast lift can be somewhat complicated. It depends on a number of factors including skin laxity and current nipple position. Generally speaking, if the nipples are lower than the inframammary line the patient will most likely need a breast lift. If the nipples are at or above the inframammary line we can generally get by with just a breast augmentation depending on the size of the implant the patient wants. I often still using implant when I perform a breast lift because it provides more upper breast fullness after the lift. To be sure a consultation with a board-certified plastic surgeon will help determine what the patient actually needs.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Do I need a breast lift? You might not need one. I recommend an in person consultation with a plastic surgeon to discuss your goals and be measured. After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what size and style breast implant is right for them. Mildly Sagging Breasts: If your breasts are mildly droopy, a saline or silicone gel implant placed behind the pectoral muscle might help create the illusion of perkiness. That’s because as the implant fills out the top of the breast, it also fills out the bottom, making it look as if the nipple has moved higher. It hasn’t. You can always get a lift later if you feel you are not perky enough when fully settled and healed. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Patient concerns regarding the appearance of their breasts can typically be divided in two pools: volume, ptosis (droop). The procedures to address these issues are as different as the issues themselves. However, these concerns are not mutually exclusive. Many patients, whether they are aware or not, will benefit from both.
There are two factors which can help to answer the question of which surgery will deliver the most satisfying result: mastopexy, augmentation or both. Patients must first consider the position of the NAC (nipple areolar complex i.e. the pigmented portion of the breast) as it relates to the inframammary crease. If the nipples are at or below the level of the crease the patient may benefit from a lift or mastopexy. The breast lift is designed to elevate sagging breasts to a more youthful position. It also helps to reshape and tighten the skin of the breasts. This is typically accomplished via a periareolar (around the nipple) incision with or without a vertical incision.
Mastopexy is an effective way to address sagging breast, however, the changes which accompany weight loss or pregnancy can also decrease volume of the breasts. When a woman wants the volume restored, or increased, a breast augmentation will also be needed in conjunction with mastopexy. Augmentation can help restore the volume loss which is well known to women following children. There are a number of options available to women considering augmentation ranging from size and implant type to access incision.
A breast augmentation alone may also be appropriate if ptosis is mild. If the patient is comfortable with the natural appearance of the breasts but desires them to be larger, a breast augmentation alone is the right procedure. Augmenting significantly ptotic or sagging breasts tends to magnify the problem. In these cases, a mastopexy performed in conjunction with an augmentation is preferred.
Based on your photos alone, it is difficult to assess the degree of ptosis/sagging. It appears you would benefit from both an aug and pexy. However, there is no replacement for an in person exam.
There is a procedure for every problem. To determine which technique is right for you, consult with a board certified plastic surgeon Patient should discuss their concerns with their physicians in order to make an educated decision.

Thank you for your question. Many years ago, I pioneered a technique specifically for patients like you termed "Reductive Augmentation". I published this in 2017. It involves a Breast augmentation, mastopexy-lift, and excision of the lower pole breast tissue. You should be able to have a beautiful appearing breast with this technique. Best wishes to you.

Hello,
Based on your history and the changes that come after pregnancy and weight fluctuations, the most effective approach for you would be a breast lift combined with an implant. This allows us to both reposition the nipple to a more youthful height and restore the lost volume and projection.
Implants alone will not correct the nipple position, but when combined with a lift, you can achieve a much more natural, full, and satisfying result.
Warm regards,Op. Dr. Yücel Sarıaltın

Whether you need a lift depends on the position of your nipple relative to your breast fold. If the nipple sits at or below the crease, implants alone usually won’t lift the breast enough to create an elevated, perky look. In your photos, there appears to be some degree of ptosis, which may limit what implants can do by themselves.

Larger implants (380–500 cc) can add fullness but won’t correct sagging and can sometimes make it look more pronounced. A lift allows the nipple and breast tissue to be repositioned while the implant provides volume, giving a better shape overall.

During a physical exam, your plastic surgeon will be able to determine if a breast lift is needed or if implants alone will be able to achieve the look you want.