I want a D cup - Do I need a lift or not? (Photos)

Question

Mom of 3, extremely deflated breasts. but I did the nipple fold test and its still above the line. I am wanting to get at least to a d cup. one surgeon is saying that large of an implant will give me the results I want. The other is saying I need a lift.

Gianfranco Frojo, MD · Answer

You need an implant with a lift +/- soft tissue support (surgeon's choice on which product). You have severe deflation with thinned out tissues. A large implant alone would likely create large problems due to the small breast footprint and weak fascia/skin due to stretch deformity.  I would recommend seeing an American Board of Plastic Surgery certified plastic surgeon, preferably one who has also completed an Aesthetic Society endorsed fellowship as well.

Daniel Barrett, MD · Answer

Dear kwhitton,

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

Paul M. Parker, MD, FACS · Answer

Deflated breasts with Grade 1 ptosis (nipple above the inframammary crease) typically will do well with breast implants only and not need a lift. Breast lifts, either peri-areolar mastopexy or vertical mastopexy, are usually reserved for nipples that are below the inframammary fold.

Elisa Stein, MD · Answer

Kwhitton,The best way to answer this question is to understand the difference between a lift and an augmentation. A breast lift, or mastopexy, will elevate the height of your nipple and tighten your skin envelope. A breast augmentation with an implant (or fat) will add volume to your breast. In some situations, an implant will add enough volume to fill in the lose skin and raise the nipple. In other situations, an implant will be combined with a breast lift for the desired result. Some patients want a breast lift alone because they want perkier breasts without any additional volume added. In your situation, to achieve a D cup volume will take an implant of significant volume which will likely offer you the projection to lift your nipple enough that you may not require a lift. Best to have a consultation with a plastic surgeon to understand the results of these options and see what meets your goals the best!

Chet Mays, MD · Answer

Thank you for your inquiry. Looking at the photos submitted I would say a lift would be a option with the Breast implants. During your consultation all the procedures will be discussed and your concerns addressed. It's always best to schedule a consultation with a Board-Certified Plastic Surgeon

Ted Eisenberg, DO, FACOS, FAACS · Answer

Do I need a breast lift? You might not need one. 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

Leila Kasrai, MD, FRCSC · Answer

Your nipples are located below your breast fold therefore a lift is recommended. Without one, you wouldn’t have any fullness in the upper pole.

Brian K. Reedy, MD · Answer

Thanks for your question! You have psuedoptosis (reverse droop) so all of your tissue is in the lower pole. I guess the answer is that it depends on your goals. If you are okay with a droopier, natural looking breast, you may be able to get by with no lift or just a reverse mastopexy. If you want optimal perkiness and cleavage, you should consider the lift. Good luck!

Paul E. Chasan, MD, FACS · Answer

Thank you for your question. I have been in practice for over 30 years and revisionary breast surgery is a large portion of my practice. Over the years, I have seen so many patients who want to avoid lift scars and fall onto the trap of having a larger implants placed. Actually, I wrote a paper termed "Poor Practice" in which the patients fall into this trap and end up with much larger and more saggy breast than they wanted.  Thank of it this way, if you are already sagging and you place an additional weight in your breast, what you think will happen? You are an excellent candidate for an augmentation and lift. Best wishes to you.

Gary M. Horndeski, MD · Answer

Your breasts lie low on the chest wall, your skin has been damaged from pregnancy and there are stretch marks above the areola. Implants alone will make your situation even worse. I recommend a breast lift using The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. Later, fat transfers or small implants can be placed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

I want a D cup - Do I need a lift or not? (Photos)

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