37yrs, 164cm and 57kg (125lb). Breast Augmentation advice: Implants with or without lift? (Photos)

Question

Hi, hoping for some insight before I start making serious inquiries. I’m 37yrs, 164cm and 57kg (125lb) I’ve had one pregnancy (daughter now 17) and breastfed for 5 months. My weight has fluctuated considerably in the past 15yrs - most notably in the 9 years since my radical hysterectomy and bilateral salpingo oopherectomy, meaning I’ve been in surgical menopause since 2016. I recently lost 29kg/64lb I have always wanted a breast augmentation, and was hoping to get away with implants only, avoiding a lift. I am hoping to go to a full D to DD, as I feel this would compliment my frame being as I’m quite broad. I’m wanting them to sit and fall quite naturally, and with the exception of the lack of volume in my breasts currently, I am happy with their shape and how they sit. Would love feedback and suggestions on what would yield the best results given my preferences and current breast condition. Many thanks

Ted Eisenberg, DO, FACOS, FAACS · Answer

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

Ira H. Rex lll, MD · Answer

It is so difficult to give you excellent advice without a full examination, but from your photographs, and the way you present your expectations, you may be a very good candidate for augmentation without a lift.  It seems you have a very good idea of what you want, so I suspect you could have a very productive conversation with a plastic surgeon.  Good luck!

Donovan Rosas, MD · Answer

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 upon your photos, you are a reasonable candidate for augmentation. Nipple position appears preserved which reduces the need for a formal lift. If you are only seeking volume and are satisfied with position a lift can be avoided by careful implant selection.
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.

37yrs, 164cm and 57kg (125lb). Breast Augmentation advice: Implants with or without lift? (Photos)

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Everything you need to know about Breast Augmentation

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37yrs, 164cm and 57kg (125lb). Breast Augmentation advice: Implants with or without lift? (Photos)

Answers (3)

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Everything you need to know about Breast Augmentation

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