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

It appears that your nipples are above the inframammary folds so technically a lift is not required. Implants alone do not provide much lift so there will still be some sagging. Also, your nipples are centered low on the breast mound which add to the sagging appearance. If these issues bother you a lift could be considered, but most patients would rather leave these conditions rather than have the extra surgery, costs, and scarring from the lift.

With the information provided most likely, you will need a lift just because of the fluctuation and weight and breast-feeding. Perhaps the skin will not be able to handle the weight of the implant however, you could try doing a breast documentation in which he would most likely have a more natural fall of the breast instead of high up , and if that doesn’t bother you, then you could just leave it as is, however in the future, the breast starts to sag because of the condition of the skin and the weight of the implant you could always have a lift in the future. Looking at your pictures, I would benefit you to have better long lasting results.

Your nipples are located in line, or just below your breast fold. For this reason, a lift would be recommended. The implants are centred behind the nipples so without a lift, yours would most likely sit too low on your chest and not give an upper pole fullness.

Hi, I think you can achieve a very natural appearance with breast augmentation without needing to have a breast lift. The implants can fill the deflation that has occurred from your weight loss, and restore the volume you want. Talk to your surgeon about what size might be most appropriate for your desired outcome. Best of luck!

Dear FoxKiwi88,

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

Thanks for your questions and for providing photos. While you have some glandular ptosis (droop) from your prior pregnancy and more recent weight loss, your nipple is in good position so you definitely have options without need for a lift. Given your size goals, you could have an implant placed either in front of or behind the muscle and have a nice filling of your deflated skin envelope. You might also consider a more moderate augmentation with an implant in front of the muscle. There are considerations with either approach, and depending on the tissue thickness and quality at the upper pole this will impact what is recommended for you. Either way, I think you are a candidate to have augmentation without a lift based on your photos. An in person consultation and exam will help your surgeon to give you the best advise about implant selection and surgical approach. Be sure to consider the long term implications of your implant size and potential need for more surgery in the future, as my experience has been that a more moderate volume tends to age better and require fewer revisions over one's lifetime than fuller/heavier implants. The most important thing is to have a comprehensive consultation so that you have a good understanding of your choices and what may work best for you. Best of luck!

Your breasts are low on the chest wall. 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.

Thank you for your photos. From your photos, it appears your nipple/areola position is above the level of your inframammary fold and therefore a lift is not needed. You mentioned that you are already happy with the shape of your breast, but only wish that they had more volume. Therefore, a simple breast augmentation will add the volume that you’re seeking. Your implant size must be determined by trying on numerous implants until you find a size that fits the look you are trying to achieve and being sure the dimensions of your breast skin, under stretch, will accommodate that implant volume. Be aware that as the weight of the implant increases ( wanting a D or DD cup), so do the negative gravitational affects on your breast tissue resulting in slight descent of your breast. This may result in you wishing to have a breast lift at some point in the future, although it does not appear that you need one now.

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

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!