Do I need a lift as well as implants? (Photo)

Thank you for your question. The photo shows excellent position of your nipple, above your infra-mammary crease, with minimal ptosis. You have loss of upper pole fullness and shape. I believe an implant without a lift is all you will need.

Hi, thanks for your question. It is difficult to provide an accurate assessment based on a single photo. Scarring following a breast uplift can be limited to around the nipple, or may also require a vertical +/- inframammary fold scar. This depends on the degree to which an uplift is required. If an uplift is not required, an implant can be inserted via a short incision in your inframammary fold. You may benefit from the use of 3D simulation in order to help you determine the best implants for you and whether the benefits of a lift in your case will be worth the additional scarring.

Thank you for your question. Determining whether you need a breast lift or implants depends on the level of sagging, asymmetry, and your desired outcome. Since your descended nipple is positioned above the crease beneath your breast, you are a candidate for a Benelli lift (donut or crescent lift) in combination with breast augmentation which has minimal scarring compared to the lollipop or anchor scars. Placing the implants subfascial is an option although submuscular treatment is typically recommended to reduce implant visibility, rippling, and risks of capsular contracture. Ultimately, the decision should be achieved through a complete discussion with a board-certified plastic surgery of all risks, benefits, and altternatives comparing all potential procedures and techniques.

The short answer to your question is that there are many options available in terms of whether you need a lift or just a simple augmentation, what type of lift, and what plane (fascial, subglandular, submuscular etc) to put the implant under. From the simple photo, I would guesstimate that a simple breast aug with the appropriate sized implants will do but you should still seek a board certified plastic surgeon to evaluate and exam you, potentially even give you a 3D simulation to figure out the best options.

Dear BASFD, thanks for sharing your questions and concerns, after evaluating your case the position of your nipple under the inframamary fold and this little ptosis you mentioned you look like a great candidate for breast augmentation with implants rather than lift with this you can ensure long term results. Make sure you go on consultation with a board-certified plastic surgeon. Hope this helps and best of lucks. Dr. Luis Mejia.

Choosing the right procedure for breast enhancement, especially considering your desire for minimal scarring and a natural look, involves careful planning and discussion with your surgeon. In cases where there's moderate asymmetry and ptosis (sagging), a combination of implants and a lift might be necessary. The crescent lift and doughnut lift you mentioned are less invasive options that involve less scarring; these techniques might be suitable if the degree of lift required is minimal. These methods remove less skin and are often used when only a slight lift is needed.
For a natural appearance and to address your preference for minimal scarring, subfascial placement of the implants (just below the fascia covering the muscles) could indeed be a good choice. This placement can offer a more natural slope of the breast compared to submuscular placements and is less invasive. It's crucial to discuss all these options with a plastic surgeon who can evaluate your specific case, taking into account your body struct.

Hi from Istanbul, thank you for this question. To achieve a natural look while addressing asymmetry and ptosis, you might require a lift with either a vertical scar or a short anchor-type horizontal scar, depending on the amount of excess skin. With proper scar management and strategic incision placement, these scars typically heal well and provide sufficient lift to the breasts. Hope this helps!

Dear BASFD,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Deciding whether you need a breast lift in addition to implants largely depends on the degree of sagging (ptosis) you're experiencing and your desired outcome. Though from that view, you likely wouldn't need a lift. If you have mild ptosis and asymmetry, larger implants may provide some lift, but they often won't adequately correct moderate to severe sagging. For minimal scarring, options like crescent or doughnut (peri-areolar) lifts might be suitable. These techniques involve less extensive incisions and can be combined with implants to achieve a more natural-looking lift without significant scarring. Subfascial placement, where the implant is placed under the fascia but above the muscle, can provide a more natural appearance without the high positioning associated with submuscular placements. It’s essential to discuss these options with a board-certified plastic surgeon to tailor the approach to your specific needs and expectations.

If your nipple is positioned above the level of the fold underneath your breast, you should not need a lift. Positioning the nipple higher than the normal position does not improve your breast contour and can create a problem which is very difficult to correct. You may get a slight elevation of your nipple, with the addition of the breast implant which could be satisfactory for you and help you avoid any scars on the front of your breast. Only an in person physical examination could determine where the level of your fold is in relation to your nipple. Have a detailed discussion with your plastic surgeon. Best wishes.

I recommend an in person consultation with a plastic surgeon, 6 months after you are done breast feeding, 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