Lift required? Advice? (photo)

Question

I am after advice / opinions on whether a breast lift would be needed alongside augmentation.

Semih Yildiz, MD, FEPOBRAS · Answer

Your photo shows the breast tissue and nipple position sitting relatively low on the chest with some lower-pole skin laxity, although an in-person exam is needed to measure this accurately. In that situation, implants alone can make the breasts larger, but they often do not reliably raise the nipple or tighten the loose skin envelope.

A lift should be seriously discussed if the nipple is at or below the breast fold, if the skin envelope is loose, or if you want a perkier breast shape rather than simply more volume. Augmentation alone may be reasonable in very mild ptosis, but it can also leave a larger breast that still sits low or create a "waterfall" appearance over the implant. The best plan depends on your measurements, skin quality, implant size, and scar tolerance, so an in-person consultation with lift-versus-implant-only simulations would be the right next step.

Benjamin Baker, BMBS MBA FRCS(Plast) · Answer

Thanks for your question. The nipples are in a good position relative to your breasts, so I would suggest that it is unlikely that a lift will be needed alongside your augmentation. However, you may wish to address any pre-existing asymmetry between your breasts by adjusting the skin envelope of the breasts at the same time as the augmentation.

Daniel Barrett, MD · Answer

Dear Sensible165643,
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

Gary M. Horndeski, MD · Answer

Your breasts are asymmetrical in volume, shape and position. I recommend a mini lift. Using a circumareola incision, your breast tissue is reshaped, elevated higher on the chest wall and more medial to increase your cleavage. At the same time, fat transfers or small implants can be placed totally submuscular.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

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, if interested. 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

George Marosan, MD · Answer

Thank you for your question and photo. Based on this photo, you have significant asymmetry. On the right side you have pseudoptosis or sagging of the lower pole of the breast. You also have thin breast tissues. You will need a breast lift on the right side with the augmentation. Breast implant selection is based on your chest wall anatomy and breast dimensions, skin stretchability. Placing a very large implant hoping to improve the sagging and avoid a lift, will just overstretch the smaller breast with very thin tissues already. This will lead to more stretching and sagging. Bad idea. See a board certified plastic surgeon for an in person consultation/evaluation. Good luck.

Finny George, MD · Answer

Hi, thank you for sharing your question. It is unlikely that you will need a lift. Based on your photo, you appear to be a good candidate for breast augmentation without implants.

Camille Cash, MD · Answer

An in person evaluation or more views would help with the best recommendation for you.  From the submitted photo it appears there is some asymmetry with one breast being larger and sagging lower.  In order to fully correct this a lift with implants would be needed.  I encourage you to visit with a board certified plastic surgeon near you for a consultation.  Together you can discuss the look you want to achieve and options available to reach that goal.

Connie Hiers, MD, FACS · Answer

One breast sags more than the other breast now. You could just have an augmentation, but you still might sag more on one side than the other. The lift on the lower breast might be the best option.

Ayse Kalay, MD · Answer

Thank you for sharing your picture Sensible,you might be able to have a breast augmentation without an uplift but seems like an uplift could give you a higher profile with a more perky shape,and help you avoid sagginess in the future.

Lift required? Advice? (photo)

Answers (11)

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