I have grade 2 ptosis and am happy with it. can I just get implants?

Question

Judging from diagrams online I without a doubt have grade ii ptosis but I don't mind. I want my breasts to look the way they do when I have my period. My bust measurement swells about 2 inches and I think they look and feel great at that time.

Leila Kasrai, MD, FRCSC · Answer

If you understand that your breasts will remain as they are but will just be bigger, then you can get implants alone. However, it is important that you express this clearly to your surgeon.

Kenneth Hughes, MD · Answer

Hello, thank you for your question. It seems like you can benefit from a breast lift with implants. A breast augmentation and a breast lift work hand and hand to enhance the overall shape and size of a woman’s breasts. These procedures are ideal for increasing the size of the breasts while restoring balance and youthfulness to a woman’s bust. Schedule an email, Skype or in-person consultation with a board certified plastic surgeon for proper evaluation.

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. You should also be aware that results of surgery can change in the future with significant weight change and/or stretching of skin from the milk of pregnancy. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Gary M. Horndeski, MD · Answer

Many women do not like breast lift because of the vertical scars associated with the traditional techniques. For that reason, an alternative was developed called 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 can be performed if additional volume is desired. Implants are not lifetime devices. 8% fail within the first year and 30% fail within six years. Fat transfers are permanent and incorporated into the body.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Joshua Cooper, MD, FACS · Answer

-For the most ideal appearing breast appearance a lift would definitely be recommended. 
-However, ultimately the choice is yours. 
-I have had women like yourself who have elected to have breast augmentation only with the understanding that if they are dissatisfied with the appearance they may undergo breast lift 6 months or so after their augmentation. 
-The key is that you are informed as to how you will appear without a lift if you go with implants only. Therefore, I recommend asking your plastic surgeon to look at photos of women similar to yourself who have a lot of breast sagginess (ptosis) but have decided not to undergo breast lift at the time of implant placement.  
-Thanks for sharing, and best of luck to you!

Gerald Minniti, MD, FACS · Answer

Your confidence in your ability to grade your ptosis is suspect. The photo you provide, although not clear, seems to show your arms up, based on visibility of your axilla, and suggest that the nipples are below your inframammary fold. With your arms down, they would be lower, suggesting that you are likely grade 3. Regardless, you can be assured your result would not neither be optimal nor normal without a breast lift. Be aware of that and realize you may want to get a breast lift at a later date.

Ronald J. Edelson, MD · Answer

Of course you can just get breast implants and many doctors would be happy to do it. I see that the result will be poor so I would advise against it.

John L. Burns Jr., MD · Answer

With Grade II breast ptosis it is generally recommended to both lift and augment your breasts.  One option would be a Dual Plane III approach and do the augmentation first.  If you are happy with that result you could forego the mastopexy.

Daniel Barrett, MD · Answer

Dear teal1234,
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

Harry T. Haramis, MD, FACS · Answer

You can absolutely just add implants, however, your breasts will still have ptosis.

Dual plane or totally above the muscle may help avoid a lift. This is acceptable if you are ok with just adding fullness.

An exam and consultation with a plastic surgeon is recommended to better discuss your options and expectations.

I have grade 2 ptosis and am happy with it. can I just get implants?

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