After multiple consultations, I am more confused. Can I get Implants without a lift? (Photos)

One PS says I need shaped/textured the other said I have to do a lift and round implants are just fine. 2 consults down both left my sad, feeling worse than I did originally. First said I have tuberous/ constricted breast deformity. Now I'm even more confused because 1st PS specifically said I didn't need a lift just anatomical implants. 2nd PS said I need a lift and round implants will be just fine. And the price between them is drastically different. Is there any way I can get away with just implants and no lift? I don't like the scar from a lift and I don't like the look either.

Doctor Answers 28

When to stage or combine a breast lift with a breast augmentation?

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Hello, and thank you for your question.  Based on your narrative, and images, it appears that you are hesitant to undergo a breast lift. I would recommend to proceed with a breast augmentation alone, with a possible need for a lift to be reconsidered about 3 to 6 months later after healing from the initial breast augmentation.  It is reasonable to predict a much improved upper breast fullness and cleavage with the breast augmentation alone. 

And as the implants settle and the breast tissue shapes around the implants you will redefine the overall appearance of your breasts. Depending if you get some "lifting" of the tissue as you heal you may not want, or feel the need of a breast lift.  In the event that you decide on a lift, it can be performed as a secondary procedure. 

I hope this helps,

Sergio P. Maggi, MD  

Confusion with these doctors

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Hi Blessedmomx3; it is truly a blessing to have children. They make our lives more meaningful and dimensional but they especially take their toll on their mom's bodies. I tell my soon-to-be-married patients that they should tell their spouses that they will probably need to have some things done after childbirth and breast feeding. This can be exacerbated with a breast shape that has undergone changes in the gland substance and position in the breast and now has position and deflation issues.

Regarding your confusion, from your photo only, I can advise with confidence that you need to have a circumareolar breast lift/mastopexy with an implant to take care of the loss of breast tissue and deflation. The type of implant that you use depends on your goals and aesthetic sensibility. I have used both round and shaped implants with your situation. You have a constricted breast, albeit a mild form of this, from your photos. 

You will be very unhappy without doing both procedures; implants only is a compromise you don't want to live with. In fact is you didn't use implants, the lift itself would improve the shape of your breasts. No one likes scars but the shape of your breasts will improve. 

We use a Vectra 3D Imaging system in our consultations for a minimal cost that will help you see the difference in these procedures and in deciding about what is the best implant as well.


Breast Implants Without a Lift

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Great question since so many women come in with a similar concern or problem.  The answer should always come down to what you want.  If you do not like or want the scars from a lift then breast implants alone should work very well for you.  The natural feeling shaped gummy bear breast implants from Sientra would work very well as these can be placed just right to give you a very nice look.  The question of round or shaped comes down to how much roundness or volume you want in the upper half of your breast. 

Make sure you ask for a rapid recovery protocol so that you can get out and enjoy your new shape in a day or so after surgery.

I have added a video and a web reference for you about this. I hope it helps.

Best regards.

Brian Windle, MD
Kirkland Plastic Surgeon
4.9 out of 5 stars 64 reviews

When consultants offer different opinions

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It can get frustrating trying to figure out what is best.  Well, in each surgeon's opinion, they believe their recommendation would provide you the best outcome.  In the end, good results can be achieve through the various recommendations.  But this is where your input is needed to determine what is best for you.  Yes, you have tuberous characteristics and you will need an implant but its probably less important as to what type of implant you have as both types of implants can produce great outcomes.  What you need to ask yourself is if you want your areola diminished in size and how much fullness you want on top.  If you want to preserve your fold where at, you will need a lift of some kind (I personally despite Benelli's) but if your anatomy could handle lowering your fold, you could avoid a lift and the scars and risks that come with it.  In the end, you should be doing what you want and your consultants are simply options to choose from.  Choose well!

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Implants without a lift?

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Thanks for your questions and photos.  It can definitely be confusing when discussing a treatment plan with several different surgeons.  Each surgeon tends to recommend the solution that they have seen work best for them in treating patients like you.  No answer is definitely wrong, but if you take a general consensus of the advice that the experts here on RealSelf give, you will likely get a result that you are happy with.

After reviewing your photos, I would usually recommend a breast lift (donut or lollipop-type, based on your measurements and tissue characteristics after an exam) and round, smooth implants for patients similar to you.  

Please seek out a board certified plastic surgeon in your area who has before and after photos of results that you like, and who you feel like understands you and your desired result. 

Best wishes!

Dr. Brown

Daniel Brown, MD, FACS
La Jolla Plastic Surgeon
5.0 out of 5 stars 32 reviews

After multiple consultations, I am more confused. Can I get Implants without a lift?

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Thank you for your pictures and questions. This is a very common issue that patients deal with. I think that based on your pictures, you would be best served with some type of lift. I do not see you having a very ideal outcome without one. An anatomical implant can help to shape the breast but it is not going to change the nipple position or the areola size. In the end, you have to choose which surgeon you think is listening to your goals and priorities and working to give you the outcome you want. Just make sure that whoever you choose is board certified by the American Board of Plastic Surgery. 

Hope this helps!

After multiple consultations, I am more confused. Can I get Implants without a lift?

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I assume both of your consultations involved a discussion of your goals and an examination.  Unfortunately they have spawned confusion because they offered different options. From your photos, I would agree with your second plastic surgeon's operative plan.  I concur with your first plastic surgeon's call on your tuberous breast deformity.  I don't believe that an anatomic implant alone would achieve a result that I would be proud of with your breast characteristics.  Best wishes

Craig Harrison, MD, PA
Tyler Plastic Surgeon

Implants without a lift?

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Thank you for your question and photos.  I would recommend a breast lift with implants for the best cosmetic result.  Personally I think smooth round implants, with breast lift.  Best of luck to you

Milind K. Ambe, MD
Orange County Plastic Surgeon
4.7 out of 5 stars 52 reviews

After multiple consultations, I am more confused. Can I get Implants without a lift

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I think implants alone would leave you with saggy beasts and an improperly positioned areola over the new breast shape

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.8 out of 5 stars 27 reviews

Lift or no lift?

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Hello and thanks for your photos-

It can be frustrating to get several different opinions and be left not knowing what is the best option. In plastic surgery, there are often multiple different approaches to each problem.

Of course, your local surgeons have examined you in person and we have not. Going strictly by your photos, I suspect a lift will be necessary in addition to implants. I know that the scars are not appealing to you, but you would probably have a better shape with implants plus lift. I am concerned that if you have implants alone, your nipple will look low on the breast, and your breast tissue will eventually fall off the bottom of the implant. The type of implants probably does not matter much; I personally prefer smooth round implants in most cases.

I hope that helps-

Best wishes-

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.