Do I have enough volume in my breast to just get a lift, or do I need a lift with implants? (Photos)

I'm 42 years old and have not had any children (no plans to), but my breasts don't have the same perkiness they had when I was young. I would love to be a perky, full C cup, but I want them to look natural, too.

Doctor Answers 13

Breast lift vs breast augmentation

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Based on your photographs, it likely that you could achieve a fully, perky natural result with breast augmentation alone.  Arrange a consultation with a fully qualified plastic surgeon to discuss your options.


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Thank you for the photos and from them without an examination, an augmentation alone without a lift should give you the desired result.  So see some experts in your area and be evaluated.
Dr. Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 65 reviews

Breast augmentation

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Hello and thank you for your question. I think you could achieve perkiness with a breast implant and a lift is not needed.  The size of the implant is based on your desired breast size/shape, your chest wall measurements, and soft tissue quality.  This decision should be based on a detailed discussion with equal input from both you and your surgeon.  This entire surgery can be performed with a small incision technique.  Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.   The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 174 reviews

Do I have enough volume in my breast to just get a lift, or do I need a lift with implants?

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Thank you for the question. A breast lift moves as sagging nipple up and reshapes the breast by removing extra skin. Breast sagging is called ptosis. From your photos, it appears that your nipple is in the correct position (above the fold below your breast) and that you would not get much benefit from a breast lift. If you would like to add volume to your breast, then you could add a conservatively sized moderate profile breast implant. Implants can give very nice improvement in the volume of the breast at the top (upper pole) which tends to lose fullness with age. After implant surgery, most women are back to day-to-day activities within one day.

Breast Augmentation and the Need for a Lift.

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Thanks for adding your photos.  That is very helpful in answering you question.  It appears that your nipple position is excellent, so no lift would be needed.  Simply adding volume with breast implants would be all that would be needed to give you a more full, perky breast.  I would recommend Sientra implants as the Velcro nature of their gummy bear implants would help get you to your goal.  I have added a video about that as well as a link to recovery options for you.I hope that helps.Best regards. 

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

Breast Lift or Augmentation-Lift

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The only person who can answer your question is you. If you are presently happy with the volume of your breasts, then all you need is a lift. If, however, you would like to be larger, and I suspect, from the way you stated your question, you might, then you need an implant placed at the same time. For a natural look, you need a relatively smaller implant, just enough to give you the size you desire. Make sure you see an experienced board certified plastic surgeon who will listen to your desires.

Robert T. Buchanan, MD
Highlands Plastic Surgeon

No lift for you is needed

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A breast lift is designed to move a low nipple up higher and to tighten the loose lower pole of the breast. Your photo shows that you have well placed nipples and not much laxity other than age appropriate. The lift puts scars on the breast that, for you, wouldn't be worth it from the very minimal change you'd get. Perhaps a conservative moderate profile implant might be better.

Lift and options

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If you are okay with being slightly smaller than your current size a lift alone should be fine. You can pinch some skin together in your lower breast to simulate what a lift could do. Other options include placing a small with a skin only lift, or doing fat transfer with a skin only lift. The last is a nice option if you would also like to do some body contouring in adjacent areas to improve the overall silhouette.

Stacey Folk, MD
Denver Plastic Surgeon
4.8 out of 5 stars 25 reviews

Do I have enough volume?

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I appreciate your question!

I perform a liposuction breast lift that removes tissue from the areas you don't want such as near the armpit and the lower portion hanging near your stomach. Once I use this to shape the breast I then remove the skin to tighten the breast and create a better shape with nice cleavage. Since I perform this less invasively the recovery time is faster and drains are not necessary. The size would depend on the proportion with your body versus going for a cup size. It works very well if there are asymmetries. I can also use the removed fat as a natural breast augmentation by grafting the fat back into the breast to create more projection or into the top to create more cleavage. If you have shoulder grooves from your bras, I can also use the fat to fill these areas in and give you more cushioning as well as contour. This procedure can also be combined with an implant if needed or wanted.  It should not affect nipple sensation, mammograms, cancer risk or breast-feeding. If you gain or lose weight, the transferred fat can do the same.

The best way to assess and give true advice would be an in-person exam. Please see a board-certified plastic surgeon that specializes in aesthetic plastic surgery.  

Best of luck!    

Dr. Schwartz 

Board Certified Plastic Surgeon



Lift without implants

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You absolutely don't need implants. A lift with an implant is controversial for two reasons.  First, when you perform a lift you are making everything tight and closing the wounds under tension.  It you add the expansive forces of the implant at the same time, you are fighting against yourself.  There are forces on the wound which try to make them separate, which results in wider, thicker, more irregular scars.  In the worst case, the wounds will open.  So compromises are usually made in the operating room by the surgeon because they cannot close the lift wounds over the appropriate sized implant.  Either less of a lift is performed so that the skin is not as tight and therefore there is less tension on the closure.  Or a smaller implant than would be appropriate is used so as to decrease the expansive forces.  Either way, you are compromising the aesthetic outcome.  Often the outcome is so compromised that a second revision surgery is required.  If however, you plan to have the lift first and then the augmentation after everything has healed, then you have two operation that are planned, both with much lower risk than the combined mastopexy/augmenation.  The outcomes of the two meticulously planned operations are much better and a more aesthetically pleasing, and a safer outcome is achieved. The second reason the combination of mastopexy and augmentation is controversial is because of the risk of nipple necrosis (death of the nipple).  By making the skin tight for the lift, you are putting external pressure on the veins that supply the nipple.  By putting an expansive force on the undersurface of the breast with an implant, you are putting pressure on the thin walled veins that supply the nipple.  If the pressure by squeezing the veins between the implant and the skin is greater than the venous pressure in the veins, the flow will stop.  If the venous outflow stops, the arterial inflow is stopped.  If the arterial inflow is stopped, there is no oxygen for the healing wounds and the tissue dies. Placing the implant on top of the muscle in combination with a lift puts the blood supply to the nipple at a much higher risk because in addition to the issue of pressure on the veins, you have to divide the blood vessels that are traveling from the pectoralis muscle directly into the breast (and to the nipple) in order to place the implant between the breast tissue and the muscle. This adds a third element of risk to an already risky operation.  Mastopexy/augmenation with sub glandular implant placement is by far the riskiest way to address your anatomic question.

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.