Breast lift vs breast augmentation
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.
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.
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
Do I have enough volume in my breast to just get a lift, or do I need a lift with implants?
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.
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.
Breast Lift or Augmentation-Lift
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.
No lift for you is needed
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.
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.
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.
Hello, it seems that you would do fine with just the implants. Please make sure that you and your surgeon are on the same page. Don't forget to discuss all your concerns, options and expectations thoroughly. Have a safe and pleasant PS Journey!
Dr. Jaime Campos-Leon
Board Certified Plastic Surgeon