500cc round implants - will I need a lift? (Photos)

Question

Recent consultation the surgeon said up lift would not be needed with 500cc round implants as this will lift the nipple. I’ve always thought I’d need a lift too. What do you think

Ira H. Rex III, MD · Answer

From your photograph it seems like you would not need a lift.  Imagine that your nipples stay in about the same position but you have a rounded lower pole.  It always is hard to predict how a patient tissue will conform to the new implant, but I think you are lucky and can have an excellent result without the extra surgery.

Ali Riza Öreroglu, MD · Answer

While the images are helpful, they are not sufficient to accurately determine whether a breast lift is necessary. A physical examination, including assessment of your breast tissue, skin quality, nipple position, and measurements, is essential before making that decision.
Based on the limited photos provided, there appears to be some asymmetry, and I would be more inclined to recommend a unilateral (one-sided) breast lift rather than relying on a 500 cc implant alone. Although a larger implant can improve upper pole fullness, it cannot reliably correct true breast ptosis or significantly elevate the nipple position when a lift is indicated.
A detailed in-person examination would allow the most appropriate surgical plan to be made for your anatomy.

Mert Demirel, MD · Answer

An implant can add volume and may give the breast a fuller appearance, but it does not truly lift the breast in the same way a breast lift does. A large implant can sometimes make mild sagging look better by filling the lower and upper breast, but it cannot reliably move the nipple to a higher position if the nipple is already low.
From the photo, it looks like there is some natural descent and loose skin. Whether you need a lift depends mainly on nipple position, breast fold position, skin quality, and how much lower-pole tissue you have. If the nipple is at or below the breast fold, implants alone may leave you with a larger but still low-looking breast.
A 500 cc implant is also a large implant for many body types. It may create fullness, but it can also make the breast heavier, stretch the tissues more, and increase the chance of bottoming out or a less natural result over time.
So my honest answer is: implants alone may be possible if your sagging is mild and you accept a fuller but not truly lifted shape. But if your goal is a higher nipple position and a more youthful breast shape, a lift may still be needed. I would not choose a very large implant simply to avoid lift scars, because that can sometimes create a larger version of the same sagging problem.

Luis A. Mejia, MD · Answer

When considering a revision to increase size and address minor sagging or nipple height, surgeons sometimes suggest increasing implant volume to "fill out" the skin envelope rather than performing a surgical lift (mastopexy).

While adding volume can create upper-pole fullness, relying solely on a large implant to lift the nipple involves significant anatomical trade-offs, especially on a petite frame. Below is a detailed evaluation of how this approach works, the anatomical risks, and what to consider.
Dr. Luis Mejia
Let's Make It Better.

Semih Yildiz, MD, FEBOPRAS · Answer

The photo shows mild breast asymmetry and lower-pole skin laxity, with the nipples appearing close to the level of the breast folds. A 500 cc implant can fill the upper breast and make the nipple look relatively higher, but it does not actually lift the nipple or remove loose skin. A large implant also adds weight and may stretch the lower pole over time.

Whether a lift is needed depends on standing measurements: nipple position relative to the fold, skin stretch, breast width, implant profile, and the shape you want. If you accept a fuller but slightly natural or low breast, augmentation alone may be reasonable; if the goal is a high, tight breast with centered nipples, a lift may be needed. The surgical plan should show the expected nipple position rather than assuming implant size will correct true ptosis.

Yasemin Aydinli, MD · Answer

A 500cc round implant may indeed give enough lift effect and fullness in your case, so your surgeon could be right. Keep in mind, however, that very large implants also add considerable weight, and over time that weight can stretch and wear the skin, which may bring sagging back earlier. This balance between volume and long term skin quality is worth discussing before you decide.

Gary M. Horndeski, MD · Answer

Unfortunately, you have not provided a lateral view. However, in the frontal view, your breasts are asymmetrical in volume, shape and position. The position of both breasts is high on the chest wall, which is good. The nipple-areola complex may be at the level of the inframammary fold on one side and possibly on the other. When implants are placed, they have to be centered underneath the nipple-areola complex otherwise it will look abnormal. This may require lowering the inframammary fold on one or both breasts. The other alternative is do a donut mastopexy, which will re-position the nipple-areola complex higher and allow placement of the implants, possibly avoiding the lowering of the inframammary fold.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Ted Eisenberg, DO, FACOS, FAACS · Answer

Do I need a breast lift? You might not need one. 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. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Manuel Diaz, MD · Answer

Hello. I can see that your breasts have mild to moderate skin laxity, but your nipples still appear to be in a relatively favorable position. 
Because of this, I do think there is a possibility that breast implants alone could provide a satisfactory result, especially if your goal is to restore upper pole fullness and increase breast volume. The added volume from the implants can improve the appearance of mild sagging.
However, I would also explain that implants alone will not tighten excess skin or significantly lift the nipples. If, during your in-person evaluation, I determine that the skin laxity is greater than it appears in these photos, I may recommend combining the implants with a breast lift to achieve the most balanced and long-lasting result.
A personalized evaluation is essential to assess your skin quality, breast measurements, and determine whether implants alone or implants with a lift would give you the best outcome.

Mauricio Serrano Reyes, MD · Answer

Hello! Yes, I believe that could be a good option for you.
Based on what we can appreciate, you may be a candidate for a periareolar mastopexy with breast implants. However, to determine whether this is truly the best approach, it is essential to have a thorough evaluation.
My recommendation is that you schedule a consultation with a board-certified plastic surgeon so we can carefully assess your anatomy, discuss your goals, and determine the surgical technique that will provide the safest and most natural-looking result for you.

500cc round implants - will I need a lift? (Photos)

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