Candidate for breast aug with no lift? (Photo)

Hello, I would recommend getting a lift with the implants. You have loss of volume to the top of the beasts and if opted for only placing an implant you may have the implant and then hanging tissue and skin below the implant. You will still be able to achieve a natural look with augmentation and lift.

Patient concerns regarding the appearance of their breasts can typically be divided in two pools: volume, ptosis (droop). The procedures to address these issues are as different as the issues themselves. However, these concerns are not mutually exclusive. Many patients, whether they are aware or not, will benefit from both.
There are two factors which can help to answer the question of which surgery will deliver the most satisfying result: mastopexy, augmentation or both. Patients must first consider the position of the NAC (nipple areolar complex i.e. the pigmented portion of the breast) as it relates to the inframammary crease. If the nipples are at or below the level of the crease the patient may benefit from a lift or mastopexy. The breast lift is designed to elevate sagging breasts to a more youthful position. It also helps to reshape and tighten the skin of the breasts. This is typically accomplished via a periareolar (around the nipple) incision with or without a vertical incision.
Mastopexy is an effective way to address sagging breast, however, the changes which accompany weight loss or pregnancy can also decrease volume of the breasts. When a woman wants the volume restored, or increased, a breast augmentation will also be needed in conjunction with mastopexy. Augmentation can help restore the volume loss which is well known to women following children. There are a number of options available to women considering augmentation ranging from size and implant type to access incision.
A breast augmentation alone may also be appropriate if ptosis is mild. If the patient is comfortable with the natural appearance of the breasts but desires them to be larger, a breast augmentation alone is the right procedure. Augmenting significantly ptotic or sagging breasts tends to magnify the problem. In these cases, a mastopexy performed in conjunction with an augmentation is preferred.
Based upon your photos, you would benefit from a lift in concert with an augmentation. An implant will restore upper pole volume loss. Foregoing a lift will result in laxity and sagging skin "waterfalling" from the implant. The procedures can be staggered, as long as the patient is comfortable with a potentially suboptimal result during the delay interval. This is often a reasonable option for patients who are struggling with the idea of a lift and allows them to fully evaluate the appearance of the augmentation without a loft before committing to increased scarring.
There is a procedure for every problem. To determine which technique is right for you, consult with a board certified plastic surgeon Patient should discuss their concerns with their physicians in order to make an educated decision.

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, if interested. 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

You are a candidate for a breast implant with a lift. This is your best option. I would not recommend performing an implant without a lift in this scenario.

Hello, thanks for asking, for sure you need breast lift, invert T, and breast implants, your breast are GIII, so you need a lift.

The implants will sit low on your chest, as they are centred behind the nipples. The main issue is that you may possibly end up with a “rocks in socks” result, where the upper portion of your breasts lack fullness and the majority of volume is in the lower portion. You may also find that asymmetry in shape is enhanced with implants alone. A lift would improve symmetry and give you more projection.

Dear NextChapter24, thanks for sharing your pictures and concern, after evaluate your you look like a great candidate for breast augmentation and lift with this you can obtain beautiful projection and symmetry. Without the lift will still look not symmetrical and saggy as your breast is under the inframmary fold. Make sure you go on consultation with a board-certified plastic surgeon. Hope this helps and best of lucks. Dr. Luis Mejia.

From the photographs, it seems you are not a candidate for breast augmentation alone. I do not think the result would produce any kind of aesthetic breast. On the other hand, breast augmentation with a lift would likely give you an excellent result. Unless there are special circumstances, I find no reason not to do both surgeries together.

Here's a more concise version of your message:

In most cases like yours, a lift is considered essential for improved symmetry and achieving the ideal breast shape, especially due to the position of your areolas relative to the inframammary fold. To address your specific questions:

1. You could opt for augmentation alone first and then decide on a lift later. The downside is undergoing two surgeries and two recoveries, but this allows you to determine if the lift scars are truly necessary for you.

2. With augmentation alone, your breasts may sit lower than desired, and some asymmetry may persist.

3. Refer to the answer to question 1.

Dr. B.

Dear NextChapter24,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery