35 year old mom of three and have 425cc under the muscle. Will I need a lift? (photo)

Your nipples are asymmetrical and one is pointing more lateral than the other. I recommend a mini lift. Using a circumareola incision, your breast tissue is reshaped, elevated higher on the chest wall and more medial to increase your cleavage.

Best Wishes,

Gary Horndeski, M.D.

Thank you for your inquiry! Based on the photo, it does not appear you need a lift. We would love to meet with you to discuss your concerns. Schedule a consultation with a Board-Certified Plastic Surgeon to help you reach your goals.

Hello, thank you for your question. Please see the video I have attached that answers your question specifically in detail. In my professional opinion, with a proper explant plus capsulectomy, a lift should not be done at the same time. Hope this helps!

Dear 08211417,
it is hard to tell for sure without an examination but based on your photo, it looks like you might need breast lift in order to make your breasts look more natural. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

In order to change nipple position, a lift or some type of lift incision/excision is required. In addition, downsizing to the correct size implant is critically important. Implant selection is one of the most important aspects of breast augmentation. I would recommend seeing a surgeon who uses tissue-based planning/measurements and a 3D imaging system. With this combination of evidence-based planning and technology, patient satisfaction rate is nearly 100% because it is proven and transparent. I recommend finding a surgeon with 6 years of integrated plastic surgery residency and also a year fellowship accredited by the Aesthetic Society. Best of luck!

it's hard to know for sure without examining you. You can remove your implants without a lift and your tissue should contract well. Occasionally, secondary breast lifts can be done if the tissue doesn't heal as well as expected.

Ultimately the decision to perform a lift depends on your aesthetic goals. The final position of the nipple will depend on the size and positioning of your implants and the ability of your surgeon to modify your breast capsule. In my opinion, your nipple are too lateral and you have excess medial pole fullness. In my practice I aim to create a natural looking breast, which would require repositioning of your nipples with a lift and alteration of the position of your implants. But it's not an absolute requirement! Your Board Certified Surgeon will be able to review the options. Thank you for your question.

Thank you for your pictures and questions. For implants that are 18 years old, you are doing very very well. The nipple position appears fairly normal (above the fold, centered on the implant/breast) although there is some mild asymmetry and presumably some stretching in the lower pole of the breast over time which has made the nipple appear "too high" when in reality its just the implant position being slightly "too low" if that makes sense? I think if you are happy with the appearance of the breasts and everything is fine and the implants are soft without signs of rupture or capsular contracture, then there is nothing that says you have to do anything...just keep what you got! If, however, there are some things you would like to improve, then see a local board certified plastic surgeon to discuss your options. Since the skin envelope has been stretched out a bit, the best case scenario would be if you wanted to "upsize" a little bit, it would provide additional filling of the stretched envelope without the need for additional procedures. But, if you want to downsize, then there is probably going to need to be something else done (lift, mesh support, etc.) to eliminate the excess skin, but would likely be limited to less scarring than a traditional anchor lift. If you want to completely remove the implants, you need to take into account that given where you started (A cup) and the 425 cc size of the implant, your current breast is composed of 90% implant and 10% breast, so when you take out the implant, there is going to be significant deflation of the skin envelope that may need more aggressive lifting. But you can always stage that when you are ready. Have the implants removed, see how things heal, do the lift later if you want. If your implants are saline, you can also have them deflated to see how things look without the implant volume and this can help guide your decision making.
Hope this helps!
Dallas Buchanan, MD
VIVIFY plastic surgery
Tampa, FL

You have some natural asymmetry (very normal) and I would agree that your nipples are sitting a bit high. This is because the implants seem to be sitting a bit low. Measurements can confirm this. You should not need a lift, but rather a wedge resection at the lower pole of the breast to lift the implant and lower the nipple

Once removed, you will probably be very flat. However, your nipples should still be in good position. You might consider going down in size and tightening your pockets internally. Remember, you were not happy with your breasts prior to surgery and may not be happy once removed.