5'3, 180lbs - doctor recommended 350cc with lift, is this necessary? (Photo)

Hi, thank you for sharing your question. Based on this one image, you are a good candidate for breast augmentation with mastopexy. You seem to have a grade 2 ptosis which will be corrected with a lift.

Implants can accentuate the sagging, and their weight can make it worse. That’s probably why your surgeon recommended a lift. However, if you understand this and clearly explain your goals to your surgeon, they may not recommend the lift.

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

Great question. The easiest way
To think about it is that an augmentation with a round implant will merely push your breast shape forward and enlarge the total Breast volume.
I offer a Mastopexy to patients who want
Their breast shape changed and their nipple position lifted to a higher position. You can always get a breast augmentation them in the future get a lift if you decide you want
To reposition your nipple.
Hope that helps. Good luck

Your breasts are low on the chest wall and the nipple-areola complex is pointing outward. Adding large implants will make your situation worse. 450 cc implants are large and weigh 1 lb each. Unfortunately, you have not told us your bra size. If you are size 32 or 34, each 100 cc implant corresponds to 1 cup size change. If you are size 36 or 38, each 200 cc implant corresponds to 1 cup size change. I recommend a breast lift using The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. At the same time, fat transfers or small implants can be placed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

DO you feel your nipples are low, or your breast skin fold is long ? If so, then you need a lift. If you don't mind the breast moving lower and being bigger, then implants alone may be the better choice.

Implants alone will not lift a saggy breast, although I have heard this repeated. Implants alone will make you bigger and in the long run, because of the added weight, more saggy.

Of course you could just get the implants but the result would be poor. There are plenty of surgeons who will do that if you tell them that's what you want. Buts it's not the correct procedure. If you don't get the lift you are better off doing nothing

Dear Witty18479,
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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

If your breasts are sagging to start, adding the implant will make things even more saggy. It is better to a lift. This does not mean you will not achieve a natural droop as the implants settle.

Your breasts sag, so you need a lift. You can choose to just have implants and you will have bigger and more sagging breasts. Implants will not correct the sagging, and bigger will be heavier and cause more sagging.