Is breast augmentation enough or would I need to do breast lift as well? (photos)

I was struggling with weight since little and my breasts have always drooped and seems deflated. My areolas are large but currently not a priority to reduce. My left breast is bigger than the right and droop more. Nipple position is as you can see from the sides. Quite a bit of deep stretch marks on my breasts. I don't mind them if the breasts seem full, currently they look wrinkly when held up. Would augmentation suffice or do I need a lift? As the first choice is much more affordable to me.

Doctor Answers 7

Is breast augmentation enough or would I need to do breast lift as well?

Thank you for the question and pictures. I think that you will benefit from breast lifting surgery.  Although there are cases where well-positioned breast implants can create the "illusion" of a breast lift,  breast implants do not ACTUALLY provide a breast lifting effect.  

Based on the position of your nipples/areola complexes (and the breast asymmetry present) on your chest wall and the amount of breast skin "sitting" on your upper abdominal wall, I do not think that you will do well with breast augmentation surgery alone.  

You are correct in that the decision of whether or not to proceed with breast lifting surgery can only be made after careful consideration of the pros/cons associated with each surgical option. For example, the "trade-off" of scars associated with the breast lifting operation should be an important consideration.   

Generally speaking, patients undergoing this combination operation should understand that it is significantly more complex than breast augmentation surgery only and that it is associated with a significantly higher risk of complications and need for additional surgery.  Again, it will be important that you educate yourself regarding the pros/cons/risks/complications associated with breast augmentation/lifting surgery. Only after doing so can you make an informed decision whether or not to proceed. You will find a lot of information on this website and on the attached link.

Also, generally speaking, the best online advice I can give to ladies who are considering breast augmentation/lifting surgery ( regarding breast implant size/profile selection) is:

1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work. 

2. Again, have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining which operation and/or breast implant size/type/profile will most likely help achieve your goals. In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or "C or D cup" etc means different things to different people and therefore prove unhelpful. Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate. The use of computer imaging may be very helpful during this communication phase.

3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery. The use of temporary intraoperative sizers with the patient in the upright position makes selection of the best breast implant size/profile relatively easy.

I hope this, and the attached link, helps. Best wishes.

Breast Augmentation Enough? Or Add Breast Lift?

If your breasts are ptotic/sagging before breast augmentation, they will also be ptotic/sagging after the breast augmentation, just bigger. If you do not mind having low-hanging, but larger breasts, then forgo the breast lift. If you would like your breasts to be perkier/more rejuvenated, then you should opt for a breast lift. If you are truly uncertain, you can always have the breast augmentation with implants first and come back later for a breast lift if you'd like, but this guarantees that you will have two separate surgeries. That said, combining the two procedures at one time is a more complex procedure, and will often times end up with some sort of revision, so you may end up with two surgeries regardless. Best of luck!

Millicent Odunze-Geers, MD, MPH
Sacramento Physician
4.6 out of 5 stars 5 reviews

Lift with or without implants

Hello dear, thanks for your question and provided information as well.. The breasts may lose their elasticity and firmness which can be caused by different factors such as pregnancy, massive weight loss, lactation and aging. To reaffirm the breasts and restore the natural look your surgeon can perform a mastopexy or breast lift with augmentation such as silicone implants, you will get very nice results.

Patients who goes to a consultation for drooping breasts (ptosis) or volume loss after pregnancy (pseudoptosis) almost always have one very important question. "Can my drooping be corrected with just implants or do I need a lift".

Implants alone will correct drooping when:

  1. Breast drooping is mild
  2. The nipple is still near the center breast and does not point downward
  3. There is some visible skin beneath the nipple/areola when looking at the breasts straight on.
  4. The patient is okay with being at least a cup size larger

A breast lift (with or without an implant) is better when:

  1. Breast drooping is moderate or severe
  2. The nipple is at the bottom of the breast or points downward
  3. There is no visible skin under the nipple/areola when looking at the breasts straight on.
  4. The patient is already a C or D cup breast size and doesn't want to be larger
  5. The areola is too large and the patient wants it reduced

I also show the patient photographs of a spectrum of breast scar present after a breast lift in order to check their tolerance for this scar. Most patients are surprised how little the scar shows and are okay with proceeding. If the patient really needs a breast lift, but is concerned about the scars, I will suggest they wait on surgery. In time the breast appearance problems will usually outweigh their concern about the scars.

I use implants in combination with a lift when:

  1. The patient wants to be larger in addition to being less droopy
  2. The patient desires to maintain projection and roundness of the breast mound
  3. The drooping is severe..... I recommend to see a board certified plastic surgeon for a personal evaluation and also to talk about your goals.

I recommend to make an appointment with a board certified surgeon for an evaluation and to talk abuot what kind of lift do you need and to talk about your goals.

Good luck :)

Tania Medina de Garcia, MD
Dominican Republic Plastic Surgeon
4.6 out of 5 stars 329 reviews

Breast augmentation vs lift

Thanks for posting your questions and photos.  Its important to note that breast augmentation on its own simply adds volume to your breasts.  A breast lift, lifts the breasts up the chest wall into a more rejuvenated position and then small implants can be used to create more volume.  If your breasts are sagging before augmentation, then they will sag after augmentation.  Its likely you would be very unhappy with the results of augmentation alone.  Arrange a consultation with a fully qualified plastic surgeon to discuss breast lift surgery.  Based on your photographs, you are an ideal candidate for this procedure.


In reviewing your photos you appear to have a somewhat tuberous breast shape and would need correction for that as well as an augment. This would include a type of lift best determined on exam.

Barry M. Schwartz, MD
Weston Plastic Surgeon
4.0 out of 5 stars 4 reviews

Breast lift with implant

Hello and thank you for your question. You are a great candidate for a breast lift with a small implant.  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.   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

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 67 reviews

Is breast augmentation enough or would I need to do breast lift as well?

Breast lift surgery changes the shape of the breast, and breast augmentation adds volume.  For a pleasing cosmetic result you need a breast lift.  You have to decide if you are happy with your breast volume or if you want to add more.  Best wishes!

Robert E. Zaworski, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 55 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.