Will Under the Muscle Dcup Breast Look Good on Me? Ptosis No Lift (photo)

My PS said I need a lift however in my pencil test it barely stays there before falling and my nipple is above the pencil. I cannot afford to do a lift and really do not want the scars. My PS is planning on doing complete unders, all 4 muscles and a saline implant. That is the only position he is willing to do on me. I'm afraid that I will never look good because I cannot get a lift. Based on my pictures and description, do you think the under the muscle implants will look good? Nip above pencil

Doctor Answers 6

Will Under the Muscle Dcup Breast Look Good on Me? Ptosis No Lift

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Size issues are best resolved at a live consultation. Your own anatomy may limit the sensible implant choices available, as your surgeon can explain. 

From the photos alone, I think you would do better with a lift, but if you are willing to accept low nipples and areolas, implants alone may give you a satisfactory outcome. 

Thank you for this question, best wishes.

Seattle Plastic Surgeon

Is breast lift needed?

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Dear Minkgurl.  If your nipples are above the inframammary folds, you have "psuedoptosis" (which means "fakey droop") and not true "ptosis".   I don't think you need any sort of lift as long as you are OK with your nipples being low.  If you want a peri-areolar (or "donut") lift after surgery to raise the nipples higher, that can easily be done with local anesthesia with you awake.  If you look on my website in the photos section; there is a breast augmentation patient (#2032) that looks like you.  You can see what you would look like with just implants.  You would also see that she has implants above the muscle.  You may want to go visit with another plastic surgeon if your current one is fixated on you having a lift.  Hope this helps!

D cup under the Muscle and No Lift

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   A D cup may push your anatomical limits, but I believe that enough volume can be placed to make you happy without a lift.  I perform transumbilical augmentation without a scar, if the patient does not have an umbilical hernia.  Examination always needs to be done in person with a thorough consultation with a board certified plastic surgeon.

Augmentation without a lift

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To start, it would be more helpful to have a true side view as opposed to one looking up.  This would help me to better appreciate the extent of ptosis.  That said, if you are placing a large implant under the muscle and I would go only under the Pectoralis as this will allow the implant to drop and fill the lower pole more effectively.  if placed totally under muscle, I fear the muscle will hold the implant up and the breast tissue will hang off the implant.  These are just thoughts based on photos and ideally an examination would be more beneficial.  I would consider a second opinion with a physician who is either willing to place a contoured gel implant under the breast tissue as this will assist in lifting your breast without additional scars or a saline under the muscle but, only under the pectoralis in a dual plane fashion.

Roger J. Friedman, MD
Bethesda Plastic Surgeon

Breast implants under the muscle

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While I place implants under the muscle, it is not full coverage and I release the muscle along the infero medial aspect so that the implant sits under the breast.  Full muscle coverage will keep the implants too high. If you need a lift then a lift is required.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Will Under the Muscle Dcup Breast Look Good on Me? Ptosis No Lift

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In my opinion based ONLY on the posted photos I would recommend a lift + implants. But better to obtain in person evaluations. 

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