Do I need a breast lift or are implants sufficient? (photos)

Based on your photos alone, I do not think you need a breast lift at the same time as your breast augmentation. What I can't determine from your photos is the quality of your skin. Breast skin that is well equipped for a long-lasting breast augmentation result has thick, durable dermis (foundation layer of skin) that does not stretch easily. Skin with thick, durable dermis can support implants over years without significant increases in surface area that would allow the implant to drop, the nipple to drop, or both.
Breast skin that is very stretchy and has the tendency to increase in surface area with stress (like breast augmentation), does not support implants well over years. Skin with this characteristic often benefits from a lift to account for the anticipated stretching to make sure the correct relationship between skin surface area, nipple position, and breast volume is maintained. A history of significant weight loss, gastric bypass, and significant breast volume changes with pregnancy are potential risk factors for stretchy skin. Physical exam findings that indicate stretchy skin are numerous stretch marks and visible stretching of the skin when pulling on the nipple (i.e. increased measured distance from nipple to breast crease when pulling the nipple forward off the chest wall).

Hello, thank you for your question. It really depends on your expectations of how perky you want your breasts and how big of the implant. Mostly likely you will need a breast lift. Its difficult to say from photos speak to your plastic surgeon about your options. Be sure to bring in lots of wish pics. Feel free to check out our before and after gallery.

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

Great question and you are indeed boarderline. Your nipples are positioned above your breast fold so you have no ptosis (droop). Usually this means that you do not need a lift. In your case however there is mild asymmetry with your breasts so I would probably use a donut incision (also called circumareolar incision). This will leave a hidden scar around your areola and allow me to place the implants while simultaneously raising the areola slightly and improving your symmetry.

Dear Luvbug0909,
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

Your photos appear to show nipples positioned somewhat laterally, and possibly a short distance from the nipple to the bottom of the breast. A lift can help with these issues, while implants alone may exaggerate the lateral nipple position.

Thank you for your question and for sharing your photos! It is challenging to say without examining you in person. A breast augmentation with implants can sometimes improve sagging, though it partially depends on what size implant you are planning/how much bigger you would like your breasts to be and whether your nipple position bothers you. Because of the position of your nipples, a combination of implants and a lift may give you a nicer result. It is also often possible to increase the size of your breasts using your own fat and without an implant, depending on how much bigger you would like to be. Using this technique, fat is removed from one part of your body (such as your thighs, hips, or tummy) using liposuction and transferred to your breasts to create a natural, fuller look without implants. All of these techniques can be performed under IV sedation as an outpatient procedure. I recommend you meet with a fully-trained plastic surgeon and have a thorough discussion about what bothers you and what your goals/expectations are.

An in person evaluation is always best, but based on your photos it appears you would be able to achieve a nice result with implants alone. This would add volume and upper pole fullness. If you are wanting to raise the position of the nipple for added "perkiness" you will want to consider the lift.

Measurements are needed to be certain. If you place implants on top of the muscles, you can avoid the lift. However, you may see the edges of the implant. Going behind the muscle would be best for you. During the consultation, you will be measured to see what is best.

Great posted photos! Yes you are “borderline” I would use slightly larger high profile implants with a donut lift . Fees ranges from $5,000-$10,000. Best to virtual consult with…