If a breast lift needed if I get implants? (Photo)

Question

I’ve gone to multiple consultations. A few doctors said I needed a lift, a few said I do not. The ones who said I do not say I’m too young for a lift with the scarring, I’m prone to keloids. Also said there is a small lift regardless with implants. The ones who say I do need it say they’re much too low. So I’m unsure

Ali Riza Öreroglu, MD · Answer

From what I see in your photos, it looks like you might need a lift, but it depends on the implant size. If you choose a larger implant, you might not need it, but it's highly likely that you do.

Daniel Barrett, MD · Answer

Dear Brittbrat95,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Carlos Marciales, MD · Answer

Hello, of course if you need a breast lift with implants, not doing a lift in your case will give a very poor result and you will feel uncomfortable and in the end you will return to have the breast lift done.

Brian K. Reedy, MD · Answer

Thanks for your question! I would say yes to a breast lift. However, I understand your concerns with keloid scarring. There are a lot of good scar options, but sometimes keloids are unavoidable. That being said, I would advise no breast surgery at all before suggesting just an implant. Good luck!

Derek Fletcher, MD · Answer

A correctly selected implant will lift your nipple position.  It is unlikely that the lifting effect of the implant will be enough to perfectly position your nipple in the ideal location relative to your breast volume.  However, with a history of keloids, that may be a reasonable compromise.  In these situations, I recommend the patient proceed with the breast augmentation and live with their new breast shape and nipple position for a year.  If they are happy, no additional surgery is necessary until the aging changes of the breast require a lift.  If the patient is unhappy, they get the lift.  But, at least they know they need it and have made the decision based on their own experience.  This strategy is especially useful if the risk of keloid formation is high.

Ted Eisenberg, DO, FACOS, FAACS · Answer

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

Paul E. Chasan, MD, FACS · Answer

Thank you for your question. I have been in practice for over 28 years, and revision breast surgery is a large portion of my practice.  I have written many peer-reviewed articles on the topic. 100% you need a lift. The surgeon who tells you otherwise just wants your money or is incompetent. There is nothing magic about an implant that we will give you a lift.  If you are already drooping adding additional weight will just make you droop further. The idea that you can put a larger implant and that will suffice is flawed logic at least if you live on earth. You are an excellent candidate for breast augmentation and a lift. My experience with African-American skin has been very favorable and have never had a keloid scarring on the breast in this population. Best wishes to you.

Gary M. Horndeski, MD · Answer

If you are satisfied with the volume of your breasts then you do not need implants. However, you do need a breast lift and the technique I recommend is 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. Later, fat transfers or small implants can be placed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Warren Schutte, MD · Answer

This is a very confusing topic for many patients. You are amongst many women who sit the fence of needed a breast lift and/or augmentation. I would consult with you a determine your primary breast aesthetic goals. If you know you want more volume, I would suggest starting with an augmentation. Allow the implant to fill out your skin envelope and you will get a subtle lift as a result. This would avoid more visible scarring (which is nice if you are prone to keloid formation). You can always do a lift/mastopexy at a later time. (In my clinic, I do not perform lifts and augmentations at the same time - they are always separated)

Ronald J. Edelson, MD · Answer

There are many surgeons who will always try to avoid a lift. But you would benefit from the lollipop type of lift so your nipples can be reduced

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