I've decided on getting a BA in the near future. I was just curious if there was a way to get it done without a lift? (photo)

I had full size D's after my son's birth. Since then (2 years ago) I've lost about 40lbs, and gone down to a deflated B. I'm aiming to have my BA done within the next month or so. My wedding will be in April, and I'd like them to be nice a healed for my dress. Thanks in advance.

Doctor Answers 13

I've decided on getting a BA in the near future. I was just curious if there was a way to get it done without a lift?

You will get a better result with a lift. However if you are absolutely against a lift,(vertical or circum-areolar)You could do an implant with some internal lifting, assess your result and perform a lift later if you are not satisfied

Boca Raton Plastic Surgeon
4.6 out of 5 stars 15 reviews

Breast augmentation

Thank you for your question  It appears from your pictures that you need a lift.  It is possible for you to undergo a doughnut lift where the scar is around the areola.  I use the bloodless Breast enlargement technique which I invented. Bleeding is minimal, typically there is no bruising after surgery, and recovery is a lot quicker versus traditional technique. There are three major types of breastlifts. They are called donut lift, lollipop lift and anchor lift.They can be performed at the same time as a breast Enlargement. They all reduce the size of your areola. 

Joshua Halpern, MD, PA
Tampa Plastic Surgeon
4.8 out of 5 stars 61 reviews

Implants with Lift

Dear aliciacg_83, You have enough drooping of your breasts that the nipple is below the level of the fold under the breast. This means you have grade II drooping and will require a lift with implants. I hope this has been helpful. Robert D. Wilcox, MD

Robert D. Wilcox, MD
Dallas Plastic Surgeon
4.0 out of 5 stars 20 reviews

Mastopexia w/Periareolar or Lollipop scar

Thank you for your pictures. Based on them you have  asymmetrical breasts and a minimal ptotic. My advise to you will be a mastopexia surgery with periareolar or lollipop scar. In my opinion doing only an implant procedure will not make you happy. Please consult with a board certified plastic surgeon. Good luck...

Ozge Ergun, MD
Turkey Plastic Surgeon
5.0 out of 5 stars 23 reviews

#breastaugmentation #plasticsurgery #breastimplants

Hello aliciag, Thanks for your question. Congratulations on your upcoming wedding!  Since there is no way to say definitively over the internet which size would be optimal for you, take comfort in the fact that the surgeon uses your unique measurements and is able to provide you with a general range.  In many cases the board certified plastic surgeon can best be your guide as they’ve met with you in person and heard your aesthetic goals. You may consider doing 3-D imaging; however with nearly all the breast cases we’ve performed, we’ve found patients enjoy doing a live “try on” session where they actually can “try on” the implant in a non-padded bra in our office.  This does not give an exact measurement of outcome, rather it gives a nice idea of what to expect. For patients who desire a more natural look we like to recommend the shaped implant.  For patients who desire a more full, voluptuous look we recommend a higher profile implant (like Inspira). Remember that all breasts have at least some amount of asymmetry (we like to say they’re like sisters and not twins).  An in-person consult is the best way to discuss your questions.   Be sure to find a surgeon with the following credentials: *Board Certified by the American Board of Plastic Surgery -- The gold star symbol   *A member of the ASPS (American Society of Plastic Surgeons) -- The circle symbol  *A member of the ASAPS (American Society of Aesthetic Plastic Surgeons) -- the Queen Nefertitti symbol with a Triangle  Feel free to contact our office, it would be our pleasure to answer your questions in person.  My very best, Brian Coan, MD, FACS  CARE Plastic Surgery

Brian Coan, MD, FACS
Raleigh-Durham Plastic Surgeon
4.9 out of 5 stars 58 reviews

Breast Implants without a Lift

Your photos would suggest that a breast lift really would be necessary. In these situations it always tempting to try the augmentation first and then see. Unfortunately, if you need a lift then you really need a lift. Putting in implants alone will increase the fullness of the upper portion of the breast (where they used to be) and the natural breast tissue will drape over the front of the implant and hang down off the front. The unfortunate reality is that they'll look worse than they do now if you don't have the lift. You will have spent a bunch of money on the augmentation and you won't be happy. If you cannot afford both the lift and the implants, I would suggest having the lift alone done. You can always add implants at a later date. If you have procedure(s) done 8 weeks or more before your wedding everything should be fine.For more information about  a breast lift with or without implants, please see the web link below.For the best results seek the consultation of a plastic surgeon certified by the American Board of Plastic Surgery. They have a website listing all the certified plastic surgeons. Members of the American Society of Aesthetic Plastic Surgery will all be board certified in plastic surgery and have demonstrated an interest and special skill in cosmetic plastic surgery as well.

Alexander G. Nein, MD, MS, FACS
Nashville Plastic Surgeon
4.5 out of 5 stars 29 reviews

I've decided on getting a BA in the near future. I was just curious if there was a way to get it done without a lift?

Thank you for your question.It's common for women to wonder whether they need a lift during a breast augmentation surgery. The answer depends on the position of the nipple in relation to the crease below the breast. If the nipple is above the crease, then people typically do well with just an augmentation. If the nipple is at or below the crease, then a lift is commonly used.Careful examination an in person measurements are used to decide whether someone needs a lift. Based on your photographs, you will not get a good result without adding a lift. In my office, I would not offer a patient with your similar anatomy in augmentation without a lifting procedure.Make sure that you see board-certified plastic surgeons so that you can discuss your options.

Austin Hayes, MD
Portland Plastic Surgeon
5.0 out of 5 stars 32 reviews

Breast lifting necessary?

Congratulations on your successful weight loss. You will benefit from breast lifting plus/minus breast augmentation surgery. You will not do well with breast augmentation surgery alone. You will do best by seeking consultation with well experienced board certified plastic surgeons. Ask to see lots of examples of their work and communicate your goals clearly. 

Generally speaking, patients who are considering breast augmentation/lifting surgery should understand that this combination surgery is significantly more complex than either one of the procedures done separately. In other words, the combination breast augmentation / mastopexy surgery differs from breast augmentation surgery alone in that it carries increased risk compared to either breast augmentation or mastopexy surgery performed separately. Furthermore, the potential need for revisionary surgery is increased with breast augmentation / mastopexy surgery done at the same time. This revisionary rate may be as high (or higher) than 20%. 

Personally, I find that the breast augmentation/lifting procedure to be one of the most challenging of the breast operations I perform, even compared to somewhat complex revisionary breast surgery. On the one hand, when performing breast augmentation/lifting surgery we are increasing the breast size with breast implants; on the other hand, we are reducing the breast “envelope” in order to achieve the breast lift. These two “forces” must be balanced as perfectly as possible in order to achieve the desired results. Removing too much skin/ breast tissue is problematic; removing too little breast skin/tissue can also be problematic. Remember also that patients presenting for breast lifting surgery and general have lost some skin elasticity/thickness making potential incision line healing problems and/or recurrent drooping/sagging important concerns to communicate.
  To achieve a surgical result where the breast implant and breast tissue “come together” and behave like a single breast is one of my goals but can be difficult to achieve. Essentially, we are trying to create a breast implant/breast tissue interface that feels and behaves as naturally ( as a single unit) as possible. Generally speaking, making sure that the breast implant has some sub muscular and some sub glandular component ( dual plane) and tailoring the overlying skin/subcutaneous tissue/breast tissue as precisely as possible over the underlying breast implant is key.

Despite these efforts, breast implants are after all a foreign body that don't necessarily stay where we wish they would; therefore, breast implant related problems such as positioning ( too high, too low, lateral displacement etc.) can occur and may be a reason for returning to the operating room for revisionary breast surgery. I use a “tailor tacking” technique that allows a determination of what breast implant should be used to SAFELY produce the results the patient is looking for. This technique involves use of a temporary sizer and temporary “closure” of the overlying breast skin over the sizer. The use of the tailor tacking technique is very helpful. Breast lifting involves removal of skin ( and tightening of the breast skin envelope) while breast augmentation involves expansion of the breast skin envelope. These 2 forces are counteracting each other. Again, despite these efforts, breast implant and/or tissue/skin complications may arise causing minor or significant complications. 

Generally speaking, it is difficult to achieve the “perfect” result with breast augmentation/lifting surgery, despite best efforts. Patients should be aware of the complexity of this combination procedure, achieve REALISTIC EXPECTATIONS prior to proceeding, and understand that additional surgery ( along with the additional recovery time, stress, expenses etc) may be necessary in the short or long-term. Patients should understand that the results of the procedure will not necessarily match aesthetically the results of patients who have undergone breast augmentation surgery only. For example, some patients who wish to maintain long-term superior pole volume/"roundness" or "implanted look" may find that this result is not achieved after the initial breast augmentation/lifting operation. An additional operation, possibly involving capsulorrhaphy, may be necessary to achieve the patient's longer-term goals ( with superior pole volume/roundness). It is helpful if patients understand that this breast implant capsule used to provide the support for the breast implant is not present during the initial breast augmentation/lifting operation. The capsule (layer of scar tissue) forms around the breast implant and may be a good source of supportive tissue during revisionary breast surgery, Including correction of breast implant displacement/malposition problems ( such as bottoming out, symmastia, lateral displacement etc). 

Potential risks associated with breast augmentation/lifting surgery include infection, bleeding, incision line healing problems, loss/change of nipple/areola complex sensation, and blood flow related issues to causing skin or tissue necrosis. Poor scarring, pigment changes, areola/nipple asymmetry etc. are also potential problems. Again, patients may experience implant related problems such as encapsulation, leakage, displacement problems ( too high, bottoming out, lateral displacement, asymmetric positioning etc.), rippling/palpability of breast implants etc. Patients may also be dissatisfied with breast size, shape, and/or how the breast implants and overlying breast tissues “interface” with one another. Occasionally, a breast implant may even have to be removed and the patient will generally be “implant free” for several months at least. Obviously, this situation can be quite physically, emotionally, and psychosocially stressful to the patient involved.

 Having discussed some of the downsides and potential risks/complications associated with breast augmentation/lifting surgery, most patients (If properly selected and who are doing the operations at the right time of their lives psychosocially) accept the scars associated with breast augmentation/breast lifting surgery as long as they are happy with the improvement in contour, size, and symmetry.

I hope that this summary of SOME of the issues surrounding breast augmentation/lifting surgery is helpful to you and other women considering this procedure in the future.  The attached link may also be helpful. Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,488 reviews

Breast Lift

Congratulations in your upcoming wedding! Best wishes! Thanks for your inquiry and your pictures, I would say that implants by themselves wouldn't give you the best result. I would recommend to have a breast lift in order to achieve the best result, with perkiness and roundness. Please make sure that you and your surgeon are on the same page. Don't forget to discuss all your concerns, options and expectations thoroughly. Have a safe and pleasant PS Journey!
Dr. Jaime Campos-Leon
Board Certified Plastic Surgeon

Jaime Campos Leon, MD
Mexico Plastic Surgeon
4.4 out of 5 stars 252 reviews

Mastopexy augmentation

Thank you for your question and photo.  It appears that you would do best with a mastopexy/augmentation.  You nipples are too low to get a good result with a breast augmentation alone.  To be sure, consult with one or more board certified plastic surgeons to discuss your options.  Best wishes!

Nicholas Tarola, MD
Nashville Plastic Surgeon
4.9 out of 5 stars 58 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.