Is it possible to lift the breasts using implants only while avoiding scars underneath? (Photos)

Question

Is it possible to lift the breasts using implants only, without scars underneath?I’ve had one pregnancy.33 years old, 70 kg, 177 cm.

Daniel Barrett, MD · Answer

Dear Gullu99,
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

Leila Kasrai, MD, FRCSC · Answer

Breast implants alone can lift the breasts that are affected by mild sagging. Because your nipple ar located below your breast fold, implants alone would not be enough. A breast lift is recommended.

Robert M. Lowen, MD · Answer

Dear Gullu,
  No, and it is a disaster in terms of looking bad. We are going to look at an example where it is possible, but not in your case.
   We want the nipple leval to be at or above the level of the inframammary fold. If it is and you put an implant in the nipple/areola will come forward or up slightly and out.  It can look OK, but not perky.
If the nipple is a bit below the fold, and increasingly so as the breast becomes more droopier, to even pinting down (grade III ptosis),  the breast falls down over the implant with a big bulge above the nipple/areola (known as waterfall or Snoopy appearance).  In such cases the distance from the sternal notch to the nipple is usually 23 cm or more.  In your photo, it looks like your arms are pulling up and back in the lateral views,  cnofusing the issue of there the nipple is in relation to the fold for surgical planning.  In the front view, it clearly shows the areola and breast are too low relative to where the implant will be to get a good result.  You can also draw a line in an arc from the little indent fold at the side of your chest by the top of the breast, over t the upper cleavage fold.   If you drop a line down from the middle of that arc toward the nipple and measure down 9-9.5 cm, if that is not where the nipple is, it is too low to use an implant without a lift.  see photo link.

Donovan Rosas, MD · Answer

Patient concerns regarding the appearance of their breasts can typically be divided in two pools: volume, ptosis (droop). The procedures to address these issues are as different as the issues themselves. However, these concerns are not mutually exclusive. Many patients, whether they are aware or not, will benefit from both.
There are two factors which can help to answer the question of which surgery will deliver the most satisfying result: mastopexy, augmentation or both. Patients must first consider the position of the NAC (nipple areolar complex i.e. the pigmented portion of the breast) as it relates to the inframammary crease. If the nipples are at or below the level of the crease the patient may benefit from a lift or mastopexy. The breast lift is designed to elevate sagging breasts to a more youthful position. It also helps to reshape and tighten the skin of the breasts. This is typically accomplished via a periareolar (around the nipple) incision with or without a vertical incision. 
Mastopexy is an effective way to address sagging breast, however, the changes which accompany weight loss or pregnancy can also decrease volume of the breasts. When a woman wants the volume restored, or increased, a breast augmentation will also be needed in conjunction with mastopexy. Augmentation can help restore the volume loss which is well known to women following children. There are a number of options available to women considering augmentation ranging from size and implant type to access incision.   
A breast augmentation alone may also be appropriate if ptosis is mild. If the patient is comfortable with the natural appearance of the breasts but desires them to be larger, a breast augmentation alone is the right procedure.  Augmenting significantly ptotic or sagging breasts tends to magnify the problem. In these cases, a mastopexy performed in conjunction with an augmentation is preferred.
Based on your photos, you would benefit from a formal lift. An augmentation alone is not likely to be adequate.
There is a procedure for every problem. To determine which technique is right for you, consult with a board certified plastic surgeon Patient should discuss their concerns with their physicians in order to make an educated decision.

Gary M. Horndeski, MD · Answer

The technique I recommend is the Bellesoma. 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 can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

George Marosan, MD · Answer

Thank you for your question and photos. I would not recommend an augmentation only based on the posted photos. You have grade II ptosis or sagging of the breasts with enlarged areolas. An augmentation cannot correct that by itself. You would do best with a breast augmentation and lift to get a youthful breast shape. A breast augmentation expands the breasts, and a lift does tighten the breasts and removes skin and breast tissue. You might be a candidate for a short scar or lollipop lift, best determined during a physical examination and measurements. I do these procedures in our certified in office surgery suite under deep intravenous sedation and not general anesthesia. This is a plus/minus operation, in your case lower pole sagging breast tissue will need to be removed. See a board-certified plastic surgeon for an in-person consultation/evaluation. Good luck.

Ronald J. Edelson, MD · Answer

You are a good candidate for a lift and I don’t think you even need implants. Although a lift does entail scars, implants saline are not a good procedure for you

Paul E. Chasan, MD, FACS · Answer

Thank you for your question. You definitely would need implants AND a lift to get an attractive result. Often times, I will perform a technique I developed called Reductive Augmentation which also involves removal of extra beast tissue so I can use the implant to shape the breast. Without a lift, your breast will even droop further, and you will not have an attractive result. however, you should be able to achieve a beautiful result If you undergo a reductive augmentation. Best wishes to you.

Mehmet Ozdemir, MD · Answer

I understand your desire to avoid scarring, but based on your photos, attempting to "lift" your breasts with implants alone would likely lead to a disappointing result. You currently have a significant degree of ptosis (sagging), where the nipple sits well below the inframammary fold and the breast tissue has settled at the bottom. If we were to place an implant without a surgical lift, the weight of the implant would most likely settle behind your existing tissue, creating a "Snoopy" or "double-bubble" deformity where the nipple points downward while the implant sits higher up. To achieve a perkier, youthful contour and properly reposition the nipple, a mastopexy (breast lift) is necessary to remove the excess skin and tighten the tissue envelope. While this does involve scars, modern techniques are designed to fade significantly over time, and it is the only reliable way to ensure your breasts are actually lifted rather than just made heavier and larger in their current low position.

Waylon Zeng, MD · Answer

Hi there, thank you so much for sharing your question and your photos! You are asking about “lifting the breasts with implants only”. Given your anatomy, this is actually possible. We measure the amount of lift needed based on the nipple position in relation to the bottom fold of the breast. For you, it appears the nipple actually is right at the position of the fold.
When an augmentation is done, the implant will fill in the volume in the upper chest as well as raise the nipple slightly. You would still need a peri-areolar mastopexy (Donut lift) to raise the nipple up slightly more so that the breast tissue will sit on top of the breast implant. This would then avoid the lower breast incisions. Hope that helps!

Is it possible to lift the breasts using implants only while avoiding scars underneath? (Photos)

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