Borderline needing lift and would like a second opinion, what do you think? (Photos)

Your breasts are low on the chest wall and if you undergo augmentation alone it is often required to lower the inframammary fold.  This often results in double bubble or bottoming out.  I recommend a lift using 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 can be performed if additional volume is desired.  Implants are not lifetime devices.  8% fail within the first year and 30% fail within six years.  Fat transfers are permanent and incorporated into the body.Best Wishes,Gary Horndeski, M.D.

Hello, thank you for your question. It seems like you can benefit from a breast lift with implants. A breast augmentation and a breast lift work hand and hand to enhance the overall shape and size of a woman’s breasts. These procedures are ideal for increasing the size of the breasts while restoring balance and youthfulness to a woman’s bust. Schedule an email, Skype or in-person consultation with a board certified plastic surgeon for proper evaluation.

Thank you for your question!  It appears your nipples are located above your inframammary fold.  With your breast shape, you could be a candidate for placement of the breast implants over the muscle rather than under without the need for a breast lift.  It would help to decrease the potential of a "double bubble" appearance.  A double bubble is when you can visualize the natural breast tissue contour and a shadow of the breast implant.  If you did, in fact, develop the double bubble due to not lifting the breast, you could fix the post operative results a breast lift.  At least this way, if the breasts look good without the added scars of a lift, you come out ahead. I would spend some time visiting with a few plastic surgeons in your neighborhood to get various opinions.  I hope this helps!

It is very common for women to want breast lifting when they get a breast augmentation. At the end of the day, an implant just pushes out what you naturally already have there. I tell all my patients that there's a 100% chance of asymmetry after any breast surgery with or without a lift. Of course, the goal is to try to make you as equal as possible but everyone has asymmetries of the ribs, the muscles etc. It's very important to understand this as you, like all women, have some breast asymmetry that would be pointed out on examination and before any surgery. When women have excess breast skin, an implant can take up some of this excess skin. So, depending what implant size you're interested in being, there's a good chance that in your case a breast augmentation will have good results without any additional breast lift scarring. As a final thought, if you pick the infraareolar scar as your choice for breast implants, usually we can do a mini breast lift at the same time and I usually don't charge people for this. Of course a full areolar breast lift or short scar breast lift is different and does involve more scars and more costs.  Aging and even pregnancy are definitely hard on the breast areas and this is a comment complaint among women visiting my office. For some women that aren't quite sure, it is okay to do just the breast implant and if they  desire more lifting afterwards, you can usually do that in the office as a separate procedure under local anesthesia and leave the implant alone and just remove some of the excess breast skin.I would recommend that you see a board-certified plastic surgeon in your area that is a member of both ASPS & ASAPS and performs a lot of breast implants. Good luck with your future surgery!I hope this helps answer your question. If it does, please take a moment to up vote this answer on the “respond” button on the top right.  

I expect you will have good results without a lift. Based on your photos and suggested implant size, I think a lift is unnecessary.  

I think you are fine without a lift. If your nipples are low it’s not by much and not worth the scars.

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. 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

Hello and thank you for your question. You are a great candidate for a breast augmentation using a dual plane technique without need for a formal lift.  There are several advantages and disadvantages to over vs under the muscle.  Under the muscle has the advantage of lower capsular contracture rates, less risk of rippling, and better visualization with future mammograms.  Most patients say that under the muscle also has a more natural look and feel.  The size, profile, and shape of the implant is based on your desired breast size/shape, your chest wall measurements, and soft tissue quality.  This decision should be based on a detailed discussion with equal input from both you and your surgeon.  Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.  

Best wishes and good luck.


Richard G. Reish, M.D. FACS

Harvard-trained plastic surgeon
 

Dear Dannielle2990,
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

Measurements are needed to be certain, but you would probably do well with just an augmentation. I prefer to go behind the muscle.