Undecided, Lift or Implants. Surgery in 3 Weeks, Opinions Please

Hello. I have my breast surgery scheduled in June, however, am still undecided which route I should take. Would 500cc saline implants be sufficent to give me some volume, or will I end up with large, saggy breasts? If I decided to go just for a lift, my boobs will be tiny and scared. Hence, I'd rather go for implants even if I will have to get a lift 10 years down the road.I don't want both surgeries, so it will be either tiny or big. What to do? I'm 40, 1 child. Thank you.

Doctor Answers 22

LIft or larger implant?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

The choice you are trying to make can be difficult but usually the best decision can be arrived at by taking all factors into consideration.  Your chosen surgeon should be able to guide you appropriately and give you your best options.  I find that thin women typically have problems with rippling when saline implants are used.  This problem becomes even worse with the larger implants.  Contrary to what many woman are led to believe, implants do not give a "lift".  They only give you bigger breasts that are going to be lower on the chest than is ideal.  An implant is not a substitute for a well performed lift.  The two can be combined effectively to give you both increased size and proper positioning of the breast.  I would recommend that you have another consultation with your surgeon to make sure that you understand all of the pros and cons of each procedure. 

Seattle Plastic Surgeon
4.7 out of 5 stars 13 reviews

Lift vs. augmentation

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Thanks for your question -

I have to agree with Dr. Rand (he and I have agreed on these issues previously as well) -

This tends to be more of a physician patient communication issue.

If your surgery is only three weeks from now and you still have significant questions (like which surgery to choose) you need to take a step back and meet with your surgeon again to discuss these issues.  If you're still finding it difficult to make a decision I'd recommend talking to 2 or 3 other surgeons.

As a general principle and depending on how large you'd be willing to go as well as the final desired shape you may be a good candidate for augmentation alone.  But if you're looking for a very "perky" look you'd likely need a lift.

Good luck on your decision and remember - take your time, ask lots of questions.

I hope this helps.

Tough choices in breast surgery

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

As a local patient, I can only encourage you to bring these questions directly back to your doctor as they would hate to think you were making your choices on line rather than with them.

Technically, you do have droopy enough tissue and are very thin so that a great big saline implant won't lift you and will only thin you even more and will probably be wrinkly.  If I show patients of mine photos of people who have come to me with implants (often above the muscle) placed by other doctors who needed a lift but didn't get one and ask if they would be happy with that look, they have never yet in all my years of practice said they would like the look.

Consequently, I would suggest you consider a full lift and an implant of the size that will make you happy.  Please revisit all issues with your doctor. 

Implant Size

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Without examining you in person, it is hard to give you specific advice.  However, based on you pictures, it appears that 500 cc will be too large for your body and skin thickness.  I would suggest an implant at 400 cc or less.  


Good Luck.

Breast Lift or Augmentation

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

First of all I think that a 500cc is much too large for your situation.  You will get your best result and,  think, be happier with both a lift and implants.  If you insist on having only one or the other and not both, you should undergo a breast lift.  You can always have implants placed at a later date.

John Whitt, MD (retired)
Louisville Plastic Surgeon

Lift versus breast augmentation, best option?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Dear Sleepless in Seattle,

Thank you for the photos, unfortunately you did not send a frontal view. As the other surgeons already stated, you need to discuss your concerns prior to your surgery so you will feel good about your decision.  Based on your photos, I can give you my point of view, which does not take the place of a consultation. You have sagging that would require a breast lift (I do this via a short scar technique). If yoyu have 500cc saline implants placed even under the muscle you will have saggy breasts and you will not need to wait 10 years to see it. Your tissues are thin and will not support large implants like that. Also, even you are contemplating to get large implants, possibly to improve your cleavage, this will not happen. Your anatomy does not allow it, your rib cage slopes down toward the armpits and that is where your large implants will end up. I personally do not combine breast lift and augmentation into one surgery. I explain this on my web site. I would suggest a lift first and come back in about 6 months and do a smaller agmentation under the muscle. Discuss these issues with your surgeon and if you do not feel comfortable get a second opinion now, not after the surgery!

Large implants have some advantages

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}


It sounds as though you have already made up your mind to go with option one, the large implants.  However, with the small amount of sagging that you have, you may not need to go to 500cc.  You should concentrate more on a goal bra cup size than a volume number.  Your surgeon can then identify the proper implant size for the bra cup size that you wish to achieve.  Anything from 350cc up should give you enough lift to avoid a lift procedure.  Good luck!

Lift versus Augmentation is based on sound principles

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I call your body type a "gray Zone" girl. That means you could do this with implants alone IF you desired to be pretty large and your physician used a high profile style. You would have to wear really well fitting bras. The other option is the lift and adding an implant at the same time. The degree of lift depends on how perky you want to be compared to how big you wanted to be! A higher nipple with a smaller areola and a smaller breast will require more than a circumareolar lift, ask your surgeon about a Lollipop lift, also know as a parachute mastopexy.  Communicate exactly what you want and be sure the plan is solidified in your mind. Good Luck.

Charles Virden, MD
Reno Plastic Surgeon
5.0 out of 5 stars 70 reviews

Lift or implant

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

If it is a choice between the two, I would recommend a lift to give you back the shape to your breast.  Like others here, I think that you need to talk through the pros and cons with your surgeon.

Lift and implants

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Just from your photos and the angle suggests that implants with a small circumareola lift will be a good procedure for you.  Of course, a full exam and consultation would allow for a proper evaluation.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 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.