Am I a Good Canidate for a Mastopexy Without Implants? (photo)

Hello, I'm 5'5 , 34 Years old and have lost 140 pounds. I have had a consultation with three plastic surgeons and two of them said that I DO NOT need implants. The other insisted that I DO need implants. Ideally, I would like fuller breast and my breasts are somewhat full toward the bottom. However, I really really do not want an implant. Can a fuller breast look be achieved without implants? Do you think that I am good candidate for just the Mastopexy? Thank you. ~B

Doctor Answers 11

Breast Lift without implants - a better choice

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You have enough breast tissue to reshape and achieve upper pole fullness without implants. There is a technique called the Ultimate Breast Lift that successfully creates beautiful breasts without implants and minimal scarring. With the UBL technique a vertical scar is never needed. The incisions are well hidden around the areola and in the inframammary fold. Implants require longterm maintenance and cannot lift breasts. I strongly suggest you visit the lift with implants forum to see that lifts with implants do not work or last. Also, visit the breast lift forum to see how vertical lifts bottom out after a short while.

I hope this helps.

Kind regards,


Breast Lift

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It is my pleasure answering this question. Observing your photos, it looks like you are a DD cup and may need a small reduction pending on the size you would like your breast to be. Usual suture lines are around the areola and avertical linegoing down toward the breast crease. Surgery should take an hour and a half to three hours depending on your surgeon and technique used. Post operatively you will need a good supporting bra, and should improve your posture. Good luck to you.

Peter L. Schwartz, MD
New York Plastic Surgeon

You do not need implants

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The reason for using the implants are to make breast larger. Some surgeons advocate implants for upper pole fullness. You have enough breast tissue for full breast lift. I do offer my patient fat grafting for the upper pole rather than implants.

Am I a Good Candidate for a Mastopexy Without Implants?

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I would favor not using implants, though this is based on incomplete info. Is your current size adequate?  A lift should involve removing a very small amount of tissue (about a tablespoonful from each side) that should cause an unnoticeable volume change. 

There is some controversy among plastic surgeons about the safety of doing combined breast lifts and augmentation. Although I usually agree with the one-stagers, in this setting with the kind of lift you would need I would not do the augmentation at the same time anyway.

It makes all the more sense to me that you have just a mastopexy, and then decide in 6 months or so if you wish to consider implants.

Thanks for your interesting question and for the helpful photos. All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

Can perform breast lift without implants

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You do not need implants with a breast lift, however you should note that your breasts may decrease a bit in size when a breast lift is performed alone. If you are okay with this, then go ahead without implants. 

To determine whether you are a good candidate for mastopexy, a physical examination and review of your medical history would be required. You should also be at a stable, normal BMI as this improves results and safety of the procedure.

Breast lift and implant options after 145 lbs weight loss

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Thank you for the photos. Congratulations on your weight loss.  It seems as though you would benefit from a lift.  If the desire is for upper pole fullness, the usual way to do that is with an implant. The implant does not necessarily have to be large. If you need or want volume, then a larger implant will help. Nipple/areola positioning is a different matter and may necessitate more work, (i.e.; a lift). Discuss your goals with the board certified plastic surgeon and make sure they are reasonable. Together you will come up with a plan.

Am I a Good Canidate for a Mastopexy Without Implants?

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I would think of things in terms of shape and volume.  In your particular situation, it's my opinion that shape should take priority, which means getting your skin envelope right.  Standard mastopexy procedures are sometimes inadequate in terms of removing enough skin to reposition your breast adequately.  You may be better off with an initial breast reduction type procedure to safely reposition your breast followed by a later implant if desired.

Combining a breast lift with an implant is common, but for you will increase the odds for a later 'touch up' procedure being necessary.  This is because in your case, skin elasticity is likely to be an issue.

Do I need implants?

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Hi BonitaApplebaum,

     Firstly, congratulations on the weight loss.  I believe  you will have two different results whether you decide on using implants or not.   To start with, I believe you will be significantly smaller as well as have very little upper pole fullness if no implants are used. Those surgeons that  preserve your volume in a lift essentially perform skin lifts.  Skin lifts, in my opinion, don't work well.  They form poor scars and bottom out relatively fast.  In my opinion, breast lifts that use the internal tissue of the breast to reshape the breast produce better shape, better scars, and a longer lasting lift.  In these lifts a significant amount of breast tissue must be removed.  Furthermore, regardless of the type of lift, upper pole fullness cannot be reliably achieved without the use of implants.  Fat transfer to the upper pole is  consideration, but may not be reliable.

     Therefore, in my opinion, if you are looking to maintain fullness along with producing fullness in the upper pole, you should use an implant in addition to the lift.  Whether you should undergo the augmentation at the same time as the lift is an important one.  There is no question that in your case doing them both together increases the risk of compromised blood supply to the nipple/areola complex.  Your nipples are quite low on your breast and need to be moved up significantly.  A good amount of blood supply is required to do that safely.  Implants placed at the same time compromise that blood supply somewhat.  

Good Luck,

Ary Krau MD

Mastopexy without Implants

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   Superior pole fullness is one reason to place implants in this situation.  However, an implant is not necessary, and the look and shape of the breast will be largely determined by how the lift is performed.  Kenneth Hughes, MD Los Angeles, CA

Mastopexy decision

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i agree with the other PS here: you would do well to have a full mastopexy WITHOUT implants. based on the photos, it appears you have enough natural breast tissue to keep you at a good volume. 


implants with a mastopexy help with projection and "perky" look, but frankly, it's not needed in your case. A well designed incision and correct measurements will provide you with a nice youthful shape and projection. 


Remember to be healthy, avoid smoking, eat well, take a multivitamin, high fiber diet, and avoid aspirin or motrin before surgery. 

Best wishes to you. 


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.