Do I Need an Uplift As Well As Implants? (photo)

I've been wanting implants for years and after breast feeding I am 100% sure I want them. I went up to ab36DD/E when breast feeding, now down to a 34B. My breast are empty at the top. I just want to fill my breast up, I'm not after fake looking round breast. I went for a consultation and was advices that I may need a nipple lift to get the best results. I'm a bit scared about a nipple lift as the surgeon advised me that the areola may stretch and I don't want that. I don't want high nipples.

Doctor Answers 7

Breast augmentation vs. breast lift

Your nipples lie at different levels and different amounts of skin are visible under the nipple complex. Neither of those can be corrected without a nipple/skin procedure. Just putting in breast implants will not fix that.

The photo you show with bad scarring can be avoided to some degree by using a lollipop incision/closure instead of a circumareolar one. The high nipple example you show is actually a case of bottoming out of the implants. The nipples are in the right position but the majority of each implant sits below the nipple rather than being centered under it. The example you give of being like you before surgery is in fact not like you. That person has symmetric breasts without the stretchmarks that you have. The gap at the top example looks like it is early after surgery in which case the implant is likely to settle more with time.

I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship in order to know if this assessment is valid.

Los Angeles Plastic Surgeon
5.0 out of 5 stars 2 reviews

If uncertain about mastopexy with breast augmentation do the breast augmentation and evaluate the results.

I think there is a good chance she will get a satisfactory result from a breast augmentation alone. The bigger the implant the better it will camouflage the ptosis. If it turns out that you do want a mastopexy is easily done as a secondary procedure. Consider silicone gel implants above the muscle.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.8 out of 5 stars 36 reviews

Do I Need an Uplift As Well As Implants? (photo)

Do a larger implant as a first operation. See if you like the result. If not than a donut lifting under local anesthesia could be a surgical plan. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 174 reviews

Asymmetry and breasts

It looks like from your photos that you might be a good candidate for a lift and implants. Best to be seen in person to review your concerns and select the right implants.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Is a breast lift needed?

Thank you for your question and photos.  This is an extremely common question in women who have volume loss to their breasts after breast feeding.  Most women are very concerned about scars on the breast as are surgeons.  There will always be trade-offs.  Often, an implant alone is not enough to create an aesthetically pleasing breast.  If the nipple position is too low, it will need to be lifted to be in the proper position.  Scars are thus the trade off to reposition the nipple. 

In your case, although the photos are from the front only and it is difficult to tell exactly where your nipple sits in relation to the bottom of the breast (inframammary fold), it appears you would be best served with a lift, at least on one side.  You have a significant asymmetry, or difference in your two breasts.  This is very common.  To create round breasts with an ideal nipple position, you will need a lift at least on one side, if not both, to create symmetry and to make sure the nipples are in an aesthetically ideal position.  The other issues you mentioned are not necessarily the result of a lift surgery and can be related to breast augmentation surgery itself.  I would suggest visiting with your plastic surgeon again or seeking a second opinion in person where the surgeon can examine you and go over the surgery in detail. 

Best of luck.


Brian C. Reuben, MD
Salt Lake City Plastic Surgeon
5.0 out of 5 stars 36 reviews

Breast augmentation after breastfeeding

I understand that you don't want high nipples or very round breasts, but the issue that concerns me more is the asymmetry of your breasts and nipples.  They are so different that I don't think you would be satisfied with the results of breast augmentation alone.  I think it helps that you don't want really high nipples or very round upper breasts, because this makes it likely that your goals can be realistically achieved with a conservative periareolar lift, which if done properly, should be able to avoid scars like the ones that you have shown.  I do a fair number of these lifts, and I don't have problems with scars looking like that.  Much of that has to do with technique, and you should find a board certified surgeon who has experience with this procedure and can show you examples of results with satisfactory scars so that you will feel comfortable about the procedure.  Good luck.

Joseph L. Grzeskiewicz, MD
San Diego Plastic Surgeon
4.9 out of 5 stars 87 reviews

Do I Need an Uplift As Well As Implants?

Thank you for your question and the attached photos. 

If both breasts were like the one on the left, you might well not need a lift. The areola on the right is low enough and different enough in position from the other side, that not doing a lift almost guarantees an unsatisfactory result and a revision operation. 

The lift scar you show is a possible outcome, but it is certainly worse than average. The post-op implant side view does show an implant that is high riding, but this is almost the rule during the first month or so after surgery, which I assume is the case since the patient still has on a steri-strip. These almost always resolve by 3 months or so as the pectoral muscles relax to accommodate the new implants. Think about returning for a second evaluation by your surgeon, or a second opinion from another. 

All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.6 out of 5 stars 45 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.