Do I need a breast lift or will just implants work? (Photo)

Question

I am 32 years old and a mother of 2 kiddos. I am 5’8 in, 133 lbs, and have a small waist.

Leila Kasrai, MD, FRCSC · Answer

It’s difficult to see the location of your nipples in relation to your breast fold, something that can be determined with a picture of your side. If your nipples are located at or below your breast fold, then a lift would most likely be recommended.

Marguerite E. Aitken, MD, FACS · Answer

You would just need implants. It looks that your left nipple might be lower or more lateral per the photos; but that can possibly be addressed by appropriate shaped implant or a small crescent incision in the areola on that side.

Irena Karanetz, MD · Answer

Hello,
Thank you for the question. 
Based on your photos, you appear to be an excellent candidate for breast augmentation and it may be be performed without a breast lift, however, it is difficult to tell definitively without an in-person examination.
Implant size discussion and implant selection is one of the most important steps during your consultation with plastic surgeon. The decision-making process depends on your desires, as well as breast and soft tissue dimensions of your chest wall. I also utilize Vectra 3D planning to further help with implant selection. 
I would seek an in-person evaluation by the Board-Certified Plastic Surgeon, in order to discuss your goals and concerns for the best cosmetic results. 
I hope this helps.Best regards, Dr. Karanetz
Dr. Irena KaranetzBreast Fellowship-TrainedBoard Certified Plastic Surgeon

Donald R. Revis Jr, MD · Answer

Good morning,
I see several issues- you have a wide gap so implant selection to minimize the gap and create nice one finger cleavage is SOOO important- make sure you discuss that and don't choose any surgeon who says "we can't do anything about that- it's your anatomy"- total hogwash. Also your breasts look like they may be two different sizes? Its an odd photo angle but if they are then two different sized implants would be the correct choice- about 1/3 of patients need this to achieve the best symmetry. Also your nipple height seems to be a little off, but again it could be the camera angle. If your nipples are not level when you stand in the mirror with your arms down by your sides then I would recommend a donut mastopexy to lift your nipple position to the same level and tighten your skin.

Vasileios Vasilakis, MD, FACS · Answer

Thank you for the question. Better photos are needed but it does not appear that you need a lift. I wish you the best of luck. Vasileios Vasilakis, MD. Double board-certified, fellowship-trained plastic surgeon, Houston. TX.

Gary M. Horndeski, MD · Answer

The technique I recommend is a mini lift. Using a circumareola incision, your breast tissue is reshaped, elevated higher on the chest wall and more medial to increase your cleavage. At the same time, fat transfers or small implants can be placed totally submuscular.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Ted Eisenberg, DO, FACOS, FAACS · Answer

I recommend an in person evaluation with a plastic surgeon to be measured and discuss your goals. 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. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. 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. Philadelphia, Pa., USA

Gerald Minniti, MD, FACS · Answer

You do not need a breast lift, at least based on this photo. However, if your arms are high enough above your shoulders, it will give a false impression of your actual breast mound shape and position. Go see a few doctors in consultation.

Scott W. Vann, MD, FACS · Answer

Your nipples appear to be well above your breast fold. Therefore  you do not need a breast lift. If you want larger breasts then implants should work well for you. You need an in person evaluation to help make your decision. Good luck.

Daniel Barrett, MD · Answer

Dear Eclectic57713,
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