Was Wondering Whether I Could Just Get Implants or Whether I Would Need a Full Lift

I want to retain a more natural look and not high by my collar bone breasts. Is it possible that they could be made fuller without the horrible scarring of a full mastopexy.

Doctor Answers 27

Breast Augmentation vs. Lift

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A breast augmentation makes your breasts larger and can look natural without the "breasts at your collar-bone" look whether you need a lift or not.  A mastopexy or breast lift moves your nipple position from the lower part of your breast to the middle of your breast.  If you are ok with where your nipples are (they will NOT move after implant surgery) and simply want fuller, bigger breasts, you can get an augmentation only.  A breast lift can be done at a separate time if you change your mind.  Good luck.

The pencil test to determine if a breast lift is necessary

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Place a pencil horizontally at the crease between your breast and your chest wall.  If your nipple is lower than the pencil then your would benefit from a lift.  A periareolar lift will give excellent results with minimal scarring for nipples that are less than an inch below the pencil. If your nipples are lower, you will probably need a periareolar and a vertical scar the extends down from the areola. 

Joseph N. Togba, MD
Oakland Plastic Surgeon

Breast lift?

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It's hard to advise you without seeing a photo.  One thing though, the scars of a breast lift- if indeed that's what you need- don't need to be 'horrible scars'. When planned properly these scars usually heal well.

Scott E. Newman, MD, FACS
New York Plastic Surgeon
4.9 out of 5 stars 42 reviews

Breast Aug or Lift

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As simple as it may sound, if your breasts are lax and your nipple droops below the crease under your breast, you need a lift.  This elevates the nipple to a more youthful position.  Augmentation simply makes whatever breast position you have, larger.  If your breast hands too much to you and your surgeon's observation a lift will give you an overall better end result.  I hope this information is helpful.

Ronald H. Stefani Jr, MD
Chicago Plastic Surgeon

Breast Augmentation with or without lift?

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Hi there-

Without a proper examination, it would be very difficult to give you a responsible answer to your question, as (in addition to the variables some of my colleagues have described) there are characteristics of your skin and breast tissue that would ned to be understood before making recommendations.

Furthermore, as some have pointed out, it is more true for this procedure than for most that no two surgeons are exactly alike in their experience and skill achieving lovely breast shapes, or in their approach.

My best recommendation to you is that you identify a few surgeons who's work you admire, and visit for consults.

I think it's also important to remember that it's usually not in your best interests to look for the easy path when it comes to your appearance. Some of the most unhappy women I have met are those who allowed someone to do some kind of a "short scar" breast lift on them when a different technique would have resulted in a better shape. The only thing worse than being unhappy with how you look is having surgery and STILL being unhappy, right? 

Choose well, and make good decisions, and you'll be happy with your breasts for many years to come.

Breast Augmentation/Lift vs. Lift Only

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Breast implants with a lift and a breast lift alone are two entirely different procedures.   The first question you must ask yourself is whether you are happy with the size of your current breasts?  If you are and have no desire to get implants then a lift alone is appropriate.  However, know that you'll likely end up with a "lollipop" or "T" scar.

A breast lift with implants, I feel, is a much better procedure.  First, the implants help fill the upper pole or top of the breast.  This area tends to get flat after pregnancy, breast feeding and age.  By using a low profile implant the upper pole can be filled without making the breasts significantly larger.  Second, I vertually never use any incision except a periariolar incision when I combine a lift with implants.  The reason is simple, there's no need to make any other incision.  If the breasts are very ptotic or sagging then usually the size is such that implants aren't necessary and a additional incisions are used.

Finally, your breasts will not end up "high." The reason is that the tissue has less elastisity and will therefore have a nicely rejuvenated appearance that looks natural.

Beverly Hills breast lift with augmentation

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Hello and thank you for the question.

Its impossible to make a determination of what you need without a proper examination, or at least, good photographs.  In general, a breast lift or mastopexy is designed to raise the breast and reshape the breast mound to a more youthful shape, whereas a breast augmentation is designed to "augment" or increase the size/volumize of the breast. While a breast augmentation may offer an element of "lift" it is by no means a replacement for the proper procedure if your primary diagnosis is ptosis or sagging of the breasts.  Additionally, while you may incurs "scars" with a breast lift, in the right patient population, the scars generally heal exceptionally well, and are a more than an acceptable trade-off especially if your breasts are markedly ptotic.  

Lastly, some patients may require a breast lift with augmentation for optimal results. This is a determination that can only be made after evaluating you.  Regardless, the results can look very natural and beautiful.

I recommend you consult up with a Board Certified Plastic Surgeon and get a formal evalution and management plan.

Best of luck,

Glenn Vallecillos, M.D., F.A.C.S. 

Glenn Vallecillos, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 30 reviews

Breast lift vs implants

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Without an exam or at least photos, it is difficult to say what you might need. If you are not full but not sagginf, you may only need breast implants. If your breasts are sagging, then you may be able to geta small lift around  the border of the areola.

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

Options for natural looking breasts

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It’s hard to say without a photo which treatment and placement fits you the best. There are various factors regarding how you want your breasts to look and feel, but if you and your doctor have a good, open line of communication, you shouldn’t need to go back and forth on your decision. If you just want to go bigger, the only way to do that is with implants. Any type of incision for a breast lift will leave a scar, but there are ways now that are minimal scarring and give a pleasing, perky result. The vertical or Le Jour technique can now be used on a wide range of sizes using an incision that looks like a lollipop that goes around the areola and down the lower half of the breast.

A major factor that effects how breast implants look and feel is whether they're inserted over or under the chest (pectoral) muscle. I do submammary and submuscular implants, inserting the implants under the breast tissue and over the muscle through an incision in the breast fold. The result is fabulous: perkiness with barely a trace of scar. 

If you want the most natural-looking breast you'll need a subpectoral implant, in which the implant is placed under the muscle. This procedure also requires the merest incision - about three centimeters in the crease under the breast or at the edge of the nipple -- and diminishes the incidence of capsular contracture, the formation of hard scar tissue around the implant which occurs in 10 to 30 percent of cases. 
Subpectoral implants aren't right for everyone, though. If you have saggy breasts, an implant placed under the muscle won't fill out that empty breast sack, and you'll get what we call the "double bubble" look, where the implant is situated next to your armpit and the breast hangs several inches below it. Instead, you can have a procedure called augmentation mastopexy, in which the implant is placed under the muscle and the skin on the breast is lifted and tightened. 

In short, you must know -- realistically -- what you are starting with, as well as what you want to look like when surgery is done. Do you want a natural appearance or a round, perky look? These are some of the factors I weigh with my patients when evaluating what type of procedure to do. 

Michelle Copeland, MD, DMD
New York Plastic Surgeon
4.6 out of 5 stars 10 reviews

Procedure best for you

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In order to answer your question with some accuracy, you need to submit photos. Having said that, it seems that you think mastopexy scars are horrible, and that is a concern. Especially if you do need one. I think you need to communicate your concerns and expectations to your plastic surgeon and go from there. Good luck

Moneer Jaibaji, MD
San Diego Plastic Surgeon

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.