I am planning on getting implants but wondering if I'll need a lift as well? (photos)

Your nipples are lower than your breast fold therefore a lift would be recommended to give you more upper pole fullness for a perkier shape.

I recommend an in person consultation with a plastic surgeon to discuss your goals and be measured. 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

Good evening,
You would definitely benefit from a lift with your augmentation- the kind I would recommend is a donut mastopexy- nice lifting but no vertical scar!

More important than implants is the breast lift. Your breasts are too low on the chest wall. 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.

Thank you for providing photos. Without in person assessment, it does appear that you do need a mastopexy. Your breast volume and nipple areolar complex are well below your inframammary fold, indicating that it is time for a lift. I do not do both of those procedures together (lift and augmentation) as literature says that we should not due to revision risk. I would recommend a mastopexy first and any time after 8 weeks post lift, adding an implant.

Dear Enthusiastic553250,
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

Hello @Enthusiastic553250 thank you for your question and showing your pictures. I suggest you have a combine treatment, a breast augmentation with lift so the nipple can be less divergent, lifted and rearrange the mammary tissue. For me a great result is a breast that has an adequate shape and proportion, that the projection is slightly conical, that has a slight descent in the upper part so that it looks esthetically adequate. I leave a link to a video to shed some light!! Best wishes!!!

Yes, you need a lift. Otherwise, you will just have bigger ad still sagging breasts that will slowly sag even more with time.

From your photos it appears a lift is recommended when you have your augmentation. The implants will provide volume and upper pole fullness, but the nipple is not lifted. Your photos show that your breasts sit low on the chest wall and you would benefit from a lift. See a board certified plastic surgeon near you to learn more.

The simple answer is yes. There are numerous options: implants alone, implants and a variation of a lift, implants and a crescent elevation of the nipple-areola, implants and a donut mastopexy without the incisions of a full lift. They each produce different degrees of cosmetic improvement.
Implants alone do not adequately lift the breast when there is significant sagging, no matter the size or the type, and will not produce a good cosmetic result in a patient who also needs some variation of a lift.

Keep in mind that following the advice from a surgeon on this or any other website who proposes to tell you exactly what to do without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of each operative procedure would not be in your best interest. I would suggest your plastic surgeon be certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person and be very realistic about your potential cosmetic result.

Robert Singer, MD FACS

La Jolla, California