Do I need a lift on just one breast or both? (Photos)

Question

Hello, I have decided that I will do a breast augmentation. I've been to two consultants with a surgeons. One doctor suggested that I need a lift on only one, bigger breast and another one said that I shoud get a lift on both and also get my milk ducts reduced. I still did not have any children. I would like to hear your opinion. Thank you

Gary M. Horndeski, MD · Answer

Your breasts are asymmetrical in volume, shape and position, are low on the chest wall and pointing outward. Implants alone will not solve your problem. The technique I recommend is The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. Later, fat transfers or small implants can be placed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

J. Timothy Katzen, MD, FACS · Answer

Hi THRIFTY162141,

Thank you for reaching out with your query about whether you should have a lift on just one breast or both, and for providing your history and pictures. This information is vital in helping to make an informed recommendation.

In cases like yours, where breast augmentation is being considered, I generally advise addressing both breasts simultaneously. This approach significantly enhances the chances of achieving symmetrical results, which is a key aspect of aesthetic breast surgery. Given that you're planning to have breast augmentation presumably with implants, I suggest that the incisions be strategically placed around the areola. This will not only facilitate the insertion of the implants but also allow for an effective lift.

For your specific situation, a donut or 360 peri-areolar mastopexy (breast lift) performed on both breasts would be a suitable option. This technique is advantageous as it allows for the reduction of areola size and can provide a subtle yet effective lift. It's particularly beneficial in your case, as it can be tailored to lift your left breast more than the right, addressing the asymmetry.

To conclude, my professional opinion is to operate on both breasts and perform a bilateral donut or Benelli breast lift (mastopexy). This should result in a more balanced and aesthetically pleasing outcome post-augmentation.

I hope this response has clarified your query regarding the need for a breast lift on one or both breasts. I'm confident that this approach will yield the best results for you. Wishing you the best for your forthcoming procedure.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS
Plastic and Aesthetic Surgeon

Leila Kasrai, MD, FRCSC · Answer

Your nipple is located just above your breast fold on the smaller breast, therefore you may not require a lift on that side. However, it would be best to follow the opinion of the surgeon you feel most comfortable with.

John L. Burns Jr., MD · Answer

You have Grade II ptosis with slightly more ptosis on your left side.  It is always best, in my opinion, to do the same procedure on each side to get the best symmetry.  You need a lift on both sides.

Ted Eisenberg, DO, FACOS, FAACS · Answer

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

Ronald J. Edelson, MD · Answer

Doing both sides gives you a much better chance of symmetry. If you only do one side I don’t think it will look right.

Connie Hiers, MD, FACS · Answer

Measurements are needed to be certain, but based on your photos, you should lift both breasts to be most even.

Mats Hagstrom, MD (license on probation) · Answer

Breast augmentation surgery is not always straightforward. There are generally three primary variables that determine breast augmentation results, excluding the need for a breast lift. For breast augmentation outcomes the variables that determine quality outcomes are patient, candidacy, implant choice, and technically placing the implant correctly.
All three of these variables are of equal importance Gahan in your case. For example, your breath is it slightly wider and fire parked on your chest wall with mild a diversion, which is greater on your right side than your left side. Divergence will be amplified with augmentation, so recognize that your right breast will point out to the side, and this will be amplified with the projection of the implant. 
Most individuals have their left breast, sit slightly higher on the chest wall and then the right. You can check yourself by putting your fingers on the inframammary fold of each breast to see where they sit on the chest wall. You have more ptosis on the left side with your left nipple, sitting lower than the right, even though most likely, your left breast is higher on your chest wall.
Needing , unilateral mastopexy is tricky, because the scars and potential areola reduction can create a symmetry.
There may have been some misunderstanding in the communication with one of your providers. I don’t think you need milk, duct reduction. I’m guessing your provider was referring to the size of your areola.
Choosing the right provider is probably the most important part of the equation. This, and understanding your candidacy, for the procedure are the fundamental Primary variables that correlate with long-term patient satisfaction. 
I generally encourage people to have more consultations rather than less. The more consultations, you have the more likely you are to find the best provider for your needs. If you were consultations the last providers you have to choose from. Being bored, certified in plastic surgery with years of experience in an overall good reputation, does not mean if somebody has mastered anyone single surgical procedure.
I generally recommend people who are in doubt to simply slow down and consider scheduling a few more consultations until you feel very comfortable with your current choice of provider.
The following are some general guidelines for helping to find the best provider for your needs.
To find the best provider, I suggest patient schedule multiple in person consultations with experienced plastic surgeons in their community. During each consultation, ask each provider to open up their portfolio and show you their entire collection of before and after pictures of previous patients who have similar body or facial characteristics to your own. An experienced plastic surgeon should have no difficulty showing you the before and after pictures of at least 50 previous patients. An experienced provider should in fact have hundreds or preferably thousands of before and after pictures to choose from for commonly performed procedures. 
Being shown a handful of preselected images, representing the best results of a provider’s career is insufficient to get a clear understanding of what average results will look like in the hands of each provider.
There is no correct number of consultations needed to find the best provider. The more consultations you scheduled the more likely you are to find the best provider for your needs. 
Take careful notes during each consultation, especially regarding the quantity and quality of before and after pictures. It’s not a bad idea to bring pictures of your own body/face to use as reference when reviewing before and after pictures. 
The biggest mistake patients make is scheduling only one consultation without properly vetting or comparing providers before scheduling surgery.
Best,
Mats Hagstrom, MD

Diego Ampudia, MD - Account Suspended · Answer

Hello, The advice to do a breast lift in one or both breasts is determined by the size of implant desired.The breast lift is intended to level out the areolas.

Do I need a lift on just one breast or both? (Photos)

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