Augmentation alone or with Lift?
As you can see, there is no right or wrong answer, and it depends on what your expectations are, and what you would like your outcome to be. Keep in mind, a breast lift alone will not provide much long term superior fullness and will introduce more scarring and can be done later if desired. (Stephen Delia, MD, Vancouver Plastic Surgeon)
Breast implants alone or with a lift?
I nearly always recommend implants alone if a reasonable result can be expected. A breast lift adds scars and expense.
The combination of breast lift and augmentation is notoriously trouble-prone and can involve multiple revisions or touch ups.
From your photos it would appear that you could obtain a good result with augmentation alone. I use the dual-plane approach which allows the implants to sit in the correct position behind the slightly drooping breasts.
After surgery most patients are happy to do whatever lift they need with a bra. It is possible that you will eventually need a lift, but at least you will have had many years without mastopexy scars. (Eric Pugash, MD, Louisville Plastic Surgeon)
Implants With/Without Breast Lift
You appear to be from your photos on the borderline of whether you can get a good result with implants alone or need a lift also. If you are willing to accept some breast sagging, then I would suggest having an augmentation alone. You can always undergo a small vertical lift later if you wish. (John Whitt, MD (retired))
Implants alone or mastopexy with implants
Every physician is different in their approaches and outcomes. however, based upon your photo, it looks like you would be a candidate for implants alone or implants with a lift. However, the outcome would differ with implants alone. The post surgical appearance would be determined, in part, by the size of the implant you choose. Implants, in general, will only lift the nipple 1-3 cm. I would recommend an implant with circumareolar mastopexy here.
Most women would prefer implants alone, however, when implants are placed in women with moderate ptosis (droopiness), a double bubble will result. That is, the implant is a separate mass from the natural breast. I don’t think this would be the case with you, though.
I would recommend visiting several plastic surgeons in your area. Then you can trust your instincts and receive a wealth of information before making your final decision. (Jason R. Hess, MD, San Diego Plastic Surgeon)
To lift or not to lift? that is the question…
It is not wrong to proceed with a breast augmentation first. Remember, your breast augmentation will help to lift up your nipple position by a little bit.
I would determine whether you would need an additional lift based on the amount and quality of any excess skin and your nipple position with respect to your overall chest wall anatomy. Based on your photos, I would likely suggest just a periareolar mastopexy but I would definitely need to assess your tissue/skin. Having said that, if you opt to just proceed with a breast augmentation, remember, you can always return later for a breast lift if it is needed. Talk to you plastic surgeon about your concerns and together you can finalize your treatment plan. (C. Bob Basu, MD, FACS, Houston Plastic Surgeon)
The whole goal of surgery is for the surgeon to create that which the patient wants to see. Their is no wrong or right, rather their is the approach that will accomplish your goal. Based on your photos, you would be a good candidate for either an augmentation alone, or a lift and augmentation.
Each would produce a different result. You should meet with several plastic surgeons who can offer you both alternatives and explore with them what your results might look like. For more information on the subject you could visit our blog on our website. (Marc Schneider, MD, Fort Myers Plastic Surgeon)
You may not need a breast lift, however to determine this you would need a consultation with a surgeon who has experience with performing breast augmentation on breasts affected by mild to moderate sagging. You can consider Allergan Inspira Truform 2 implants with a narrower base width for more projection. Please see an experienced board certified plastic surgeon to find out whether you are a suitable candidate. (Jerome Edelstein, MD, Toronto Plastic Surgeon)
Dual Plane Breast Augmentation or Breast Augmentation with Lift
I think if you are choosing a small implant, 300 or less, then I would consider a donut mastopexy. If you are going 350 or larger, I think you will achieve a nice result with a dual plane primary breast augmentation. Here are my criteria:
Candidates for a Breast Lift (Primary Breast Shape Concern):
1. Patient is happy with breast size in a bra, but desires improvement in shape.
2. Nipple position sits at or below the level of the breast crease (inframammary fold)
3. Significant amount of loose skin and breast tissue, which hangs over the crease leading to a hollow appearance in the upper pole of the breast.
Candidates for Breast Augmentation (Primary Breast Size Concern):
1. Patient is happy with nipple position and amount of skin in relation to crease.
2. Desires increase in volume of breast to increase bra cup size and provide more cleavage and fullness to upper and lower pole of breast. In many cases, patients have concerns of both size and shape, therefore requiring a breast augmentation with a breast lift to achieve desired results. (Paul S. Gill, MD, Houston Plastic Surgeon)
A low fold can be deceiving in regards to lifting with an augmentation. It appears that you have relatively low inframammary folds. I would not be surprised if your nipples are still visually above the folds while they measure below. I think you would be fine with placement above the muscle without a lift at the time of your TT. You might wind up with a subtle lift from this and not more ptotic, but not “perky.”
And if you want to keep down the number of visible scars, I would also suggest transaxillary approach so there are no scars on your breasts. Yes..transaxillary approach can be done for both over and under the muscles. (Myles Goldflies, MD, Bellevue Plastic Surgeon)
I agree with the majority of my colleagues who say it can go either way. You should get an acceptable result with just implants. I think you wil get a slightly better result with a lift + implants, meaning that your breasts will look more perky and “youthful”. There is a tradeoff.the scars of a lift. You need to think about what you would rather have – great outcome with scars OR pretty good outcome without scars? This may be simplistic but I think it is a good way of thinking about it. (Matthew Schulman, MD, New York Plastic Surgeon)
Implants or lift? focus on implant demensions and approach!
I would strongly recommend avoiding a lift. You have a very low inframammary crease with nipples exactly at the crease. Because your ‘breast footprint’ is low, it is tempting to recommend a lift but in reality this would be an aesthetic mistake leading to upward pointing strange nipples.
Make sure that the implant selected is wider then your current breasts and do not have a lift. this will fill out your lateral deflation and give you some upper pole fill. the ideal procedure for your body type is a transaxillary approach with subfascial placement of wide silicone gel implants. To learn more about my ‘cold-subfascial approach please see the link below. (Rian A. Maercks, MD, Miami Plastic Surgeon)
Breast lift with breast enlargement
I do a small lift, periareolar on the top side of the areola only on many of my patient such as yourself that have had children and their breasts sag a little. An implant will not uplift your breasts. My recommendation would be a periarelar cut through which I place the implant. I would recommend a silicone gel and on top of the muscle to get you the best cosmetic result. The size I want the patient to chose with my guidance. Check out our unbeatable allinclusive special price for breast enlargement surgery. Watch my videos! (Edward J. Domanskis, MD, Newport Beach Plastic Surgeon)
Augmentation and/or lift
Patients that are borderline for a formal lift often do very nicely with a circumareolar lift which only places an incision around the border of the areola. This may be the right thing for you, but a formal exam is necessary. (Steven Wallach, MD, Manhattan Plastic Surgeon)
Breast Implants Do Not Lift The Breast.
The common thought is that a breast implant can lift the breast and a big breast implant can lift the breast more. This is false and when you think about it, how could that work? A breast implant in your breast will sit central on the chest and since your nipple is below your crease and you have a long chest, the implant will sit well above your nipple giving a “snoopy deformity”, and a larger implant will only accentuate this and or lead to more sagging of your breast tissue. The only way to lift the breast is with a mastopexy or breast lift, which will reposition the nipple and centralize it. This can be performed with an implant and it looks like you would be a good candidate for this. If your surgeon is indecisive typically they will be that in operating room which you do not want. (Andrew P. Trussler, MD, Austin Plastic Surgeon)