When evaluating whether a woman who desires a breast augmentation also needs a breast lift in order to achieve the best overall result, I look at where her nipples are located.
If her nipples are located above the breast crease or even just at the breast crease (with minimal breast tissue below it), she does not need a breast lift with her breast augmentation.
Your nipples and a significant amount of breast tissue are located below your breast creases. A breast lift along with an augmentation will provide you with a better shape and contour.
In addition, the shape and size of your areolae can be reduced and your nipples can be placed in better positions. Scars do fade (though don’t completely disappear) over time.
And there are many effective scar therapies available.
Beware! I am certain that you can find a surgeon who will just “fill up the sack” with large implants. Usually larger than what you really want. This is much easier for the surgeon to do. A breast augmentation with a breast lift requires more skill with attention to detail. For you, a breast augmentation alone will just give you large, droopy breasts. And you will regret it. (Cecilia Franco-Webb, MD, Denver Plastic Surgeon)
Lift vs implants
It depends on your goals. All an implant will do is “fill them up”. A breast lift will “lift them up”.
If you are happy with the way you look and just want them larger, then an implant may work. If you don’t like the appearance of them or feel the nipple position is too low, then a lift is the better option. I put all of my implants in through the under arm so there is no scar on your breast at all if you go the implant route. (Lawrence Scott Ennis, MD, FACS, Pensacola Plastic Surgeon)
Breast Lift Needed?
I have to agree with the other MD’s that have answered here. The issue is the position of your nipples/areola. They are pointing downward, and located below your inframammary fold (crease under your breasts). If you were to have implants without a lift you would be left with a 4-breasted look, as the implants (if placed under the muscle) would sit higher than your natural breasts. Although scars can be an issue in patients with history of keloids and thick (hypertrophic) scars, for most women these incisions heal well and fade over time. (Ruth Celestin, MD, Atlanta Plastic Surgeon)
Do you need a lift with an augmentation for your empty B-cup breasts?
Breast lift together with an implant
You will greatly benefit from a lift so that your nipple and areola are better positioned on the breast mound. In a bra and clothing, you would be satisfied with an augmentation alone, but naked, you would have a sub-par result. I see that the scarring is a concern of yours. In my practice with the scar care regimen that I recommend for my patients, after a year, the scars are typically thin, fine white lines. I would recommend asking your PS what he suggests for scar care. (Brian Reedy, MD, Reading Plastic Surgeon)
With only breast augmentation your nipples will still be pointing down.
Patients with nipples that point downward and are below the crease require a breast lift. This improves the shape tremendously. (Earl Stephenson, Jr., MD, DDS, Atlanta Plastic Surgeon)
Breast augmentation alone will give you a very poor breast shape as your nipples are very low. The scars from a lift heal well and I’ve never had patient complaints about them. (Peter Kreymerman, MD, FACS, Morehead City Plastic Surgeon)
With the nipple oriented in a downward direction, like it is in the photo, doing a breast lift together with an implant would give you the best result by far. With an implant only, the nipple position would still be too low.
While I understand that the scars are a concern, the shaping of the breast would be dramatically better with a lift. And with modern post-op care methods, scarring can be kept to a minimum. (Thomas Fiala, MD, Orlando Plastic Surgeon)
I would not consider any augmentation under these conditions without moving the nipples into a more aesthetic position. There are various types of breast lifts that can achieve that. The discussion with your plastic surgeon would allow you to start considering the options. (Ira H. Rex lll, MD, Fall River Plastic Surgeon)