Breast Augmentation: Cost, Reviews, Photos

Breast implants alone won’t do it. Of all the procedures we do on the breasts, augmentation with a mastopexy (Breast Lift) can be the most challenging , both for the patient and the surgeon.

Your tattoos add an interesting twist. The final decision is between you and your surgeon.

With your size I would advise that you go in stepwise fashion doing the lift first then the decide on the augmentation.

You can use the tattoos to your advantage by covering the scars with another tattoo. (Richard D. Nadal, MD, San Juan Plastic Surgeon)

Breast lifts vs implants

Realize that your anatomy dictates what you can and cannot have. Implants alone WILL NOT LIFT YOU but will just make you a bigger version of yourself.

A lift will elevate the nipples and reshape and tighten the breast but not make it bigger.

You probably need both and wanting to go to DD, you might be wise to do this in 2 stages. (Richard P. Rand, MD, FACS, Seattle Plastic Surgeon)

Implants only, Lift only, or both?

Implants are designed to add volume, breast lift procedures are designed to shape the breasts. Consider what is most important to you. You will definitely need implants since a lift will not add any volume. You will also need a lift since implants do not “lift” the breasts. (Remus Repta, MD, Scottsdale Plastic Surgeon)

Your sagging will definitely require a lift. A very large implant might fill out some of the extra skin, but you would be so large that you would be way out of proportion. The lift will allow you to re-position the nipple where it should be and to remove the excess skin to tight the tissues, pushing your breasts back up on your chest where they should be.

The trade off is a scar around the areola, a vertical scar from the areola to the fold of your breast and possibly a very short horizontal scar in the fold of the breast. The lift will make your breasts smaller by compacting the breast tissue. You could also have a small implant to restore the loss of size. The implant will also help hold our breasts up. Of coarse there can be problems with implants, although they are much less frequent with the newer implants. (E. Anthony Musarra II, MD, Atlanta Plastic Surgeon)

It appears that you are an ideal candidate for a pectoralis sling modified vertical breast lift and fat grafting. In this way the most beautiful and natural appearing breasts can be created without any implant associated problems.

The pectoralis sling modified vertical lift is a technique that allows reshaping of your breasts creating fullness in the upper pole (top of the breasts) by using tissue that is normally thrown away in a vertical breast lift. It is quite possible that you would be extremelly happy with this technique alone, however I like to perfect the shape and give more volume to the breasts in patients that are interested in more of an augmentation such as yourself.

An implant without a lift would not give you an acceptable result, and a lift and augmentation ( a mastoaugmentation) with conventional techniques would involve removing tissue and adding an implant which not only does not make sense to me, but leads to a less natural appearing result. You are very slim but you certainly have enough subcutaneous fat to achieve your desired size and will have the added beneit of shaping your midsection. (Rian A. Maercks, MD, Miami Plastic Surgeon)

Your breasts need to be lifted ideally. The main problem in your particular case, however, is that the skin removal from a lift might involve removing parts of you chest tattoos which you might not want. You can find this out by going to a plastic surgeon and having him or her mark out exactly where the scars would be.

I think the size of your breasts would be satisfactory without implants. Performing a lift and placing large implants at the same time could be asking for trouble, especially sagging or bottoming out of the breasts over time.

Chances are if you go to several surgeons you will likely get multiple different answers as there are many ways to approach your situation. (Ronald J. Edelson, MD, San Diego Plastic Surgeon)

Breast augmentation with a breast lift

Your nipples appear to be below the level of your inframammary crease. This means that there is excessive vertical length of the breasts. The only way to give you a nice result would be a breast lift. It would be possible to give you an improved appearance with or without implants.

If your desire is to be a DD size then an implant in the 350 cc range would achieve your goal. I would caution against going excessively large the implant since it will only add additional weight to your breasts and increase your risk of recurrent sagging. Most likely a vertical or lollipop type breast lift would be necessary. (Jeffrey Zwiren, MD, Atlanta Plastic Surgeon)

Several of the doictors have described why we perform lifts. If you were my patient I would strongly suggest a lift to elevated the position of your breast mound and nipple areolar complex. (Vishnu Rumalla, MD, Dallas Plastic Surgeon)

A Breast Lift does not add volume to the breast. If your stated goal is to have larger breasts then breast implants will need to be added.

However, with your extent of breast sagging, attempting to do the lifting with a very large breast implant s a common mistake which always fails.

In advanced breast sagging a breast lift needs to be done. I would recommend either a breast augmentation followed by a breast lift or by a combination breast augmentation with a lift. (Peter A. Aldea, MD, Memphis Plastic Surgeon)

if you are looking for a breast that is higher and less overhanging and a nipple position that is higher, then you need a lift.

If that is true, but you also want some increase in size, OR upper pole fullness that a lift will not give you, then you need implants as well.

Implants do NOT lift the breast, they fill them out WHERE THEY ARE. The problems with implants in patients that have overhanging breasts is that the implant rests up higher on the chest, with the bottom of the implant at the level of the inframammary crease, and they establish a breast “mound” at that level, so if the breast is too low then the breast will hang off the implant and the contour will be unsatisfactory. (Robert M. Grenley, MD, Seattle Plastic Surgeon)

Lifting breasts with implants

In truth, the answers to your questions are in this blog. Yes, you would need both a lift and an augmentation. I would likely use a “lollipop” incision around your areola and down. The size of implant used determines the amount of loose skin that can safely be removed.

In time, fat grafting may be used, but the jury is definitely out. The biggest error that can happen, in my opinion, is excessive skin removal leading to breakdown and implant infection. Many feel that doing this operation in stages is safer. (David Janssen, MD, FACS, Oshkosh Plastic Surgeon)

Lifts for shape- Implants for volume!

Simple rule of thumb; 1- If you want more volume, get an augmentation 2- If you do not like your shape, get a lift. 3- sagging breasts do not lift with implants – they become larger sagging breasts! For you, it looks that your nipple areolar complex may be below the level of the inframammary fold, this would suggest the need for a lift. (Robert M. Freund, MD, New York Plastic Surgeon)

A lift will not supplement the volume of the breast. If you want an increase in size this will require an implant. As far as a lift and nipple position,there will be new scars on the breasts. If the the scars are acceptable the nipple position can be changed. (Jay M. Pensler, MD, Chicago Plastic Surgeon)

Looking at your photos, if you are accepting of scar, it looks like a lift will accomplish your desires for increased fullness and more centralized nipple position. Augmentation will provide fullness but will not raise your nipple position adequately. (Michele A. Shermak, MD, Baltimore Plastic Surgeon)

In my opinion what you “need” depends a lot on what you “want”. I have had patients with a similar appearance to you have a satisfactory result with just augmentation. Some patients who desire more change with the nipple position require a lift. Sometimes I think it is OK to settle for a little less perkiness to avoid the scaring that comes with a lift. Even though I do most of my augmentation and breast lifts all at one surgery in you in might be advisable to just do the augmentation, see how you like it, then commit to a lift once you know it is absolutely necessary to make you happy. (Gary Hall, MD, Kansas City Plastic Surgeon)

I think you need a better and attractive shape and that will happen only with a breast lift ( mastopexy) and implant will give more volume. (Fatema S. Alsubhi, MD, UAE Plastic Surgeon)

Pick your priority – correct sagging (which isn’t so bad considering the size of your breasts) or size.

I Your breasts are never going to look “lifted” if you want to be a DD. To get to a DD from where you are now I think will take an implant of at least 450 cc, which you could handle without a problem.

However, it is gong to add weight to your breasts and will not allow your breasts to be “lifted”.

When you refer to “lifted” as really your nipple position, you could have just a minor periareloar mastopexy simply to help raise the nipple just a little.

I might even suggest going for the augmentation first and then later go back to raise the nipple if it is still an issue.

Two steps but perhaps a bit more predictable in result. Just my opinion. (Ronald Schuster, MD, Baltimore Plastic Surgeon)

Implants or lifts?

Without seeing you in person, is it impossible to give you specific advice. However, I would likely advice a combination of an implant plus a lifts to achieve the best result. Special care would need to be taken to help minimize any distortion to your tattoo. (David Shafer, MD, New York Plastic Surgeon)

The tattoo location, a questionable need of lifting vs implants or a combination. Over the internet we would be doing you a dis service, best is in person evaluations. My GUESS is a small implant with a donut or l-shaped lift. (Darryl J. Blinski, MD, Miami Plastic Surgeon)

Who needs a lifts?

Lifts help to lift up breast tissue. Implants make breasts larger. Many ladies try to avoid lifts due to the scars, the recovery, and additional expense however often this is a big mistake. While it is impossible to do a consult over the internet without an exam, from the photo you shared it appears that you DEFINITELY need a lift. Most ladies would be unhappy with bigger droopy breasts and that is what is likely going to happen if you just get implants. I shared a link below discussing the differences between lifts and implants alone. (Evan Sorokin, MD, Cherry Hill Plastic Surgeon)

Breast Implants Vs. lifts

Adding weight to your breasts by placing an implant alone will cause your breasts to move lower. If you desire more fullness in the upper half, and a more uplifted look then a lift will be your best option, with or without implants. The scar wil be a tradeoff for the imporved shape, however. (John LoMonaco, MD, FACS, Houston Plastic Surgeon)

Implants should do it

From your side view it seems that your nipples are at the right position, and therefore an implant only should do the trick. A breast lifts (mastopexy) is done when the nipple has fallen below the breast fold (the crease underneath the breast).

Your nipple and areola seems to be well above the fold. Therefore, placement of implant only should do it. With the appropriate dissection, a better cleavage can be obtained.

However, even though the nipples will apear slightly lifted, they will not come significantly closer together. (Robert Morgan Davoudi, MD, Atlanta Plastic Surgeon)

Generally, it is difficult to give you good advice without knowing exactly what your goals are. However, based on your pictures and description of your breasts and nipples/areola, I think you will benefit from breast augmentation and breast lifting. If you undergo breast augmentation only you will end up with larger but low breasts or a situation where your breast implants sit higher on the chest wall and your breast tissue continues to “sag”.

Neither one would be acceptable results. On the other hand, breast augmentation/lifting will help correct the “sagging” and may help prevent the nipple from “looking around”. In person consultation with well experienced board-certified plastic surgeons will be helpful. Make sure you see lots of examples of his/her work. (Tom J. Pousti, MD, FACS, San Diego Plastic Surgeon)