Breast Augmentation: Cost, Reviews, Photos

Breast Lift and Breast Augmentation

This is something a qualified board certified plastic surgeon can help you decide on.

If you have drooping skin with the nipple and areola hanging down, perhaps pointing downwards then you require a lift.

Now if there is lack of breast tissue and volume, for example if you feel that you dont fill out your bra enough, then you also need implants as well. (Farbod Esmailian, MD, Orange County Plastic Surgeon)

Lift or implants

There are many factors that determine whether you require breast implants, a breast lift or both.

Your current breast size, skin elasticity and amount of ptosis (sagging) are just a few. You should consult with a plastic surgeon for an opinion about what would be the best option to provide you with the result that you desire. (Kenneth R. Francis, MD, FACS, Manhattan Plastic Surgeon)

Not either or situation

A breast lift is usually required if the nipple position drops down below the crease where the underwire of the bra sits. The breast lift will raise the nipple, improve symmetry, shape the breast, but will usually result in a slightly smaller breast. Upper pole fullness is usually not greatly improved. The augmentation on the other hand, will give some uplift, shape the breasts, improves symmetry, improves upper pole fullness.

If the breast tissue is too low, it will flagg off of the implant, causing a “double bubble” effect. A breast augmentation may be done at the same time as a lift, or they can be done separately, as staged procedures.

The choice of which to perform first will depend on your exam, and desires, as well as the surgeon’s guidance. Depends on what you’re looking for (Scott E. Kasden, MD, Dallas Plastic Surgeon)

Depends on what you’re looking for

Most women who come to me seeking a breast lift know why they are there. The sagging is usually quite noticeable and bothersome. Normally the nipple lies on an imaginary with the inframammary fold. Once the nipple falls below that line this is considered ptosis or sagging. This occurs after pregnancy, breastfeeding, aging etc. An augmentation is used to enhance volume. In addition it can elevate the nipple giving a slight breast lift. An augmentation mastopexy (breast lift) is performed when either a significant volume of breast tissue has been lost and/or there is loss of breast tissue in the upper pole of the breast. (Christopher L. Hess, MD, Fairfax Plastic Surgeon)

Breast lift and implant

When do you required both or one? That is the key to the physical exam while be examined by a plastic surgeon. Options for treatment should be discussed with you during your consultation and realistic results with each technique should be discussed. To Lift or to do an augmentation? (Steven Wallach, MD, Manhattan Plastic Surgeon)

Sagging breasts with nipples below the crease require a lift

A breast augmentation is done to increase the size of the normally shaped breast. If the breast sags – called mammary ptosis – then placing an implant under the sagging breast can look abnormal (snoopy deformity). Ptosis is defined by the position of the nipple – if the nipple is below a line at the level of the inframammary crease (the fold beneath your breast), then you have ptosis.

Depending on the severity of the ptosis, you may require a breast lift. In many cases a breast augmentation and lift are done at the same operation when the patient wants a fuller larger lifted breast. In some cases of mild ptosis a breat implant can be placed in a position to push the breaast forward and the nipple up, avoiding the need for a breast lift. See before and after photos of breast lift and augmentation. (Brooke R. Seckel, MD, FACS, Boston Plastic Surgeon)

Breast lift versus breast implant

Breast implants are indicated to increase the size of your breast. You do get a small amount of lift as the volume of the breast increases do to filling the empty space / replacing the lost volume. A breast lift is indicated if the level of the areola has shifted downward due to time and/or gravity or just your natural anatomy.

In general, if your areola is lower than your breast fold, then you likely would benefit from a lift. Also, many people choose to have an implant and a lift at the same time to address the level of the areola and the size of the breast. Position of breast/nipple related to breast fold is key in breast lift (David Shafer, MD, New York Plastic Surgeon)

Position of breast/nipple related to breast fold is key in breast lift

The best way to determine whether or not you require a lift is to have a comprehensive consultation with a board certified plastic surgeon to determine your specific options. The decision is made based on your physical exam – if you breast/nipple position is at or above the level of your breast fold (the crease of your breast under the chest) you will not need a breast lift usually. If your breast/nipple is below the fold, then you will likley require a breast lift. The types of lift differ depending on the severity of your breast shape/position or sagging. If the nipple is at the lowest point of your breast, then you will require the most poweful lift to get the best outcome.

Each type of lift has different scarring pattern – around the areola first, then a vertical extension in the lower part of your breast and lastly another extension in the fold of your breast. The type of lift you will benefit from will depend on your anatomy, whether or not you want a breast implant, and how willing your are to accept scarring on your breast. The definite trade-off in breast lift surgery is scar vs. shape. Easy way to know if you require a lift or not is to turn sideways in front of a mirror and look at the position of your breast/nipple compared to your breast fold. Make sure you discuss with your surgeon your expected outcome and scarring involved. (Bahram Ghaderi, MD, Chicago Plastic Surgeon)

Can implants lift my breasts?

Implants only make you fuller; they do not lift your breasts, but they can create the illusion of a lift.

As the implant fills out the upper portion of the breast, it also fills out the lower portion, which makes it appear as if the nipple is located higher on the breast.

If implants are placed behind moderately to severely droopy breasts that have not been lifted, it could give the impression that you have four breasts: the implants up high and your own breasts down low. (Ted Eisenberg, DO, Philadelphia Plastic Surgeon)

Augment without a lift

Any surgical alteration on your breasts that does not involve a lift will unfortunately be disastrous. There is no way that an implant can fill up your breast envelope.

Your envelope needs to be tailored aand appropriate size and shape of a submuscular implant. You will not be happy with anything less than that (David J. Goodkind, MD, New Haven Plastic Surgeon)

You definitely require a lift and implants to achieve an attractive augmented refreshed appearance. (Justin Yovino, MD, FACS, Beverly Hills Plastic Surgeon)

Can implants lift my breasts without getting a breast lift?

Implants do not lift breasts, they fill them out where they are. And if they overhang the inframammary fold (the crease under the breast) more than a little bit (more than a couple centimeters or so), then the breast will hang off of the implant and the bottom of the breast will be loose and deflated.

The bottom of the implant is placed at the level of that crease, and regardless of how large the implant is, it will not fill out a breast that is simply too overhanging. From your photos, it is apparent that you need a breast lift, and that would be one that includes a vertical scar from areola to fold. Not just a circular lift. I would recommend a standard anchor or inverted T breast lift. Your areolas should be reduced in size and lifted to a better position and the excess skin that allows the breast to hang over too far should be excised. The scars usually heal well, though certainly the scars are the “trade-off”. But usually that trade-off is well worth it. (Robert M. Grenley, MD, Seattle Plastic Surgeon)

This is a rather common question plastic surgeons get. Based on your picture, it does appear that you would greatly benefit from getting a breast lift. I do not believe an breast implants no lift would fill in like you would like and you would still remain with extra skin in the lower part of your breast; creating a cosmetically inadequate result. While the scars can be scary, they tend to heal very nicely. (Khashayar Mohebali, MD, Bay Area Plastic Surgeon)

Breast implants no lift

From the picture you show I would agree with your surgeons assessment that you would require a breast lift for overall best results. The only way to give you the most accurate suggestions are to see you in person. I would never try to use a large implant to try and lift a breast. Pick the appropriate implant and if you require a lift..you need a lift.

The answer is yes implants can lift a breast but only a very small amount. So for patients on the borderline of needing a lift they may be able to get just breast implants no lift. (Richard J. Brown, MD, Scottsdale Plastic Surgeon)

Needing a lift

Your photo shows an absolute indication for a lift. Breast implants no lift will not lift your breasts nor will they look good. If you cannot accept the scars from a lift, it is generally better to not do anything. (Richard P. Rand, MD, FACS, Seattle Plastic Surgeon)

Breast implants or a lift?

Although it would be nice to avoid a breast lift, your photos are fairly clear that you require one. If not, your implants sit above the breast – creating a very odd look. Your breasts need to be raised back up so they sit on your chest, not your tummy. A breast implant may be done at the same time or later if you want one – let your surgeon advise you. Breast lift scars are noticeable after surgery – but they fade in time. Most women are very pleased with their results. Always see a Board Certified Plastic Surgeon (Elizabeth Morgan, MD, PhD, Atlanta Plastic Surgeon)

Saggy breasts and breast augmentation

Breast augmentation primarily achieves an increase in breast volume.

Although, to a small extent, implants can lift the breasts, many women require a breast lift in addition to breast augmentation.

Depending on the patient’s anatomy, this may be accomplished at the same time as breast augmentation, or may require a second surgery.

The incisions also vary depending on the amount of sagginess, but the most common incisions are a small incision just around the areola to a “lollipop” incision (around the areola and a vertical incision extending inferiorly).

In patient’s with really saggy breasts, sometimes an anchor incision is required, which consists of incisions around the areola, a vertical incision, and an incision is the crease at the bottom of the breast.

If you’ve had 3 kids and currently have saggy breasts, you probably require a lift in addition to a breast augmentation. Your best best is to seek consultation with a board certified plastic surgeon in your area. (Sam Jejurikar, MD, Dallas Plastic Surgeon)

Breast implants in saggy breasts.

1. They still look saggy because breast augmentation alone was not the right operation.
2. Since your breasts are “very saggy”, you require a combinaton breast augmentation and breast lift.
3. This combination will make your breasts perky, and only leaves a circular scar around your nipples, where the skin changes color.

Don’t be afraid of the scar, which fades. Most of our patients who do this are very happy. (George J. Beraka, MD (retired), Manhattan Plastic Surgeon)

Breast augmentation and sagging

Some breasts that do not have good quality elastic properties can sag after having implants. The larger the implants, the heavier they are, the more likely they will sag.

Many times a breast lift needs to be combined with implants for women that have had a few children or are getting older. (Steven Wallach, MD, Manhattan Plastic Surgeon)

Saggy breast implants

Perhaps, you are looking at pictures of very large implants, over the muscle, that may have been in place for several years. This scenario will cause saggy looking implants.

The overwhelming majority of breast implants do maintain their shape and position giving longstanding excellent results. (Kenneth R. Francis, MD, FACS, Manhattan Plastic Surgeon)

Why some breast augmentation results appear saggy

It question can be interpreted in 2 ways.

1. Why aren’t ALL breast Augmentation results IMMEDIATELY fully perky without any descent?

2. Aren’t breast augmentation results supposed to REMAIN perky?

Let’s tackle number

1. If the proper implant is chosen by the patient and surgeon and the proper operation is done, the post operative result will be a perky breast. Ideally, the amount of breast coverage, position of the nipple vis a vis the under breast fold, the stretchiness of the breast skin envelope, the shape of the chest are all contrasted to several implants which could bu used.

But – The problem is that many women have a slight droop and all women have asymmetry between their breasts. A a result, a LOT more women who would benefit from an augmentation-lift are NOT having this operation because they wish to avoid the vertical scars. But – a breast augmentation does NOT offer a good substiute for a breast Augmentation AND Lift. As a result, when larger implants are put in, instead of performing a lift, this always weighs the breasts down and after a brief period of fullness, these breasts sag even faster. Another clear example of why BIGGER is definitely not always BETTER. As regards number

2. NOTHING stays up. We all age and our tissues thin and droop. As I just explained, this happens faster the more weight you weigh your breasts with.

So, KNOWING that we age and knowing that things will sag, it behooves you and your surgeon to pick the implant that will best fit you and weigh you down the least KNOWING that in the long term it will have the lowest rate of droopiness. (Peter A. Aldea, MD, Memphis Plastic Surgeon)

Large sagging breasts require breast lift and contouring of existing breast tissue.

You already have large amount of breast tissue. I will never use implants in someone with your size. A lift and reduction with reshaping of your own tissue would give you a large D-cup. You do not require implants. You have to accept scars as trade off for pretty new breasts. There is no other way to achieve the look that you want. Keloids is another risk. If you don’t want to take a risk of scar or keloids, you should not have any surgery. (Vasdev Rai, MD, Dallas Plastic Surgeon)

I do not think you need implants. A well done mastopexy should give you the lift you want and attractive looking breasts (Rick Rosen, MD, Norwalk Plastic Surgeon)

Do I require a breast lift along with breast augmentation?

After reviewing your photos it appears that you require to have a breast lift. In the absence of lifting your breast augmentation will not have an result. You may be able to benefit from performing the breast lifting by making an incision only around the areola. This wil greatly minimize scarring, which may be more pronounced in the African-American patient. But you really need to be examined, and if necessary by more than one Board certifoed Plastic Surgeon. (George Lefkovits, MD, New York Plastic Surgeon)

This will raise the nipples and will also reduce the size of your areolas. The result will be as if your are in a push-up bra. The scarring will be a lollipop. In my practie, I operate on a large number of African American women and suprisingly the scars tend not to be bad.even in women who have a tendency for hypertrophic/keloid scars. Now, if you still want to be bigger, than implants can be placed at the same time as the lift through the same incisions.

So to sum things up, I think you need a lift at the very least, and a lift + implants if you desire. Come see me in Manhattan and we can talk more about what would be best for you. (Matthew Schulman, MD, New York Plastic Surgeon)

From your photographs it appears that you might obtain a nice result with a breast lift or mastopexy alone but you probably would be unhappy with an augmentation alone. It appears that your nipples are situated below your inframammary folds. If this is this case, your are unlikely to obtain anice result with an augmenttion alone. Looking at the volume of breast tissue in your “ideal result”, it looks as if this could be achieved with a mastopexy without the need for an implant. Please arrange for consultation with a BC plastic surgeon (who is preferably a member of ASAPS) who can discus with you your options. (John Whitt, MD (retired), Louisville Plastic Surgeon)

The lift will get you there

The nipple should lie above the breast fold, and near the mid-point of the upper arm. Breast implants just will not get you to the look that you want. Keloids should not be a problem for you,and we don’t ‘like’ the scar either, but an implant alone will not work. (Peter E. Johnson, MD, Chicago Plastic Surgeon)

You would benefit significantly from a breast lift. Although you are African American, each person is unique and the way one person scars may be much different from the way another person may scar. Unfortunately, your breasts will not be bigger without implants. On this site, I do my best to give advice without a physical examination but I want you to know that a physical examination by a board certified physician is always the best way to get the most accurate information. (Tom J. Pousti, MD, FACS, San Diego Plastic Surgeon)

Breast augmentation together with breast lift

No you are not! Your photos show large drooping breasts with the right breast slightly larger than the left. Under no circumstances should you have a breast augmentation without a lift. That will only make your current situation worse and your drooping will go past the belly button if the implants are not under the muscle.

If they are placed under the muscle they will be no where near your current breast tissue position and you will look like you have 4 breasts. With your current breast size I would not give you breast implants even after a lift as the weight and size of the implants will only serve to stretch the lift scars and make them look worse.

I do not know why you would want to look like the woman in the third photo. Her areola are stretched out and you can see the outline of the implant edges. It looks like her implants are sitting on top of her chest muscles. Just look at her left breast and trace the round edge of the implant on the upper half of the breast.

I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.

My response to your question /post does not represent formal medical advice or constitute a doctor patient relationship.

You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship. (Aaron Stone, MD, Los Angeles Plastic Surgeon)