Ptosis breasts
In my practice, I tell my patients that breast implants are not designed to correct drooping. While adding an implant can revolumize the breast “envelope”, the primary benefit is not lifting the nipple. Implant/lift combination allows more flexibility in the size of implant used as well as improving symmetry of nipple size and symmetry. (Patrick Proffer, MD, Amarillo Plastic Surgeon)
First you don’t have that much ptosis. Where you put the implant will help to a degree. More importantly I have patients who are post partum get to the ideal weight or as close to it so I can see along with them how they would like to appear and design and operation for them. Many breast augs are done with 350 to 400 cc implants. You just have to make sure it is right for you. (Robert Whitfield, MD, FACS, Austin Plastic Surgeon)
The best advice would be to recommend a breast augmentation and a breast lift. This would equalize the breast and the implant.
Type of incision to be used is best determined by physical examination. (Earl Stephenson, Jr., MD, DDS, Atlanta Plastic Surgeon)
Ptosis breasts And Augmentation
Judging from the pictures an augmentation without a mastopexy (lift) will increase your chances of a snoopy deformity. I would lean towards a sub-muscular plane for the augmentation as a sub-glandular augmentation over time will most likely cause a “rock in a sock” appearance of the breasts.
I would recommend that you consult with a Board Certified Plastic Surgeon for a comprehensive evaluation and discussion of your goals so as to determine what would be the best procedure for you. (Pedro M. Soler, Jr., MD, Tampa Plastic Surgeon)
Implants and lifting
We all have different experiences with what works for our practice and what doesn’t. I know this may be confusing, but it is an inherent part of plastic surgery. My criteria is to look at the nipple position and the angle. your nipples point forward mostly and the position is good. You are at or slightly above the 50/50 mark between the armpit and elbow crease. I would recommend an under the muscle implant. The more natural look and lower risk of Capsular contracture is worth any trade off in degree of nipple lift.
You can opt for the lift or not. You don’t burn any bridges either way. ( again, in person consultation is best to answer your questions ) One key concept to remember is that the implant, whether above or below the muscle does stretch the skin. If it stretches the skin UNDER the nipple, it will have the effect of lifting the nipple position.
If it stretches the skin OVER the nipple, it will have the opposite effect. This is why the original position of the nipple is important to note in assessing the need for a lift. This is why we sometimes see the implants creating a significant degree of lift alone, no lift, or sometimes making the breast sag worse. (Bennett Yang, MD, Rockville Plastic Surgeon)
You have obviously been very thoughtful to your approach with breast augmentation. In my practice I would reccomend a lift as part of your procedure along with your augmentation to reduce the likelihood of a snoopy-boob. It is important to set the right expectation and I believe without a lift you might be dissapointed, but other surgeons would suggest an aggressive dual place technique and lowering of the crease to avoid the cost and scar of a lift (Vishnu Rumalla, MD, Dallas Plastic Surgeon)
Unfortunately, you are not a good candidate for breast augmentation surgery only; breast lifting will be necessary to achieve an aesthetically pleasant result. As you know, one of the downsides associated with breast lifting surgery, is the necessity for additional incisions/scars. Many patients (If properly selected and who are doing the operations at the right time of their lives psychosocially) accept the scars associated with breast augmentation/breast lifting surgery as long as they are happy with the improvement in contour, size, and symmetry. (Tom J. Pousti, MD)
Best results are with implant and lift
You have too much ptosis for implants only. A lift is needed as well to produce a nice result. Just implants will produce the “Snoopy Dog deformity”. Generally the scars of lift heal well. (John Squires, MD, Denver Plastic Surgeon)
your nipples are above the fold and so you can get an attractive look without a lift. You will need either a submuscular dual plane technique or a subglandular placement to allow the implants to fill out the lower part of the breast properly. (Ronald V. DeMars, MD, Portland Plastic Surgeon)