It is hard for any of us to give you a concrete answer for your situation without seeing pictures. Having said that, yes, there are many women who are able to avoid a lift and just using an implant. It will all come down to your breast measurements and how descended they are. An implant can only do so much. What you don't want is to end up with a result that leaves you with the implant disconnected from your lower hanging breast tissue which is called a "waterfall" effect. The best advice I can provide you is to visit up to 3 plastic surgeons and gather as much information as possible so you can make an educated decision.

Published on Jul 11, 2012

The best way to see if you would be able to avoid a lift is to come in for a consultation with a board-certified plastic surgeon. They will be best able to evaluate your soft tissues and make a recommendation for you. Voice your concerns and I am sure they will tell you if what you want can be accomplished reasonably. Good luck!

Published on Jul 11, 2012

Patient concerns regarding the appearance of their breasts can typically be divided in two pools: volume and ptosis (droop). The procedures to address these issues are as different as the issues themselves. However, these concerns are not mutually exclusive—some want smaller, less droopy breasts and others want larger, less droopy breasts.

There are some factors that can help to answer the question of which surgery will deliver the most satisfying result—be it mastopexy, augmentation, or both. Patients must first consider the position of the NAC (nipple areolar complex i.e., the pigmented portion of the breast) as it relates to the inframammary crease. If the nipples are at or below the level of the crease, the patient may benefit from a lift (mastopexy). The breast lift is designed to elevate sagging breasts to a more youthful position. It also helps to reshape and tighten the skin of the breasts. This is typically accomplished via a periareolar (around the nipple) incision, with or without a vertical incision.

Mastopexy is an effective way to address sagging breast; however, the changes that accompany weight loss or pregnancy can also decrease the volume of the breasts. When a woman wants the volume restored, or increased, a breast augmentation will also be needed in conjunction with mastopexy. Augmentation can help restore the volume loss that is well known to women following children. There are a number of options available to women considering augmentation, ranging from size and implant type to access incision.

A breast augmentation alone may be appropriate if ptosis is mild. If the patient is comfortable with the natural appearance of the breasts but desires them to be larger, a breast augmentation alone is the right procedure. Augmenting significantly ptotic or sagging breasts tends to magnify the problem. In these cases, a mastopexy performed in conjunction with an augmentation is preferred.

With regards to your specific question, the hallmark of a breast that needs lifting is a nipple-areolar complex that has descended below the fold. For milder ptosis, a larger subglandular augmentation may be sufficient.

There is a procedure for every problem. To determine which technique is right for you, consult with a board-certified plastic surgeon (ABPS). Patients should discuss their concerns with their physicians in order to make an educated decision.

Published on Jul 11, 2012

High profile saline is your best shot at avoiding a lift. I always recommend under the muscle. Measure from sternal notch to nipple (less than 26 cm bodes well for just implant) and from nipple to inframammary crease (less than 9 cm critical to avoid lift). If the nipple is below the inframammary crease and pointing down, you will probably need a lift.

Published on Jul 11, 2012

This is a difficult question and can only be accurately answered with an in-person exam. However, if your nipple is above the fold of the breast (use a pencil), then usually an implant will be all that is needed.

Published on Jul 11, 2012

The decision whether or not to undergo a lift with augmentation depends on a few factors, but the location of the nipple on the breast is the most important one. Only an in-person evaluation by an experienced plastic surgeon can determine if you will get the results you desire with augmentation alone.

Published on Jul 11, 2012

Thank you for your question. If you have a great deal of breast ptosis, then a very large implant will likely end up looking like very large breasts and still droopy, with unsatisfactory results. It is best to be evaluated personally to determine if you are a candidate for axillary, submammary incisions or periareolar incisions to avoid any loss of sensation. Recovery is usually not more than one week to 10 days. Of course, incisions heal over time, but you may go about your daily activities.

Published on Jul 11, 2012

Thank you for asking. This is a common issue and not one that can be assessed fully in this type of forum. Only an in-person consultation and exam can determine a patient's needs. In general, if there is too much skin envelope or too much laxity, no implant alone will properly fix that issue, and a lift (of some type) would be the correct treatment. Cost, incisions, and recovery are factors to consider. Also consider the proper treatment necessary if a board-certified plastic surgeon deems it appropriate. Hope this helps. See your local PS.

Published on Jul 11, 2012

The need for a breast lift is dependent on the position of the nipples. If the nipples are above the lower breast fold, the breast my appear deflated but still NOT require a lift. In these patients, we perform a dual plane augmentation, which provides a lifted breast appearance without any breast lift incisions/scars.

Published on Jul 11, 2012

Using a larger implant will help. However, if you have a large degree of deflation and ptosis, or droop to the breast then a lift might be required regardless. If you have just a little bit of ptosis (Grade 2) then a larger implant with a higher profile implant, placed through an inframammary fold incision could do the trick. I'd also use a Dual Plane technique in that case to raise the nipple and avoid the need for a lift. It really depends on the degree of ptosis that you have, which is defined by where your nipple is in relation to the level of the fold under the breast. If your nipple is at or just dipping below the level of the fold you could likely avoid a lift. If the nipple is well below the fold then a lift most likely would be required. Hope this helps! Best wishes!

Published on Jul 11, 2012

For patients who are unsure as to whether or not a breast lift is necessary to help boost the breasts and get a more youthful breast shape, I would recommend that they have a consultation with a board-certified plastic surgeon who is well-experienced in these procedures. Short of doing that, my best advice would be to stand in front of a mirror and ask yourself the following questions:

* Is your nipple resting below your breast crease?
* Do you see any breast skin below the nipple?
* Could your breasts hold a pencil if placed within the breast crease?

If you've answered yes to the first and third question and no to the second, there is a very good chance that you would require a breast lift or mastopexy to lift your breasts.

Published on Jul 11, 2012

Thank you for your question. It is not possible for online consultants to give you good advice without an examination.

I always caution patients from getting "larger" implants to avoid breast lifting - please visit with well experienced board certified plastic surgeons to see if you are a candidate for breast augmentation ONLY without the breast lift. If you need breast lifting, you will most likely not achieve an aesthetically pleasing result with only breast implants.

I hope this helps.

Published on Jul 11, 2012

Great question. Although nothing can take the place of an in person exam/consult, there are some qualities that may indicate you can avoid a breast lift. A breast that is deflated but whose nipple and areola complex are above the fold can just undergo
a breast augmentation. Another quality is if there is not that much breast tissue below the fold. A shaped implant in a dual plane or subfascial position is likely to be the most apt to allow you to avoid a breast lift.

Published on Jul 11, 2012