Many women who are considering breast augmentation surgery wonder if they also need a breast lift. They may have had several consults with reputable plastic surgeons who have given them differing recommendations. Many times these recommendations come with little explanation, leaving them more confused.
This post explains more about this sometimes confusing subject. Click "Read More" to check out our VIDEO and to learn more about the process of when to add a lift to an augmentation surgery.
How do I know if I need a lift?
When it comes to breast sagging (ptosis), there's a wide spectrum between women. Breast sagging is the primary reason why lifts may be needed during an augmentation. There are those who definitely need a lift, those who definitely do not need a lift, and many women in between, who could go either way. It's the in-between cases that leave more options, and in these situations it depends greatly on each women's specific goals.
"Women typically benefit from a breast lift if their nipple sits lower than the crease that is below their breast."
Dr. Hayes uses a combination of breast measurements and nipple position to decide when to add a lift to a breast augmentation surgery. He measures the distance from the nipple to the crease and also determines how much excess skin there is in each woman's breasts. Using these measurements, AND the nipple position, he decides when to add a lift.
I don't want scars, but my surgeon says I need a lift. What happens if I don't get a lift?
The answer goes back to the degree of breast sagging that you have. If there is significant sagging, or nipples the point towards the ground, then a lift is ALWAYS needed. A breast augmentation without a lift, will lead to an unnatural appearance called a "waterfall" or "Snoopy" deformity. This is where the breast tissue sags off of the face of the implant. This look is very unnatural, and if the #1 goal is to avoid a breast lift, then it's better to avoid augmentation surgery altogether. For more minor degrees of ptosis, a lift is not always needed. The decision depends on your goal look. Natural breasts = no lift. The perkiest breast possible = breast lift.
Can I just use larger implants to avoid a lift?
Unfortunately, breast implants do not lift the breast. Even a large implant will only fill the skin envelope, but won't actually lift the nipple. When a lift is needed, using large implants isn't a great strategy to avoid a lift, because it adds unnecessary size and weight to the breast. Breasts are sagging because they have been stretched and the tissues have lost their ability to spring back. Adding unnecessary weight from large implants is a recipe for more sagging, which can undo the beautiful results that a lift creates.
Everywhere I go I get a different opinion, what's the best choice for me?
Find a plastic that you have a good relationship with. During the consultation you should feel that all of your questions are being answered and that your surgeon is explaining the reasoning behind their treatment plan. You should never feel rushed. For "borderline" cases of breast sagging, it's always reasonable to perform an augmentation first, and then wait six months to determine whether a lift is actually needed. Many times you'll get a great result from just the augmentation, and the lift can be avoided.
Dr. Austin Hayes is a Board-Certified Plastic Surgeon with offices in Portland, Seattle, and Hood River.