Breast Lift or Big Breast Implants? | SF Bay Area

Posted April 23, 2016 in Breast Augmentation, Breast Lift (Mastopexy), Breast Reduction, Home

When a patient asks me, “Do you think I need a Breast Lift or could I obtain good results with just large Breast Implants?”, I know I have some explaining to do. It’s a common misconception that larger breast implants can lift the breasts. The reality is that Breast Augmentation and Mastopexy (Breast Lift) are two completely different, but complementary procedures.

How To Evaluate Your Breast Enhancement

Optimal Breast Enhancement pays attention to both the size and the shape of the breasts. Above Breast Augmentation with Breast Implants is performed to enhance the size of the breasts and even out the asymmetry.

Optimal Breast Enhancement pays attention to both the size and the shape of the breasts. Above Breast Augmentation with Breast Implants is performed to enhance the size of the breasts and even out the asymmetry (the uncensored before and after pictures are below under “What Is Breast Pseudoptosis?”.

I separate Breast Enhancement into two areas for optimization: the best size and the best shape. Breast Implants are the safest and most predictable means we have to significantly increase breast size, but they do not lift the breasts, ever. Breast Lifts can change the shape of the breast, but they do not change the size of the breasts. Let’s go over each procedure separately, and then talk about the combination of Mastopexy Augmentation.

Breast Augmentation With Breast Implants

Choosing the best size for your breasts is the most subjective, and challenging, aspect of Breast Augmentation. I could spend an entire blog post on How To Chose the Best Breast Implant Size. Clicking on the link under Categories: Breast Implant Options gives you a quick series of San Francisco Plastic Surgery Blog posts that go over the most common options available for Breast Augmentation. The best advice I can give you is to do your homework. Stuff your bra. Try on different clothes. Look at pictures. Review online before and after photos. Whatever it takes for you to know what size is right, do it.

The Ideal Breast Size

Once you have your Ideal Breast Size in mind, you need to explain it to your chosen Board Certified Plastic Surgeon. If you desire smaller breasts, Breast Reduction Surgery is used. Because the volume of the breast is reduced during the Reduction Mammoplasty operation, the breast naturally deflates. A Breast Lift is incorporated into the Breast Reduction to enhance the shape.

Breast Implants enlarge the shape you already have. The Breast Augmentation before and after pictures above show Breast Augmentation without a Breast Lift.

Breast Implants enlarge the shape you already have. The Breast Augmentation before and after pictures above show Breast Augmentation without a Breast Lift.

If you desire larger breasts, Breast Augmentation is safest and most predictable option. Breast Implants provide the appropriate boost in volume to enhance your breasts. If you already have a pretty shape, Breast Augmentation is all that is required. Breast Implants provide a proportionate increase in breast dimensions.

The Ideal Breast Shape

When the breast volume is good, but the breast needs a lift, Breast Lifts can help. The Breast Lift (Mastopexy) before and after pictures above show how the breast can be reshaped without adding volume.

When the breast volume is good, but the breast needs a lift, Breast Lifts can help. The Breast Lift (Mastopexy) before and after pictures above show how the breast can be reshaped without adding volume.

The Ideal Breast Shape is independent of size. The ideal breast has the nipple at the front of the breast; the nipple is located on the most forward projecting part of the breast (or slightly higher), and most of the breast tissue is located above the inframammary fold (IMF). The IMF is the junction between the bottom of the breast and the chest wall. When the nipple is located below the level of the IMF this is termed ptosis (true sagging).

Ptosis does not improve with Breast Implants. In fact, large breast implants increase the chance of developing ptosis due to their weight. Implants over 350 cc’s are more likely to require future surgery. Additionally, when the nipple is lower than the IMF, adding more volume to the breast tends to push the nipple down lower on the breast mound. The bigger the Breast Implant, the more weight, and the more the nipple gets pushed down. Not ideal. The best procedure in this case is a Mastopexy Augmentation, or Breast Lift with a Breast Implant.

What Is Breast Pseudoptosis?

Breast Augmentation can help with pseudoptosis and  asymmetry. The breasts appear bottomed out before surgery, with most the breast volume located below the nipple and mild pseudoptosis. The Breast Augmentation before and after pictures above show how Asymmetrical Breast Augmentation can correct the shape of the breasts and the size discrepancy. In this case, the right breast was smaller than the left before surgery, so a larger Breast Implants was used on the right.

Breast Augmentation can help with pseudoptosis and asymmetry. The breasts appear bottomed out before surgery, with most the breast volume located below the nipple and mild pseudoptosis. The Breast Augmentation before and after pictures above show how Asymmetrical Breast Augmentation can correct the shape of the breasts and the size discrepancy. In this case, the right breast was smaller than the left before surgery, so a larger Breast Implants was used on the right.

There is a specific type of Breast Deflation that can occur with weight loss, or after pregnancy, called Pseudoptosis (fake sagging) that responds well to Breast Augmentation alone. Pseudoptosis is likely the source of confusion about Breast Implants fixing sagging breasts. I review the difference between pseudoptosis and true sagging (ptosis) in the post: Do I Need A Breast Lift? (The Pencil Vs. The Pinch Test). With pseudoptosis, the nipple is above the IMF, while the breast tissue is below the IMF. Pseudoptosis is not the same as breast sagging, so it does not require a Breast Lift when Breast Augmentation is performed.

Breast Lift or Big Breast Implants?

The Breast Augmentation Mastopexy before and after pictures above show what is possible when Breast Implants are used with a Breast Lift. Correction of both size and shape is possible.

The Breast Augmentation Mastopexy before and after pictures above show what is possible when Breast Implants are used with a Breast Lift. Correction of both size and shape is possible.

So, to answer the question, “Breast Lift or Big Breast Implants?” If you are happy with the shape of your breast, and desire a larger cup size, Breast Augmentation with a Breast Implant is likely the best option. On the other hand, if most of your breast is located below the IMF and your nipple is headed south, a Breast Lift is needed to enhance your breast’s shape. A Breast Lift can be used along with a Breast Implant (Mastopexy Augmentation) if the breast needs to be lifted, and additional volume is desired.

Breast Enhancement Consultations

Above, I have tried to simplify the decision tree for Breast Enhancement, but as more details are considered, the plan may need to be customized. If you are unhappy with your breasts’ shape, or you would like to make them a little larger, give me a call at (925) 943-6353, and make a personalized consultation appointment. We can go over all the details and formulate a plan that works best for your specific situation. Need information in Spanish? Click here: Aumento de Senos.